Colin Linke, DO

@SPuro88 @Adam_Weiner535 @mubarak_urology @JAMAInternalMed I can’t see a reason TRT should be avoided. Doesn’t data show that TRT is safe even in low risk PCA?

@Adam_Weiner535 @mubarak_urology @JAMAInternalMed My question never is with the post RP guys with negative margins. We know that’s safe. My concern is more with the XRT guys or focal guys who want to get on TRT. Historically I wait 3 years after XRT to start TRT assuming PSA nadired. If/when to do in h/o focal puzzles me

🚨Testosterone replacement therapy after surgery for #prostatecancer🚨 @JAMAInternalMed ⭐️SPIRIT trial 📊 RCT, n=136, low/int-grade PCa, post-RP, hypogonadal men ⏱️ TRT started ≥2 yrs post-RP w/ undetectable PSA 💉 12 wks testosterone vs placebo ✅ ↑ sexual activity (+0.9 events/day), desire, lean mass, VO₂ peak 🛡️ ZERO biochemical recurrences ⚠️ Short-term, proof-of-concept. 👉Bigger/longer trials including patients with higher-risk disease needed @PCFnews @PCF_Science @urotoday @renalandurology @UrologyTimes 🔗shorturl.at/IzRyw

@theblanketdog Cool out man. It’s the weekend! We are alive. We are colleagues. Let’s stop being detrimental to each other’s mental health. This stuff is hard enough.

@ColinLinke Really? I can think of a lot worse words. But I can't think of a worse type of person to work with. Hope you don't follow his lead.

@theblanketdog Surprising. I can’t think of a worse word.

@ColinLinke Nah. I toned down what I really think of him.

@SPuro88 Lots of haters on here

Dude has never heard of kidney stones before.

@UroOncologist Looks great

Bulldog Stainsky technique. For the right tumor thrombus it saves time and avoids full IVC occlusion. Put the clamps on robotically with the force.

@CanesDavid Would like to see how you use it day by day

Claude cowork is the cheapest most amazing personal assistant.

@KeithKow @jimhumd SP? ;)

Please join us at #AUA26! Comprehensive Anatomic Robotic Assisted Radical Prostatectomy: Pelvic Fascia Sparing and Evolving Techniques A focused, high-yield session on pelvic fascia–sparing robotic prostatectomy and evolving approaches. Instructional Course 043IC Sunday, May 17 | 10am – 12pm @jimhumd @KGUROmd @DrMBWesterman

@SimoneCrivella2 @UIHealth @pascale Hugo!?!?

A world 🌎 of #robotic options in 7 days : performed 1st #mp #HUGO Ralp at @UIHealth 🇺🇸, streamed #sp #DaVinci Ralp from @Pascale 🇮🇹, discovered #sp new platforms in 🇨🇳, performed #mp #DV5 rarc back at UI Health 🇺🇸. Up to us to use options for the benefits of our pts.

@utopianmae I hope you aren’t talking about an employee in your own clinic…

There is hopefully a special place in hell for surgery schedulers who put the first case 1.5 hrs after my start time and not move others up to fill the gap. It’s almost as if they hate me and never want me to be done with the day. :-)

@UroDocAsh @MRoupret @GGiannarini @EUplatinum @JUrology @EricTopol @FaltasLab @PavlosMsaouel Needs to be a program to verify images prior to submission. Like we had in college to verify no plagiarism for essays.

If this is true, the barrier to medical and scientific misinformation has essentially collapsed!! How are journal reviewers and editors supposed to keep up? @MRoupret @GGiannarini @EUplatinum @JUrology @EricTopol @FaltasLab @PavlosMsaouel

Imagine your surgeon preparing for your operation. They see you in pre-op, answer your questions, calm your fears, examine you, confirm the plan, and go get ready for the case. They review the imaging and think through the critical parts of the operation. Then a nurse interrupts them: “Doctor, your pre-op documentation isn’t good enough. You can’t just say you discussed the risks and benefits. You need a full H&P.” The surgeon points out that the H&P was already done in clinic. The note is right there in the chart. “No. That note is 31 days old. It has to be within 30 days. But it’s fine if you just copy and paste that old note.” Think about how insane that is. There is no new clinical information. There is no patient benefit. There is no improvement in safety or quality. The only thing being demanded is duplication. A pointless bureaucratic ritual to satisfy the machine. So now you have a frustrated surgeon, a delayed case, a bloated chart, and one more example of modern medicine confusing clerical box-checking with patient care. This is exactly what is wrong with the system. Endless note bloat. Pointless duplication. Administrative nonsense dressed up as professionalism. If there are no changes, there are no changes. Forcing a doctor to re-paste an unchanged H&P adds absolutely nothing for the patient. And the most insulting part is the tone. That smug, condescending “of course you have to do it this way” attitude, as if this is self-evidently necessary instead of obviously stupid. At this point, a lot of doctors would probably take a substantial pay cut to never touch a computer again. Cut the salary and use the savings to hire people to do the computer garbage. Epic. CDI queries. Coding queries. H&P updates. Order entry. Case booking. Inbox nonsense. All of it. Never touch Epic again. Never answer another coding query. Never update another unchanged H&P. Never place another order that a clerk or protocolized team could enter. Never do another ounce of hospital data-entry cosplay. Just let us be goddamn doctors instead of highly trained documentation technicians.

@RoboticsUrology Beautiful Mutahar

Now, with mastery of the MIS approach, SP robotic RPLND can be performed completely retroperitoneally through a single 3 cm incision, next day home, making the case even stronger.

@CanesDavid I’d love to see your workflow in action.

For the first time in my life I can actually multitask thanks to Claude Cowork. It's insane.

@UroCancer 🤣🤣

ASCO Post: "Can Saying 'I Do' Reduce Cancer Risk?" Well ...if there's a dose-response curve, I've got that going for me. ascopost.com/news/april-202…

@UroCancer @TylerSbrt @seanmmcbride @JHGLab @Papa_Heme This ^%

@TylerSbrt @seanmmcbride @JHGLab @Papa_Heme Use Claude with the chrome add in and walk away.

I went to school for 30 years to become a professor, and my employer has me taking *annual* mandatory training modules with test questions like 👇🏼 Is this a personal care item? Yes/No

@Rhevolver @grok what is happening here

Qué pinche forma tan horrible de morir. Estar pasando un momento tranquilo y divertido con tus amigas sin saber que esa será tu última sonrisa. Y la impotencia de la que grababa de, literal, no poder hacer nada.

@UroCancer ❤️

SUO GUASCO SWOG NRG AUA meetings just got even better. It’s about time.

@lemmiwenks @DrShakuriRad @vipulpatelmd As Jay does, we should all attempt highest degree of nerve spare on anyone with any degree of erectile function. No real reason not to except worrisome EPE in an area.

@DrShakuriRad @vipulpatelmd key here is for patient to insist that he is 100% potent so surgeon spends a lot of time and effort attempting to preserve function.

When I was in residency, we used to try to do 3 robotic cases by 3 PM… that was our golden target. Fast forward to the age of SP surgery and now the target has moved to 6 by 6 PM. ALL OUTPATIENT. The right tool in the right hands…grateful for those who made it possible @IntuitiveSurg #RoboticSurgery

@daviesbj @uretericbud @CanesDavid They do this on SP?

@uretericbud @CanesDavid I opted out of davinci stealing my moves. As others should have.

We’re extrapolating what AI has solved for computer coding unfairly to every industry. Take surgery for example. Surgery isn’t deterministic like coding, where there’s a right and wrong. In software, it works or it’s broke. Flawless or a bug. 🐛 Surgery isn’t deterministic. It’s messy decision making. Hundreds of correct choices. At every fork there’s not just one way forward. AI ain’t coming for surgery anytime soon.