Dr. Kristofer Wagner

Now online! Second Transurethral Resection of Bladder Tumor Can Be Safely Omitted in Selected Patients with T1 Non–muscle-invasive Bladder Cancer: Results from the Prospective HuNIRe Trial by Roberto Contieri et al. Thank you to the authors for choosing #EUO to publish your work. Read the full article here: buff.ly/5gskvCp @uroweb @mroupret @jteoh_hk @Ric_Campi @CaPsurvivorship @UroDocAsh @LauraMarandino @RenuEapen @Ecastromarcos @OncoAlert @Sciencedirect @RobertoContieri

Excellent essay, well done Doctor @TaylorGoodstein 👏 ascopubs.org/doi/full/10.12…

HUGELY IMPORTANT Urology friends: votervoice.net/AUA/Campaigns/… CMS is looking to cut procedural reimbursement by 2.5% on the presumption that we are becoming more efficient. Sign this petition.

@CanesDavid Amen

I'm amazed how often prostate size is known, and PSA density is never calculated or discussed even once. Patient subjected to numerous biopsies for PSA "spikes" that are perfectly explainable by a zero cost calculator test.

@CanesDavid I do TP biopsies at our (hospital owned) ASC. I’m fortunate to have block time there, and the patients definitely appreciate it. I did them in office TR for years. Although it’s tolerable with local only, it is a much more pleasant experience with the propofol.

Urologists: Take a look at this thread. reddit.com/r/ProstateCanc… Say what you will - there's selection bias in public forums that brings in the more extreme comments - you can show me published papers... whatever. Prostate biopsy awake hurts. Patients don't speak up - they just grit their teeth and bear it. The patient voice is important.

@AdityaBagrodia I’ll second that! We were lucky to have had him come to Texas as a VP at our program recently as well.

What a treat! One of the most thoughtful GCT clinicians and researchers out there!

@CanesDavid I still get pregnancy drug warnings when it is documented that patient has has hysterectomy. For sure, someone can definitely do better, but they have a monopoly.

#EPICRant: This is mind boggling to me: entering a surgical order set in EPIC, a user needs to manually tick a box saying whether the patient is on anticoagulants or not. For hundreds of millions of dollars, with an updated med list in there, detecting this without user input is a collossal failure. It's not complex. Doesn't require AI. Simple logic. Is this just my EPIC build? Anyone out there have a build where this is automatic? Or at least that it serves you the med list in the same screen at the decision point? -😡

Seems like this could help with logistics and prevent elective case cancellations.

"2 RCTs have failed to show a benefit of an extended approach versus a limited pelvic LN dissection on early oncological outcomes, and it is associated with a nearly 20% risk of complication rates mainly related to significant lymphoceles" Both statements clearly false.

@CanesDavid For complex results (biopsy path, MRI/CT, etc), I always schedule an appointment with me or my APP to discuss the results (telemedicine or face to face). This is scheduled in advance so it is possible to find a time slot. Important to set clear expectations.

Uncomfortable but honest question for my fellow doctors: How do you feel about patients requesting communication/interpretation of results through chart messaging? I'm talking about things that require more than a very brief analysis? My feeling is that when our analysis is in the context of a visit (virtual or in person), we get compensated for our time and expertise, just like other professions. As it should. Has anyone taken a hard line on this? Am I being too callous?

@LauraBukavinaMD Sadly it’s an uphill battle

@KristoferWagner trying to bring academic twitter back .. less ads more knowledge

Dr. Bukavina is a great one to follow 👇

Transperineal biopsy had similar cancer detection rates as transrectal biopsy, but there were no infections after transperineal biopsy, this study found. ja.ma/3ZajVjc @jimhumd

⚡️ Stage T1 bladder cancer: diagnostic criteria and pitfalls #BladderCancer sciencedirect.com/science/articl…

@marawaneltayeb @jasonkweiss @priscillaandert @Baine_H @BSWHTemple_Urol Charting in my office all day 😔

@jasonkweiss @priscillaandert @Baine_H @BSWHTemple_Urol where is @KristoferWagner 😀?

Team breakfast with the weekend crew. @priscillaandert @Baine_H @BSWHTemple_Urol

@VickersBiostats @TouijerKarim Been doing extended nodes for years. A good LND takes a lot of time, but I have long felt that it was the right thing to do. My life would be easier if your results were different.

First single center RCT in the modern era to show a treatment effect on metastasis. Extended LND during radical prostatectomy superior to limited LND europeanurology.com/article/S0302-… @TouijerKarim

@AdamRMetwalli XGP is usually radical !

I’ve stopped using the term simple. I say total. Bc cases like these are often far from simple

Sports > Everything Else

@CjWarren_MayoAZ Does your institution charge for patient message replies, or free?

Urologists get a lot of msgs! We looked at >23k cases —> >100k pt messages Overall 4.35 msg/case ⬆️ 3: Interstim, cystectomy, urethroplasty ⬇️ 3: Plication, AUS, Urs/LL Pts who sent messages had ⬆️ outcomes with 33% ⬇️ ER use 90 days post surgery auajournals.org/doi/10.1097/UP…