KC Safi

First images from the GE Omni 128 cm Total Body PET/CT 🚀 The new scanner detected a <5 mm local recurrence of prostate cancer missed by standard PSMA PET/CT - despite 79% shorter acquisition ⏱️ Delayed imaging boosted lesion uptake and informed dose-painted salvage RT 🎯 @JournalofNucMed @PeterMacCC @declangmurphy @_ShankarSiva jnm.snmjournals.org/content/early/…

Real case: very low-risk prostate cancer (PSA 3.4 ng, Gleason 3+3, 2-12, ISUP 1) appropriate for active surveillance. A family seeks a second opinion; a surgical oncologist orders a PSMA PET-CT? and refers to medical oncology. The scan, performed at a low-experience center, is read as metastatic (bone and nodal), leading to unnecessary chemotherapy + ADT + ARPI. When the patient returned to me, the findings did not match the clinical picture, so I recommended a second nuclear medicine review. Conclusion: rib and cervical “lesions” were inflammatory/benign uptake, not metastases. Likely technical issue: residual sodium fluoride in an aged PSMA radiotracer causing nonspecific bone uptake. No CT structural correlate. Key takeaway: Integrate clinical context, pathology, and technical quality. #prostatecancer

I have performed numerous re-treatments post-REZUM surgery and encountered various complications, but this is the first time I have come across such a finding.. !! Have you ever face similar findings? @hazemelmansy1 @fgomsan @Mohamedendourol @dr_mohannad_ksa @mohamed92902484 @trwherrmann

@Mohamedendourol @Endo_Sec_Eua @Moser_DanielC @toshutosh @LamideyNoury @KARLSTORZUro @DRAAA86 @noddy_urologist @Urologeman @UroHeClinicUK @BernardoNor9 Totally agree with your points.

Bipolar enucleation = winning on every front 💰 Cost-effective/ No machine breakdown 🫡 🩸 Excellent hemostasis 🧠 Anatomical dissection 🛡️ Less stress on the sphincter ✋ Superior tactile feedback → easier plane recognition 🚫 No postoperative irrigation 🏃‍♂️ Discharge after one spinal anesthesia session

HoLEP as a cure of a metabolic problem. Interesting paper! Refractory hypernatremia in a 52yo male — BPH was the cause. Sodium peaked at 162 mmol/L despite standard care. Diagnosis: partial urinary tract obstruction impairing renal medullary concentrating ability. After HoLEP + cystolithotripsy: sodium normalized to 139.7 mmol/L. pubmed.ncbi.nlm.nih.gov/41948557/ drgomezsancha.com

Original Article: Perioperative Enfortumab Vedotin and Pembrolizumab in Bladder Cancer (phase 3 KEYNOTE-905 trial) nejm.org/doi/full/10.10… Editorial: Enfortumab Vedotin plus Pembrolizumab as Perioperative Therapy nejm.org/doi/full/10.10… #Oncology

Get updated @EUplatinum published results in interactive format on our WhatsApp channel whatsapp.com/channel/0029Vb… such as 👇👇 from updated pure 01 5 year data europeanurology.com/article/S0302-…

🚨Tansdermal Estradiol (tE2) vs ADT for locally advanced #prostatecancer🚨 @NEJM New phase 3 RCT (PATCH/STAMPEDE-1) 🔑tE2 patches are noninferior to LHRH agonists for metastasis-free survival (n=1,360) ✅ 87.1% vs 85.9% 3-yr MFS 🌡️ Way fewer hot flashes (44% vs 89%) 🦴 Lower fracture rates ⚠️ More gynecomastia 🔥Same cancer control. Better side effect profile. Patient-applied. Cheaper. 👀Time to rethink ADT? 👀 @PCFnews @PCF_Science @UrologyTimes @renalandurology @urotoday 🔗shorturl.at/rC2x3

@tompowles1 @weoncologists @Uromigos @kalasri3 Thanks for the shoutout Tom. We need to help our patients and deliver a unified message: The OS advantage seen with EV+P relies on consolidation with Radical Cystectomy + PLND (not observation, not TMT) #EAU26

Superb podcast reviewing the peri-operative EV pembro data and the future of MIBC treatments incorporating ctDNA etc. @Uromigos @MattGalsky @tompowles1 @brian_rini @uromigosjapan @TresUramigas

Phase 3 LITESPARK-022 trial Presented at #GU26 dailynews.ascopubs.org/do/litespark-0… The addition of belzutifan to one year of pembrolizumab after nephrectomy in patients with high-risk clear cell RCC significantly improved disease-free survival compared with pembrolizumab alone, lowering📉the risk of recurrence or death by 28% (HR 0.72). At 24 months, DFS rates were 80.7% with the combination versus 73.7% with pembrolizumab🧪 Although grade ≥3 adverse events were more frequent—including anemia, hypoxia, and elevated liver enzymes—they were generally manageable with dose adjustments and supportive care. Source Linked: ASCO Daily News @DrChoueiri @motzermd @DrIacovelli @DrYukselUrun @elena_verzoni @tompowles1 @OncoAlert 🚨

Looking for the latest insights on the management of muscle-invasive #bladdercancer? Our webinar “Modern management of muscle-invasive bladder cancer (MIBC): From trials to multidisciplinary practice” is now available on demand! 🌍 Spanish subtitles available. 👉 Watch here: mirrorsmed.org/bca-webinar-02… @OncoAlert

Summary of LASERS used in Urology and an overview of their properties. #TFL #Holmium #Thulium @DocGauhar @Dmitry_Enikeev @jl_kwok @kmoretry @steffiyuen @OTRAXER @TFL_URO_APIS

Bladder preservation after neoadjuvant therapy for muscle-invasive #BladderCancer. @UroDocAsh @MDAndersonNews joins @ERPlimackMD @FoxChaseCancer to discuss bladder preservation in the era of neoadjuvant EV–pembrolizumab, noting pathologic complete response rates around 57–60% that could support more platinum‑agnostic strategies. They highlight an international consensus on defining clinical complete response—negative cystoscopy, cytology, biopsies, MRI, and ideally undetectable ctDNA—while acknowledging global resource constraints. #WatchNow on UroToday > bit.ly/46Ow4Pw @EurUrolFocus

Comparing minimally invasive surgical therapies for benign prostatic hyperplasia #BPH. @DrDeanElterman @UofT joins Alan Wein, MD, PhD, FACS @dsui_miami_uro to discuss BPH procedure selection based on patient characteristics and preferences. Dr. Elterman explains how the treatment landscape has evolved beyond traditional TURP, driven by patients prioritizing sexual function preservation and faster recovery over maximum durability. #WatchNow on UroToday > bit.ly/4a3vG1H

It’s disappointing to me that TURBT continues to be dismissed as a “low-priority” procedure in so many training programs. This single step defines the entire course for a bladder cancer patient. Accurate diagnosis, precise staging, and the choice of therapy all hinge on a high quality TURBT. And the “advanced genomic analysis and molecular profiling” these same programs love to promote? It all begins with adequate, high-quality tissue obtained through a TURBT. Yet incomplete resections leave behind residual tumor in up to 78% of cases at restaging, leading to higher recurrence rates and unnecessary progression. If we are serious about improving outcomes in NMIBC - and even MIBC - we must treat TURBT with the respect it deserves: structured, deliberate training curricula, hands-on attending involvement, and real performance metrics. This is why the @IBCG_BladderCA will make this one of the focus topics of our retreat this year, #IBCG26 @UrogerliMD @JoshMeeks @bbmdmsk @siadaneshmand @RobertoContieri @paolo_gontero @ParamMariappan @joanfundi @jteoh_hk @spsutkaMD @WorldBladderCan @BladderCancerUS @drgaganprakash @SUO_YUO @veerukasi

Surgery is a "wicked" environment: feedback is delayed, noisy, and often biased. My essay on why experience doesn't always equal mastery, and how to learn when the feedback loops are broken. leezhaomd.org/post/the-wicke… #MedTwitter #Surgery #MedEd

I'm an unabashed techno-optimist, but autonomous surgery is more than 3 years away @elonmusk. Hope I'm wrong though! leezhaomd.org/post/elon-musk…

@Mohamedendourol @endourologyucsd @drkemalsarica @StefaniaFerret @Urologeman @TFL_URO_APIS @wroclawski_uro @Endo_Sec_Eua @MedicalPotent @EndoLuminalEndo @endouro @DocGauhar Those patient still need metabolic eval. according to Prof. Traxer. Suppose Prof . Omr you couldn’t see ostieum . What are your tricks?

RIRS surprises 🤯 When the “big stone” is nowhere to be found… what to do boss @endourologyucsd 1️⃣ Calyceal diverticulum — challenge detecting and opening the hidden neck 🔍✨ 2️⃣ Respiratory motion artifact — a “single large stone” on NCCT turns out to be 25 tiny stones 😲

@yang_kunlin Definitely, its a heroic surgery But how do we define adequate divided function in that kidney before we embark on such difficult surgery.

Let’s see the 6-month postoperative MRU image of this tough re-re-re do pyeloplasty case, now successfully salvaged with renal pelvic flap. Sometimes, I think 🤔 if the first pyeloplasty all surgeons can keep the principle well, maybe too much repair work can be avoided.