Dr. Geo converses with Dr. Herb Lepor, the esteemed Chairman of Urology at NYU Langone Health. (Quick note: He's also Dr. Geo's boss, so expect some fun dynamics!) Dr. Lepor's deep involvement in this field, particularly alongside Dr. Patrick Walsh, makes him an authority. Together, they delve into their coauthored research on the nervesparing technique, tracing its origin and understanding its significance in today's medical paradigm.
In this episode, they explore:
The latest breakthroughs in prostate cancer treatments.
A comparative discussion on open versus robotic prostatectomy.
A deep dive into focal therapies and where prostate cancer treatments are headed.
But there's more to medicine than just procedures and techniques. Dr. Lepore is approaching a rare milestone: 30 years as the chair of a medical department. What does leading with consistency and vision take in an everevolving domain like urology? Dr. Lepore shares his insights, challenges, and the human side of his extraordinary journey.
Chapters
00:00 History of Nerve Sparing Prostate Cancer Surgery with Herbert Lepor, MD [EP 78]
15:05 1983 Scientific Paper, Journal of Urology…Radical Prostatectomy
15:37 What was prostate surgery like before 1983?
17:31 Dr. Walsh looked at these drawings and said...that's the pathway nerves that control erection
18:22 The nerves…controlling erection…outside of the prostate | Possibility to do a nerve sparing.
19:22 Nerve sparing.
20:46 What exactly is happening so that you can spare important nerves for penile erections?
21:39 Whether or not the man will regain his erectile function depends on many factors.
23:19 50yearold with very good erections |Nervesparing Bilaterally |Erectile function is 80, 90%.
24:55 Different ages, there's different…Baseline function…|Fueled my interest in Focal Therapy
25:42 Amount of prostates you've removed throughout your life.
26:28 The robot… legitimate study |Comparing the two has failed to show any difference
28:47 Open surgical approach |Faster recovery because we're outside their intestinal cavity.
32:30 I always say to patients, look, the most important thing… is … experience.
34:25 95% of my patients go home the same day.
36:50 When I talk to a patient, I differentiate between perfect and continent.
38:40 The Duke study..depends on two things…How did you do, and how did you expect to do?
40:56 Our department really…pioneers in using MRI to identify where the aggressive cancers are
41:22 The Lumpectomy of the prostate,
46:25 We are one of three centers using Aquablation for Focal Therapy.
53:25 Your legacy is your urologic progeny..hundreds of residents I've trained over the 30 years… are the patients that you've cared for…the lives you touched, and providing the environment for others to excel.
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DISCLAIMER: This video is educational and does not constitute medical advice. The content of this video is my personal opinion and not that of my employer(s). Use of this information is at your own risk. Geovanni Espinosa, N.D., will not assume any liability for any direct or indirect losses or damages that may result from using the information contained in this video, including but not limited to economic loss, injury, illness, or death.