Dr. Benjamin N. Breyer

Not tying, you know, dissecting tissues, counter traction, exposure.

just those core principles, because we do so much endo and so much robotics, you get a little less of that.

And so I think at least in our program, that's a good time for them to get some exposure to that.

But yeah, you know, the more exotic the urethroplasty gets, obviously, and that's one of the tough things about urethral reconstruction is that you kind of

mean the rug is fine great okay scope i'm sure you i think you have a good sense for what you're getting into but like even yesterday i did a case where i was a little bit deceived by the rug and it turned out to basically be a membranous stricture a short membranous stricture and a heavy guy yeah b you know bmi probably like 38 or something a lot maybe that's like for you guys like yeah you know in ohio i'd love some 38s teasing uh but yeah so like

all of a sudden we're in there and he's young, youngish.

And so his good vasculature, it's not, you know, dry.

And all of a sudden you're like, okay, this is, we're doing a case here.

And it wasn't exactly the case that I had envisioned.

And so if you don't have,

If you don't have exposure to that, if you don't have the experience, I think sometimes that kind of thing can, it could be hard for someone in practice to manage that or even wanna manage that.

I think in terms of, you're right, we have a shortage.

I think the fact that we're training so many reconstructive urologists really is helping.

I also think, yeah, Optalume is something that's helped.

How much, I'm not sure.

But I do think the guideline basically says, refer to someone who has experience or who does urethroplasty.

And I think that's fair, but if you're someone that's training in residency and you're going, you know, you're going to be out in general practice and you don't have a partner that does it, or you're in a rural community and you feel comfortable, like I would definitely go for it.

But yeah, I also know that there are all of these centers now that have three, four or five reconstructive urologists that can help.

You're right.

It's specific to level where you are in training.