Ep. 329 Surgical Approaches to Bladder Outlet Obstruction with Dr. John DiBianco
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What is the overall focus of the episode and who is the guest?
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what's really fascinating and fun for me is guys that have just been told no. You you're not a candidate for a procedure, your bladder doesn't work.
You offer some I typically will offer them a procedure If they're healthy enough, if it's the right thing to do, and if they're up for it. I tell them, you know, this may or may not work. And if they're like, you know, I want the highest odds of getting rid of this catheter and we do it. And maybe they have to catheth for a couple of months or so forth post operatively. But what's really fun for me is s getting a my chart message or a call that just says, Hey doc, I'm not getting any urine out when I calf anymore. I'm just peeing normally. Do I still need to calf? And I'm just like, No, you're good.
Hello everyone and welcome back to Backtable Urology, your source for all things urology. You can find all episodes on Apple, Spotify, YouTube, and on Backtable.com. This is Jose Ocheciba, your host this week. We have today Dr. John DiBianco. He's a urologist at UF Gainesville. So John, uh, welcome to Backtable.
Thank you for having me. It's an honor.
So today uh we're gonna be talking about um BPH, uh bladder abstruction and and and some of the uh treatments that are out there and and how to decide when is a better option one versus the other. But before we go dive into that, uh can you talk talk uh tell us a little bit about yourself, uh some of your background, uh where you did the the fellowship and and whatnot.
Sure. So yep, John Michael DiBianco, um, born and raised in Washington, DC. I did my residency at the University of uh I was sorry, George Washington University in Washington DC. I did my fellowship at the University of Michigan where in endo urology it's a two year fellowship where first year is research focusing on Kid Stones, quality of improvement and BPH. And then second year is uh clinical, uh mostly focusing on PCN L, complex stone disease, and BPH including HOLUP.
So just funny story, my my uh cousin of my dad was the CMO of uh George Washington uh hospital back probably like twenty, twenty five years ago. And and he was there for for Carlos Silva anyway. Nice.
He probably helped take care of Reagan.
Most likely. I mean he was uh uh internal medicine. Uh but yeah, so so yeah. Anyway, so you are the BPH guy uh in in Gainesville. How many is it you you only the one doing the BP all the BPH in the area or or is there's other uh you're always doing uh some of the BPH at your group?
Yeah. So at the University of Florida, I see probably the majority of BPH, although mostly the surgical BPH. We have a it's a whole team of both physicians and uh APPs that manage BPH. So from a surgical perspective, it's myself and two others. Um the other people typically offer robotic simple. I've not done robotic simple, so I've incorporated that in my practice. Bryson's residency. And then the others do a smattering of maybe TERP or EuroLyft um and some odd green light lasers. In the area of Gainesville, there are certainly some private practice urologists that work at um uh surgical centers, but certainly the complex cases and so forth come to Gainesville.
And when you say complex, I mean you're talking about uh patients that have huge prostates, uh patients on blood thinners, that they cannot stop the blood thinners, comorbidity, so so so w what would you consider a a complex uh BPH case?
Yeah, it's interesting. I mean, so in general it's all of those things. I think it's anything that um if you're have a surgical center and you're focused on outpatient procedures, it's anything that you're concerned that might require an overnight stay or anything like that. Or They have an ASA that uh anesthesia's not willing to put to sleep at a surgical center.
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Chapters
8 chapters
1
What is the overall focus of the episode and who is the guest?
0:01–8:03
2
How do Dr. Silva and Dr. DiBianco assess complex BPH referrals and lower urinary‑tract symptoms?
8:03–16:44
3
When should a clinician decide to operate on a patient with bladder outlet obstruction?
16:44–24:09
4
What imaging modalities and prostate‑sizing techniques are recommended before surgery?
24:09–31:55
5
When and why should cystoscopy or urodynamics be used in high‑risk BPH cases?
31:55–39:53
6
How do patient preferences, medical therapy, and decision‑aid tools influence the choice of procedure?
39:53–46:35
7
What are the key differences, complications, and recent advances between HoLEP, TURP, and ThULeP?
46:35–53:36
8
What future directions and counseling strategies are suggested for BPH management?
53:36–1:00:00
Speakers
1 identifiedMore from BackTable Urology
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