Dr. Burnett true legend in the field!
Can you really keep your erections after prostate cancer surgery? In this episode of the Dr. Geo Prostate Podcast, Dr. Geo sits down with world-renowned urologist Dr. Arthur “Bud” Burnett — the Patrick C. Walsh Distinguished Professor at Johns Hopkins. Dr. Burnett has published over 400 papers, pioneered major breakthroughs in sexual medicine, and helped develop the science behind today’s erectile dysfunction treatments.
Together, they explore the latest advancements in preserving erectile function after prostate cancer surgery, including cutting-edge AI and nerve-sparing techniques that help men maintain their quality of life. You’ll hear about intraoperative neuromonitoring, the future of penile implants, and Dr. Burnett’s groundbreaking work to personalize surgery using real-time nerve mapping.
This is a must-watch for any man facing prostate cancer surgery — and anyone interested in the future of sexual medicine.
* Learn how AI is changing prostate surgery
* Discover what nerve-sparing really means and why it matters
* Hear the story behind Viagra and the evolution of ED treatments
Chapters
00:00 Saving Erections with AI
03:14 Early Treatments for Erectile Dysfunction
05:37 The Viagra Revolution
07:37 Advancements in Penile Implants
12:38 Challenges in Prostate Surgery
17:53 Innovations in Nerve-Sparing Techniques
8:51 Understanding Low Testosterone
20:53 Understanding Prostate Variability and Precision Medicine
21:17 Intraoperative Neuromonitoring: A Decade of Innovation
24:00 The Role of Technicians in Surgery
26:53 Mapping Nerves During Prostatectomy
28:37 AI and Machine Learning in Surgery
37:14 Future of Nerve Preservation and Regeneration
39:54 Participating in Clinical Trials at Johns Hopkins
Can you really keep your erections after prostate cancer surgery? In this episode of the Dr. Geo Prostate Podcast, Dr. Geo sits down with world-renowned urologist Dr. Arthur “Bud” Burnett — the Patrick C. Walsh Distinguished Professor at Johns Hopkins. Dr. Burnett has published over 400 papers, pioneered major breakthroughs in sexual medicine, and helped develop the science behind today’s erectile dysfunction treatments.
Together, they explore the latest advancements in preserving erectile function after prostate cancer surgery, including cutting-edge AI and nerve-sparing techniques that help men maintain their quality of life. You’ll hear about intraoperative neuromonitoring, the future of penile implants, and Dr. Burnett’s groundbreaking work to personalize surgery using real-time nerve mapping.
This is a must-watch for any man facing prostate cancer surgery — and anyone interested in the future of sexual medicine.
* Learn how AI is changing prostate surgery
* Discover what nerve-sparing really means and why it matters
* Hear the story behind Viagra and the evolution of ED treatments
Chapters
00:00 Saving Erections with AI
03:14 Early Treatments for Erectile Dysfunction
05:37 The Viagra Revolution
07:37 Advancements in Penile Implants
12:38 Challenges in Prostate Surgery
17:53 Innovations in Nerve-Sparing Techniques
8:51 Understanding Low Testosterone
20:53 Understanding Prostate Variability and Precision Medicine
21:17 Intraoperative Neuromonitoring: A Decade of Innovation
24:00 The Role of Technicians in Surgery
26:53 Mapping Nerves During Prostatectomy
28:37 AI and Machine Learning in Surgery
37:14 Future of Nerve Preservation and Regeneration
39:54 Participating in Clinical Trials at Johns Hopkins
Revolutionizing Prostate Cancer Surgery: AI, Nerve-Sparing, and the Future of Erectile Function
Introduction
Prostate cancer surgery has long been associated with significant risks to sexual health, particularly erectile dysfunction (ED). In a recent episode of the Dr. Gio Prostate Podcast, Dr. Arthur "Bud" Burnett, a distinguished professor of urology at Johns Hopkins, shared insights into the evolution of sexual medicine, the challenges of nerve preservation during prostatectomy, and how artificial intelligence (AI) and advanced intraoperative techniques are transforming patient outcomes.The Early Days: Limited Options for Erectile Dysfunction
In the 1980s, men's sexual health was a taboo subject, even within urology. Treatment options for ED were limited and often ineffective:- Yohimbine: A prescription derived from the yohimbe bark, commonly used but with limited efficacy.
- Penile Prostheses: Early versions were primitive, offering little more than basic rigidity.
- Testosterone Therapy: Recognized for its role in libido, but not a solution for erectile function loss due to nerve damage.
Penile Implants: Evolution and Patient Satisfaction
Penile implants have been available since the 1980s, evolving from basic devices to sophisticated, inflatable prosthetics that closely mimic natural erections. Key advancements include:- Hydraulic Pumps: Allowing for more natural appearance and function.
- Remote Technology: Future devices may be controlled via smartphone apps, increasing convenience and discretion.
- High Satisfaction Rates: Modern implants offer spontaneity and normal sensation, leading to high patient satisfaction, especially for those who do not respond to medications.
The Challenge of Nerve Preservation in Prostatectomy
Erectile function after prostate cancer surgery depends heavily on the preservation of the neurovascular bundle—a complex network of nerves and blood vessels surrounding the prostate. Dr. Burnett emphasized several critical points:- Anatomical Variability: Each patient’s nerve anatomy is unique, making nerve-sparing surgery technically demanding.
- Surgical Limitations: Even experienced surgeons face challenges in identifying and preserving these delicate structures, as they are often tightly adhered to the prostate and difficult to distinguish during surgery.
- Realistic Outcomes: Reported rates of erectile function recovery are often optimistic; true rates are lower, highlighting the need for better techniques.
Intraoperative Neuromonitoring and AI: A New Frontier
To address these challenges, Dr. Burnett and his team have pioneered intraoperative neuromonitoring combined with AI and machine learning. This approach aims to personalize and improve nerve-sparing during prostatectomy:How It Works
- Spinal Electrodes: Temporary probes are placed near the lower spine to stimulate and monitor nerve activity during surgery.
- Real-Time Mapping: Surgeons receive immediate feedback—such as auditory signals—when they approach critical nerves, allowing for precise adjustments.
- AI Integration: Machine learning algorithms analyze nerve responses, helping to identify which nerves are essential for erectile function and guiding surgical technique.
Benefits
- Personalized Surgery: Each patient’s unique anatomy is mapped, increasing the likelihood of preserving erectile function.
- Minimal Additional Time: The technology adds only minutes to the procedure.
- Continuous Improvement: Data from surgeries are used to refine AI algorithms, further enhancing outcomes over time.
The Future: Nerve Regeneration and Broader Access
While current techniques focus on preserving existing nerve function, research is underway to promote nerve regeneration:- Implantable Electrodes: Experimental trials are testing whether small, programmable electrodes placed during surgery can accelerate nerve healing and potentially improve function beyond pre-surgery levels.
- Wider Availability: Although these innovations are currently in clinical trials at Johns Hopkins, broader access is expected within five years, pending regulatory approvals and multi-institutional studies.
Patient Participation and Next Steps
Patients interested in participating in these groundbreaking trials can contact Dr. Burnett’s team at Johns Hopkins. As the technology matures, it promises to set a new standard for prostate cancer surgery, offering hope for better sexual health outcomes.Conclusion
The integration of AI and advanced nerve-sparing techniques marks a significant leap forward in prostate cancer surgery. By personalizing procedures and leveraging real-time data, surgeons can better preserve erectile function, improving quality of life for countless men. As research continues, the future holds even greater promise for nerve regeneration and functional recovery after prostatectomy
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