>> Narrator: Here at the Brady Urological Institute
at Johns Hopkins Hospital,
we are proud pioneers in urological advances.
Exploring new diagnostics, treatments, and protocols,
we are reshaping the futures of men and women
who previously had limited options.
Here are three examples.
>> Since the first radical prostatectomy was performed
here at Johns Hopkins in 1904,
we have been pushing the boundaries.
Upwards of a million men a year in the United States
undergo a prostate biopsy,
and many more face the uncertainty
of a prostate cancer diagnosis.
Urologists at Johns Hopkins have embraced
a new biopsy approach called the perineal biopsy,
which gives us some unique advantages
to performing a prostate biopsy.
These include less use of antibiotics,
less infection risk for the patient,
and an ability to sample areas of the prostate
that are not approachable
through the transrectal traditional approach.
When we couple technology with this biopsy,
we're able to then get additional diagnostics
including genomics and the latest in imaging technology
such as PSMA-PET scan to obtain additional information
for our patients.
This information is integrated in our precision medicine
center of excellence and our analytical platforms
to give us the latest information
that is specific to our patients.
We use tools developed here at Johns Hopkins,
such as the Partin tables, the Han nomograms,
and our new app for active surveillance that helps predict
when a patient requires another biopsy.
And thus we avoid overtreatment,
we minimize undertreatment, and we're able to provide
the patient with a management strategy for their cancer
that fits their unique situation.
>> Narrator: Another unique innovation
at the Brady Urological Institute
is the way that we manage chronic scrotal pain.
>> Chronic scrotal pain is a very common condition
in the United States.
It consumes a large portion of urology practices.
One procedure that we perform often
that causes a lot of this chronic scrotal pain
is the vasectomy procedure.
About 500,000 procedures are performed each year,
and unfortunately, about one to two percent of these men
will develop chronic scrotal pain.
A lot of the pain that arises after a vasectomy procedure
comes from inappropriate nerve signals that travel from
the vas deferens nerves up to the brain.
And the way that urologists have typically treated this
using a procedure that's called a microsurgical
denervation of the spermatic chord.
Unfortunately, this procedure has about a 70% success rate.
What we do here at Johns Hopkins that's unique
is that we offer patients an image-guided approach,
where we identify the nerves with millimeter accuracy
using a 3 Tesla MRI.
We can take these patients into the operating room
and resect their nerve fibers higher up
and offer them much lower morbidity with their procedure
by taking out those selective nerves.
>> Narrator: Complex cancers demand complex teams
to care for patients.
Innovation focused on how we work together
is improving patient outcomes and satisfaction.
>> Like Paul.
Paul is a pharmacist and father of two,
who presented with a 20-year history of an inoperable,
benign tumor in his abdomen.
When we saw him, he had been on pain medications
for over a year and could no longer eat.
We quickly evaluated him,
ran some advanced diagnostics,
and realized that he had a complex cancer
that would require both systemic therapy and surgery.
We initiated his therapy within that week,
and a few weeks later, he had a two-day operation
and is now cancer-free.
To pull this off requires capacity,
commitment, and expertise.
One such example are our Go Teams.
>> A Go Team is a team of 25 individuals
who all mobilize to provide timely, guideline-based
complex care.
This includes surgeons, oncologists, nurses,
as well as hospital administrators.
All of these individuals have signed a pledge,
guaranteeing that patients can be seen in two weeks.
>> Phillip: Complex care can involve surgery,
advanced diagnostics, or medical therapies.
We make sure to deliver all of these
under the umbrella of Johns Hopkins in a timely fashion.
>> Narrator: Our work has changed the prospects
for patients like Paul.
All the individuals at the Brady Urological Institute
have dedicated their careers
to advancing the field of urology,
much like we have for over 100 years.
People saving people.