Narayan Bhusal M.D

Urologist and Chief Kidney Transplant Surgeon at KIST Medical college and Teaching Hospital, Nepal
Stone Crusher, Father, Pizza Maker

[Justin Welsh @thejustinwelsh]

My life's goal isn't to be rich.

It's to work 3-4 hours per day, help thousands of people, have plenty of time for exploring hobbies, spend time outside, cook with my wife, exercise whenever I want, and avoid pointless meetings.

That's all I care about.

[Stijn Noorman @stijnnoorman]

The most valuable skill in the world:

Decision-making.

I studied how Naval and Elon Musk make decisions.

Here's how you make decisions like world-class entrepreneurs:

[د.عبدالرحمن السنبل. Dr.Abdulrahman Alsunbul @abdulrahman_uro]

Laparoscopic intra-corporeal ileal loop diversion( ileal conduit) followed by laparoscopic simple cystectomy (Michigan group technique).

Total operative time: ~5 hrs.
Special thanks to @Alialsulihem @malmuaiqel
And to our resident @khalafalshmrani

عملية تحوير المسار البولي بالكامل عن طريق المنظار الجراحي ، واستئصال المثانه بالكامل لأسباب حميدة.

[Austin Bourgeois @AustinBourgeois]

Prostatic Artery Embolization vs TURP:

"All outcomes, including IPSS, QOL, peak flow, and postvoid residual volume (PVR), were equivalent at 12 and 24 months. TURP --> higher rates of bladder catheterization and hospitalization. Major complications were encountered only in the TURP group."

https://t.co/fnjDNBENmD

#iRad

[Dr Amol Akhade @SuyogCancer]

Whats new and exciting data to look forward in ASCO GU 2026 🙂👇 @ASCO #ASCOGU26 @brunolarvol @MedwatchKate

[Fernando GomezSancha @fgomsan]

🔬 BREAKTHROUGH ALERT: Revolutionary HoLEP (Holmium Laser Enucleation of the Prostate) en bloc technique showing unprecedented success rates! The new approach reduces the operation time by 30% while improving patient outcomes. This minimally invasive approach improves benign prostatic hyperplasia treatment. The future of urology is here! #HoLEP #LaserSurgery #BPH #MinimallyInvasive #UrologyInnovation #PatientCare #ICUA

[Max Kates @MaxKates]

The beginning of a sea change in how we care for muscle invasive bladder cancer...

[Yüksel Ürün @DrYukselUrun]

New data shows ultra-low-dose nivolumab (20mg) outperforms standard chemo in advanced cancers. It extended life, cut severe side effects by nearly 20%, and protected QoL.
Less can be more.
@ASCO @JCO_ASCO @OncoAlert

[Mohamed_omar @Mohamedendourol]

Bipolar Enucleation (En-bloc) with STORZ electrodes ⚡️
🧠 90-g prostate in 40 minutes
💡Corrected-angle regular electrode → early apical release
🔹 Herrmann electrode → efficient, anatomical enucleation
Join our https://t.co/bqk95ysbM1 for more details

[Fernando GomezSancha @fgomsan]

I uploaded two more videos to my Youtube channel with challenging en bloc HoLEP cases… https://t.co/IuWOrh0y2T and https://t.co/2Ju8oD89kA

[Katy Beckermann @katy_beckermann]

Really enjoyed this consensus conference tackling the gray areas in GU oncology 👥🧠
Bringing together experienced GU colleagues, acknowledging where evidence is limited, and laying out thoughtful, real-world options sparked a truly rich discussion 💬✨

A great read and practical resource for anyone caring for GU patients 📚👇https://t.co/PHfWCICrlz

#GUonc #BladderCancer #KidneyCancer

[Matt Cooperberg @dr_coops]

2026 @AmericanCancer Statistics are out. #prostatecancer is now #1 in incidence for all US ppl. Mortality numbers also up though ASR is slightly down; mortality still >2x for Black men.

New USPSTF guidelines expected this year… Get screened!!

https://t.co/7KktgaNbCi

[Tom Powles @tompowles1]

ctDNA gives a good indicator of MRD post surgery in MIBC & is predictive of response to atezo. It is also prognostic in most MIBC settings. Less is known about utDNA. In SUNRISE4 the utDNA results are novel & show utDNA clearance, which may correlate with pCR. Integrated utDNA and ctDNA analysis will help guide treatment IMO @AndreaNecchi

[Dr Rishabh Jain @DrRishabhOnco]

Localised prostate cancer just changed. Again.

ESMO 2026 brings clarity on who to observe, who to escalate, and which trials actually matter 👇

🧠 Diagnosis
MRI before biopsy is standard
High-resolution US is a valid alternative (RCT n=678)

🧭 Low risk
Active surveillance is safe
ProtecT 15-yr data shows similar survival vs RP/RT

☢️ Radiotherapy
Shorter is better
CHHiP ➜ moderate hypofractionation
HYPO-RT-PC ➜ ultra-hypofractionation
PACE-B ➜ SBRT works in selected IR disease

📈 High risk
RT + long-term ADT saves lives
SPCG-7 | NCIC/MRC
Dose escalation improves OS (GETUG-AFU 18)

🚨 Very high-risk / cN1
RT + ADT + abiraterone is the new benchmark
STAMPEDE delivers MFS + OS benefit

🔁 Biochemical recurrence
Avoid routine adjuvant RT
Early salvage RT preferred
RADICALS-RT | RAVES | GETUG-AFU 17
High-risk BCR? Intensify
EMBARK supports enzalutamide + ADT

🧠 Bottom line
Risk-adapted care > overtreatment
Imaging-driven decisions
Escalate only when trials prove benefit

📖 Full paper in comment ⬇️

#OncoTwitter #MedTwitter #ProstateCancer #GUOncology
@OncoAlert @myesmo @esmo_open @asco @OncBrothers

[Tom Powles @tompowles1]

What’s the future of muscle invasive bladder cancer #SimposioSOGUG25
Pathological CR rates of 57% for EVP points towards cystectomy being delayed until maximum EVP effectiveness. Also fewer patients will have cystectomy. Studies are needed to ensure this approach is safe.

[Tom Powles @tompowles1]

While discussing ctDNA in bladder Ca #SimposioSOGUG25 more data from IM011 becomes available. Negative patients are at low risk while +ves benefit from atezo. These data further support using ctDNA rather than other approaches to select patients for adjuvant IO in UC #SUO2025

[Narayan Bhusal M.D @yanprasmd]

Do you remember when you joined X? I do! #MyXAnniversary

[Fernando GomezSancha @fgomsan]

An important read for all enucleators… great work from Prof. Mario Sofer and cols. They propose a very interesting new concept, a new mechanism that contributes to explain temporary stress incontinence after AEEP, the radial forces exerted by the scope during enucleation