In this episode of Pearls and Perspectives, host Amy Pearlman, MD, is joined by Polly Rodriguez, CEO and co-founder of Unbound, for a candid and wide-ranging conversation at the intersection of sexual health, innovation, and patient advocacy. Rodriguez shares the deeply personal experience that shaped her mission: a cancer diagnosis at age 21 that led to early menopause—without warning from her care team about the profound sexual health consequences that would follow. That gap in care became the catalyst for building a company focused on accessible, body-safe, and stigma-free sexual wellness products.

Together, Pearlman and Rodriguez explore the persistent disconnect between medical treatment and quality-of-life conversations, particularly when it comes to sexual health. Rodriguez reflects on how discussions during her cancer care centered on fertility but overlooked equally critical issues such as pain with sex, loss of libido, and vaginal dryness—symptoms that significantly affect long-term well-being. Pearlman builds on this by emphasizing the importance of normalizing these conversations in clinical practice, offering practical frameworks for clinicians to introduce sexual health in a way that is brief, inclusive, and non-intimidating for patients.

The discussion then shifts to the broader landscape of sexual wellness, where Rodriguez outlines the challenges of building a company in a largely unregulated and stigmatized industry. She highlights gaps in safety standards, noting that many sexual wellness products are not subject to FDA oversight, and explains how Unbound prioritizes body-safe materials, affordability, and modern design. The conversation also touches on systemic disparities in how products for male vs female sexual health are marketed and regulated, underscoring the ongoing barriers to innovation and education in this space.

From a clinical perspective, the episode offers practical insights into how sexual wellness products—such as lubricants and vibrators—can play a meaningful role in patient care, particularly for individuals recovering from cancer treatment or experiencing menopause-related symptoms. Rodriguez and Pearlman discuss the nuances of different product types, from water-based vs silicone lubricants to emerging technologies like suction-based stimulation, framing these tools not as luxury items but as essential components of sexual health and recovery.

Importantly, the conversation expands beyond products to address the psychological and relational dimensions of intimacy. Rodriguez speaks to the process of reconnecting with one’s body after illness, while Pearlman highlights how open communication and a willingness to explore can transform partnered relationships. Both emphasize that pleasure, curiosity, and agency are lifelong aspects of health—ones that deserve the same attention and normalization as any other clinical outcome.

The episode ultimately reinforces a central message: Sexual health is not ancillary to overall health—it is integral. By bridging the gap between medicine, innovation, and patient experience, Pearlman and Rodriguez advocate for a more holistic, informed, and stigma-free approach to care.

In this episode of The Expert APProach: Conversations in Uro-Oncology, host Joy Maulik, CRNP, sits down with Melissa Kestler, DNP, FNP-BC, for a thoughtful discussion centered on advanced practice provider (APP) leadership, clinical growth, and the evolving role of APPs in urologic oncology.

Kestler shares her professional journey into urology, reflecting on how curiosity, mentorship, and a willingness to step outside of traditional role expectations helped shape her career. What stands out in her story is not just the acquisition of clinical skills, but the intentional development of confidence—particularly in procedural competency and independent clinical decision-making. She emphasizes that growth in this field often requires APPs to advocate for their own training opportunities while also being supported by forward-thinking physician partners.

A central theme of the conversation is the importance of practicing at the top of one’s license. Kestler highlights how APPs can meaningfully expand access to care, improve efficiency, and enhance patient outcomes when they are empowered to take on more advanced responsibilities. This includes not only clinic-based care but also procedural work, care coordination, and longitudinal patient management. She underscores that this evolution is not about replacing physicians, but about strengthening the care team in a way that meets the increasing demands of modern health care.

Maulik and Kestler also explore the realities of navigating complex patient populations in uro-oncology. From managing treatment adverse events to supporting patients through emotionally and physically taxing diagnoses, Kestler speaks to the depth of the APP–patient relationship. Education emerges as a recurring pillar—ensuring patients understand their disease, treatment options, and expectations is just as critical as the treatments themselves.

Leadership is another key focus. Kestler discusses how APPs are increasingly stepping into leadership roles, whether formally through administrative titles or informally through mentorship, program development, and clinical innovation. She encourages APPs to seek out these opportunities, noting that leadership does not always require a title—it often begins with initiative, consistency, and a commitment to improving care delivery.

The conversation also touches on interdisciplinary collaboration. Kestler reinforces the value of strong partnerships between APPs, physicians, nurses, and administrative teams, particularly in complex fields like uro-oncology where coordinated care is essential. These collaborative models not only improve patient outcomes but also help reduce provider burnout by distributing responsibilities more effectively.

Ultimately, this episode paints a clear picture of a field in transition—one where APPs are no longer seen solely as support roles, but as integral contributors to both clinical excellence and healthcare innovation. Kestler’s insights serve as both a roadmap and an encouragement for APPs looking to expand their impact, reminding listeners that growth in this space is driven by curiosity, collaboration, and a willingness to lead.