SUFU podcast

Moderator: John Speich, PhD Speaker: Janet Keast, PhD, BSc (Hons)

Moderator: Jason P. Van Batavia, MD Predicting Hydronephrosis in Spina BifidaSpeaker: Stephen A. Zderic, MD Predicting Outcomes of OAB TherapiesSpeaker: Glenn T. Werneburg, MD, PhD Other Applications of Deep Learning in UrologySpeaker: Gregory E. Tasian, MD, MSc, MSCE

Panel: Complex Abdominal ReconstructionModerator: Jaspreet S. Sandhu, MD Creating a Continent Catheterizable Channel – What Works Best?Panelist: Rose Khavari, MD Ureteral Strictures After Urinary DiversionPanelist: O. Lenaine Westney, MD Treatment of Stoma ComplicationsPanelist: John T. Stoffel, MD Case DiscussionsPanelists: Rose Khavari, MD John T. Stoffel, MD O. Lenaine Westney, MD

SUFU 2023Panel 1: Advances in Neural EngineeringModerator: Aaron D. Mickle, PhD The UroMonitor Enables Ambulatory Wireless Catheter-Free Closed LoopNeuromodulationPanelist: Margot S. Damaser, PhD Interfacing with the Peripheral Nervous system for Responsive BladderNeuromodulationPanelist: Tim Bruns, PhD Systems Level LUT Computational Modeling as an Approach to UnderstandNeurourology and Design NeuromodulationPanelist: Zachary Danziger, PhD

Dr. Giulia Lane and Dr. Unwanaobong Nseyo Intervew Dr. Steven Siegel on the history of sacral neuromodulation at SUFU 2023

Dr. Rena Malik Interviews Dr. Jacqueline Zilloux, the first author of the 2022. SUFU white paper on overactive bladder anticholinergic medications and dementia risk. Available online at: https://onlinelibrary.wiley.com/doi/10.1002/nau.25037

Dr. Giulia Lane discusses the highlights of the recently updated AUA IC/BPS Guidelines. Find them here: https://www.auanet.org/documents/Guidelines/PDF/ICBPS%20Guideline.pdf

Claire Burton, MD current 2nd year Stanford FPMRS Fellow interviews her program director Dr. Craig Comiter to get answers to the most commonly asked questions about their FPMRS FellowshipLearn more here: https://urology.stanford.edu/education/clinical-fellowships/fellowships-fpmrs.html#:~:text=The%20Stanford%20female%20pelvic%20medicine,in%20basic%20science%20or%20clinical

Speaker: Doreen E. Chung, MD, FRCSC, FPMRS

Director: Michael J. Kennelly, MDPanelists: Rochell Burton, APRN-BCBenjamin E. Dillon, MDW. Stuart Reynolds, MD, MPH, FACS

Allyship: Making it MeaningfulPanelist: Suzette E. Sutherland, MD, MS, FPMRSImposter Syndrome – Prevalence, Predictors, and Ways to MitigatePanelist: Toby C. Chai, MD

Patricia Maymi-Castrodad, MD interviews her program director Dr. J Quentin Clemens about the University of MIchigan FPMRS Fellowship!Find out more here: https://medicine.umich.edu/dept/urology/education/fellowships/female-pelvic-medicine-reconstructive-surgery-urology-fpmrs-fellowship

Dr. J. Quentin Clemens, MD of University of Michigan presents a tribute to the late Dr. Ed McGuire folloewed by the McGuire-Zimskind awardee lecture featuring Dr. Benjamin  Brucker on everything he learned from PGY 8 to PGY 1

Speaker: Shlomo Raz, MD Discusses the indicationsfor flap use in female pelvic surgical reconstruction and a discussion of how a variety of these flaps are performed,7

The Social Ecology of Pelvic Floor Disorders-  Conditions involving the lower urinary tract and pelvic floor can have a tremendous impact on the quality of life of patientsand their families and can also result in a huge economic burden.  Moderator: Casey Kowalik, MD Social Ecology of Benign Urinary ConditionsPanelist: Tamara G. Bavendam, MD, MSThe Hidden Burden of Benign Urinary ConditionsPanelist: James A. Hokanson, PhDSocial Determinants of Benign Urinary Conditions Panelist: Nitya Abraham, MD

What is  the best initial therapy for female SUI (bulking agent versus midurethral sling) Moderator: A. Lenore Ackerman, MD, PhD Mid Urethral Sling Speaker: Howard B. Goldman, MD, FACS Bulking Agent Speaker: Eric S. Rovner, MD

A review on how the use of “big data” (variousadministrative data sets) can guide decisions and outcomes in FPMRS Moderator: Jennifer T. Anger, MD, MPH, FPMRS Panelists: Bilal Chughtai, MD Anne M. Suskind, MD, MS, FACS, FPMRS Blayne Welk, MD

A review on risk stratification for patients with neurogenic lower urinary tract dysfunction Speaker: Anne P. Cameron, MD, FPMRS

Moderator: Gary E. LemackMD Panelists: Sara M. Lenherr, MD, MS, FPMRS Olufenwa Milhouse, MD, FPMRS Charles R. Powell, II, MD, FPMRS

The American Urological Association (AUA), in partnership with the Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (SUFU) released the 2021 clinical guideline for the diagnosis, evaluation, treatment and follow-up of Neurogenic Lower Urinary Tract Dysfunction (NLUTD) in adults.NLUTD is a term used to refer to the abnormal function of either the bladder, bladder neck and/or its sphincters related to a neurologic disorder. Prior terminology commonly used "neurogenic bladder" to describe this condition. With the understanding this is not an issue confined to the bladder, NLUTD is now the preferred way to describe the various voiding issues seen in patients with a neurologic disorder.The focus of this guideline is on the evaluation, treatment and follow up of care for adults with NLUTD. A total of 60 recommendations, including those associated with initial evaluation, autonomic dysreflexia, urinary tract infections, non-surgical and surgical treatment options, as well as follow up and post treatment care are reflected within this new clinical guidance.Highlights include:An algorithm that allows for risk stratification of patients with NLUTD (low-, moderate- or high-risk), helping guide appropriate follow-up and surveillance.Recommendations on which patients need to be monitored for autonomic dysreflexia (AD) during procedures and how to intervene if AD occurs.UTI recommendations focusing on issues such as not treating asymptomatic bacteruria, not obtaining screening urinalysis or culture in asymptomatic patients and the consideration of daily antibiotic prophylaxis for NLUTD patients who manage their bladder with clean intermittent catheterization and have recurrent UTI.Treatment options to improve bladder storage parameters such as oral therapies (antimuscarinics and/or beta-3 agonists) or, if oral therapies fail, onabotulinumtoxinA to improve bladder storage parameters, decrease episodes of incontinence, and improve quality of life measures.David A. Ginsberg, MD is the Chair of the guideline development panel and Professor of Clinical Urology at the University of Southern California, Keck School of MedicineSeth Cohen, MD is an Assistant Clinical Professor of Urology and specialist in Female Pelvic Medicine & Reconstructive Surgery at City of Hope follow him on Twitter at https://twitter.com/drscohen?lang=en

Modulating Bladder Function with Light: The Application of Optogenetics to the Urinary System

Moderator:       Ariana L. Smith,      MD Speaker:    Amy Rosenman, MD 

Moderator:       Jennifer T. Anger, MD, MPH, FPMRS Speaker:          Adrian Wagg, MB, BS, FRCP(Lond) FRCP (Edin) FHEA 

Multiomics Analysis of the Neurogenic BladderPanelist: Rosalyn M. Adam, PhDMetagenomics and the Urinary MicrobiomePanelist: Catherine Putonti, PhDOpportunities and Challenges in AI at the Department of Veterans AffairsPanelist: Seth Hurley, PhDQ & A

Value in HealthcareSpeaker:         David F. Penson, MD, MPH The Future of Reimbursement in Urology Speaker: Cary W. Stimson, Jr., MD, JDThe Elusive Craft of Urologic Advocacy Speaker: Eugene Y. Rhee, MD, MBABladders Matter: Advocacy SUFU Style Speaker: Elizabeth Timbrook Brown, MD, MPHSUFU Health Policy Scholar Speaker: J. Quentin Clemens, MDQ&A

Moderator:       Tracey S. Wilson, MD, FACSURM Patients and FPMRS – What Do We Need to Know? Speaker:          Yahir Santiago-Lastra, MD, FPMRSRacial Bias and URMs in Academic Medicine Speaker:          Larissa V. Rodriguez, MD, FPMRS

Moderator:       Ekene A. Enemchukwu, MD, MPH Speaker:              Michael J. Kennelly, MD, FACS 

Moderator:       Kathleen C. Kobashi, MD, FACS Speaker:          John Heesakkers, MD, PhD 

Moderator:       Anne M. Suskind, MD, MS, FACS, FPMRSSpeaker:          Nirit Rosenblum, MD

Moderator:       Anne M. Suskind, MD, MS, FACS, FPMRSSpeaker:          Duane R. Hickling, MD, MSCI 

Establishing research collaborations between clinician-scientists and basic scientists can be challenging but highly rewarding. Host Lysanne Campeau interviews two SUFU investigators, Dr. Adam Klausner and Dr. John Speich, who offer insights on how to build successful alliances.

South America Panelist: Marcio A. Averbeck, MD, MSc, PhD UK Panelist: Tamsin J. Greenwell, MBChB, MD FRCS(Urol) Canada Panelist: Blayne K. Welk, MD Continental Europe Panelist: Matteo Balzarro, MD Blayne K. Welk, MD St. Josephs Hospital London, ON Consistent with many other societies, the Canadian Urology Association supports the use of midurethral synthetic slings for the treatment of stress incontinence. However, these procedures have decreased substantial over the last 10 years in Canada in response to public awareness of the legal cases and the North American regulatory warnings. Marcio A. Averbeck, MD, MSc, PhD Moinhos de Vento Hospital Porto Alegre, Brazil According to a cross-sectional study, which used a 37-item internet-based survey applied to members of urologic and gynecologic associations from 18 countries in Latin America, most participants (75.2%) indicated that the use of mesh has declined after FDA warnings, and 41.9% considered this has had a negative effect in the use of midurethral synthetic slings (MUS) as well (1). One of the largest series of MUS in Southern Brazil has been presented during the 2014 ICS Annual Congress in Rio de Janeiro (2). From January 2008 to December 2013, 315 patients underwent TOT implantation at a single terciary hospital. Mean age was 58.66±11.87 years. Postoperative continence rate was 78% at a mean follow-up of 33.83±20.67 months (6 to 72 months). Surgical complications were found in 17.4% of patients. Most frequent complications were dyspareunia (16 cases), groin pain (12 cases), new onset of recurrent urinary tract infections (5 cases), de novo urgency (5 cases), vaginal erosion (3 cases) and persistent urinary retention requiring urethrolysis (3 cases). 90.3% of patients stated that they did not regret undergoing TOT implantion and were happy with their surgical outcomes. Consistent with many other international medical societies, the Brazilian Society of Urology (SBU) still supports the use of midurethral synthetic slings for the treatment of stress urinary incontinence in women. However, public hospitals usually have budget restrictions and the ‘mesh controversy’ has been perceived as an excuse to postpone regular acquisition of surgical materials (eg. synthetic sling kits). Curiously, the decision-making process for surgical interventions is mostly surgeon-centered in most South-American countries. References 1. Plata M, Bravo-Balado A, Robledo D, Castaño JC, Averbeck MA, Plata MA, Cataño JG, Caicedo JI, Trujillo CG. Trends in pelvic organ prolapse management in Latin America. Neurourol Urodyn. 2018 Mar;37(3):1039-1045. doi: 10.1002/nau.23392. Epub 2017 Sep 6. 2. Averbeck MA, Wachter L, Dörr D, Schneider N, Ramos J, Ledesma AG, Prado Schmidt A, Camargo SF. Long-term outcomes of transobturator tension-free midurethral slings for the surgical treatment of stress urinary incontinence in women. Podium presentation during ICS Congress in Rio de Janeiro (2014). Session 16; abstract 271.

Speaker: Christian O. Twiss, MD

Speaker: Bradley C. Gill, MD, MS

This breakout session will review assessing practice value, physician compensation trends, discuss mergers and private equity acquisitions of practices, and discuss ancillary opportunities within a private FPMRS practice. Director: David O. Sussman, DO Panelists: Polina Reyblat, MD

Moderator: E. Ann Gormley, MD On Caring For Each Other Recipient: Roger Dmochowski, MD, MMHC, FACS

Moderator: Ariana L. Smith, MD Hysteropexy Speaker: Nirit Rosenblum, MD Hysterectomy Speaker: Karyn S. Eilber, MD

Moderator: Polina Reyblat, MD Panelists: Cecile Ferrando, MD, MPH Ervin Kocjancic, MD Kamran P. Sajadi, MD

Speaker: Rachel S. Rubin, MD

This breakout session will highlight non-traditional, innovative practical implementation of ancillary services beneficial to contemporary dedicated FPMRS practice. We will cover aspects such as the use of scribes and navigators, 3-D and perineal ultrasounds, and virtual visits. Director: Michael J. Kennelly, MD Panelists: Anne P. Cameron, MD Cecile Ferrando, MD, MPH

Urologic Issues in Pregnancy Panel Pregnancy represents a distinct and exceptionally complex physiologic state with significant impact on a variety of urologic concerns. Considerations must be made for not only the anatomic and physiologic alterations in the mother which may manifest during pregnancy, but also for the vulnerability of the fetus. Urologic issues such as stones and hydronephrosis, urinary diversion, and urinary tract infections often require a multidisciplinary approach given the unique maternal-fetal environment. I. Urinary Diversion Although considerable debate exists regarding management of pregnant patients with a urinary diversion, this session is designed to introduce concepts and present treatment options for potential issues that can arise. Best practices regarding surgical interventions and common pharmaceutical treatments for pregnant patients with diversions will be presented. Information will be provided regarding the impact of pregnancy on the physiology of urinary diversion, particularly with regards to hydronephrosis and renal function, along with special emphasis on matters encountered with catheterizable channels. Risks and strategies for contending with lower urinary tract and ascending infections in the pregnant diversion patient will be discussed. Counseling regarding potential selection criteria for determination of the mode of delivery will additionally be illustrated. II. Urinary Tract Infections Urinary tract infections are the most common type of infection during pregnancy, affecting 10% of women. The usual offender is Escherichia coli, but recent rise of resistance are narrowing available and safe antibiotics for expectant mothers. UTI in pregnancy can lead to hospitalization due to worsening infectious presentation in the mother as well as preterm labor. In addition, potential complications to the offspring are low birthweight, long term infectious morbidity and risks of specific birth defects. Although the dogmatic recommendations are to always treat urinary tract infections and asymptomatic bacteriuria in pregnancy, risks of infections should be weighed against effects of antibiotics such as antimicrobial resistance and developmental risks to the fetus. III. Stones & Hydronephrosis Overall risk of stones in pregnancy is similar to non-pregnant women. Additional risk factors (increased filtered loads of Ca, Na, and uric acid) are balanced by factors that decrease risk (forced diuresis, increased excretion of citrate, Mg, and glycoproteins). The usual evaluation of nephrolithiasis is complicated by physiologic changes in the urinary tract as 90% of pregnant women have hydronephrosis (right > left) and desire to avoid radiation to the fetus. Stones/Hydronephrosis Panelist: Karen L. Stern, MD Urinary Diversion Panelist: Melissa R. Kaufman, MD, PhD, FACS UTI Panelist: Lysanne Campeau, MDCM, PhD, FRCSC

Speaker: Alana M. Murphy, MD

Moderator: Cristiano Gomes, MD Sacral is the Target Speaker: Steven W. Siegel, MD Other Targets Speaker: Scott A. MacDiarmid, MD Just think of the number of patients we see each and every day with overactive bladder and who do not reach their treatment goal in spite of us trying a number of medications and behavioral interventions. And to make the problem worse, the penetrance of our thirdline therapies in patients with refractory OAB (ROAB) is less than 5%. Dr. Siegel will highlight the benefits of sacral nerve stimulation for the management of this difficult population of patients. I will shine the light on neuromodulation directed towards ‘other targets’ concentrating on the tibial and saphenous nerve. I will briefly remind us of the excellent efficacy and safety of percutaneous tibial nerve stimulation (PTNS) advancing us one step closer to neuromodulation for the masses. I will introduce a subcutaneously implanted coin-sized tibial nerve stimulator (eCoin), an exciting new office-based implant currently under investigation. Transcutaneous electrical stimulation of the saphenous nerve will also be noted. Our goal is to highlight therapies and to energize the audience in pursuing excellence in the management of the overactive bladder patient. Steve plays tennis, I’m hockey. Not a fair fight but welcome to our program. Cheers.

Check out this replay from the SUFU 2020 Winter meeting on Amplifying your Digital Footprint. Featuring Dr. Seth Cohen, Dr. Yahir Santiago Lastra, Dr. Nitya Abraham, and Dr. Rena Malik discussing using social media for your clinical practice, managing your online reputation and visual abstracts Find out more about us at: On twitter: @YSL_MD, @RenaMalikMD, @NityaAbraham @DrSCohen On Instagram: @RenaMalikMD, @the_neuro_urologist

Learn about the FPMRS fellowship opportunity at the Memorial Sloan Kettering Cancer Center featuring Dr. Jaspreet Sandhu. Learn more here: https://sufuorg.com/fellowships/non-accredited/memorial-sloan-kettering-cancer-center.aspx Interview by Dr. Rena Malik (@RenaMalikMD)

Learn about the FPMRS fellowship at Oakland University William Beaumont Hospital with Dr. Larry Sirls https://www.beaumont.edu/graduate-medical-education/fellowship-programs/female-pelvic-medicine-reconstructive-surgery/female-pelvic-medicine-and-reconstructive-surgery-royal-oak nterview by Dr. Rena Malik (twitter: @RenaMalikMD)

This special member spotlight features Dr. Gregory Bales, professor at University of Chicago Medicine and mentor to countless urology residents, many of whom have gone on to pursue fellowship in reconstructive urology. What's his secret? Find out what he has to say while he gets interviewed by two of his own past residents - Dr. Fenwa Milhouse and Dr. Rena Malik Find out more about him at: https://www.uchicagomedicine.org/find-a-physician/physician/gregory-bales Dr. Malik & Dr. Milhouse on twitter as: @RenaMalikMD, @FMilhouseMD and instagram: @RenaMalikMD @DrMilhouse

Learn about the FPMRS fellowship at Minnesota Urology with Dr. Steven Siegel, MD and Dr. Michael Ehlert, MD Interview by Dr. Una Lee (twitter: @DrUnaLee https://mnurology.com/about-us/fellowship-program/

Check out this FPMS fellowship spotlight on Stanford featuring Dr. Craig Comiter, interviewed by Dr. Una Lee. Find out more about the program here: You can find out more about the speakers on twitter: @DrUnaLee & @CraigComiter

Join us for part 3 of our healthcare disparities podcast series featuring Dr. Fenwa Milhouse, Dr. Yahir Santiago Lastra & Dr. Rena Malik discussing how to increase the diversity in urology. Find out the current status of diversity in urology, benefits of urology in the workplace, managing implicit bias and microaggressions and much more. Find out more about us on: https://www.renamalikmd.com https://www.dupagemedicalgroup.com/our-physicians/fenwa-milhouse/ https://providers.ucsd.edu/details/32623/yahir-santiago-lastra-surgery-urology-la_jolla-san_diego= And on twitter as: @YSL_MD, @RenaMalikMD, @FMilhouseMD and on instagram as: @the_neuro_urologist, @RenaMalikMD @DrMilhouse

Join Dr. Yahir Santiago Lastra, Dr. Fenwa Milhouse and Dr. Rena Malik for our second episode of the health disparities series. In this episode we focus on the challenges and disparities in the care of the hispanic population. What are the barriers in offering equal and fair care to this patient population and how can we do better? Find out that and much more. Find out more about us on: https://www.renamalikmd.com https://www.dupagemedicalgroup.com/our-physicians/fenwa-milhouse/ https://providers.ucsd.edu/details/32623/yahir-santiago-lastra-surgery-urology-la_jolla-san_diego= And on twitter as: @YSL_MD, @RenaMalikMD, @FMilhouseMD and on instagram as: @the_neuro_urologist, @RenaMalikMD @DrMilhouse