Podcasts about urinary

Send us Fan MailIs five days of antibiotics enough to treat a urinary tract infection in a NICU infant? In this Journal Club episode, Ben and Daphna review a single-center study from Nationwide Children's Hospital examining adherence and safety of a five-day antibiotic treatment guideline for culture and urinalysis-proven UTIs in the NICU. Among 77 infants with 93 bacterial UTIs, the five-day course was associated with a 1% failure rate, defined as reinitiation of antibiotics within seven days for the same organism. The episode also explores the potential role of enteral antibiotic therapy and what shorter treatment courses could mean for babies still weeks away from discharge.----Urinary tract infection in the neonatal intensive care unit. Magers J, Burton A, Prusakov P, White NO, Miller RR, Moraille R, Theile AR, Sánchez PJ; Nationwide Children's Hospital Neonatal Antimicrobial Stewardship Program (NEO-ASP).J Perinatol. 2026 May;46(5):754-760. doi: 10.1038/s41372-026-02690-1. Epub 2026 Apr 29.PMID: 42056240 Free PMC article.Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below.Enjoy!

Are we prescribing medications for FIC that lack meaningful evidence? Dr. Serge Chalhoub, a board-certified small animal internal medicine specialist and Professor at the University of Calgary's Faculty of Veterinary Medicine, joins the Purr Podcast to discuss best practices in feline urinary disease management. His clinical and research interests focus on nephrology, urology, point-of-care ultrasound, and minimally invasive procedures. What should be first-line therapy for cats with lower urinary tract disease?Thanks for tuning in to the Purr Podcast with Dr. Susan and Dr. Jolle!If you enjoyed today's episode, don't forget to subscribe, rate, and leave us a review—it really helps other cat lovers and vet nerds find the show. Follow us on social media for behind-the-scenes stories, cat trivia, and the occasional bad pun. And remember: every day is better with cats, curiosity, and maybe just a little purring in the background. Until next time—stay curious, stay kind, and give your cats an extra chin scratch from us. The Purr Podcast – where feline medicine meets feline fun.

Are we giving cats medications that don't actually help? Dr. Serge Chalhoub, a veterinary kidney and bladder specialist at the University of Calgary, joins the Purr Podcast to talk about the best ways to care for cats with urinary problems. He has a special interest in how cats' kidneys and bladders work, and in using bedside ultrasound -- think instant imaging right there in the exam room -- to get faster, clearer answers without putting cats through unnecessary procedures. Tune in to find out what really works -- and what might be nothing more than habit -- when your cat is having trouble in the litter box.

Learn more about Parkinson's and find support: https://dpf.org In part three of this three-part series on Parkinson's and the senses, the panel covers vision changes like difficulty driving at night, light sensitivity, depth perception, and how DBS adjustments can affect focus. They also discuss vertigo, dizziness, and the urinary urgency that many people with Parkinson's experience but rarely talk about, including practical strategies like pre-boarding flights and planning bathroom access. Sign up for updates on webinars, events, and resources for the Parkinson's community: https://dpf.org/newsletter-signup  Season 7 Episode 8 Davis Phinney Foundation, Copyright 2026

Welcome to episode two of The Women's Health Wellness Edit — a brand new Slightly Spiritual mini series bringing you real, honest conversations with some of the top experts in women's health, longevity, hormones, brain health, and modern wellness. Because frankly? Too many women are being told their exhaustion, brain fog, anxiety, inflammation, and burnout are “normal” — and we think it's time for a deeper conversation. In today's episode, we sit down with Ariana Thacker, founder and CEO of MoldCo, for one of our most requested conversations yet: mold illness, mold exposure, mycotoxins, CIRS, and the hidden ways our environments can impact our health. Ariana shares her personal journey with mold illness and how it ultimately led her to build MoldCo, a healthcare technology platform dedicated to helping patients identify and navigate mold toxicity. Together, we dive into why so many people, especially women and children, are experiencing chronic symptoms while being told their labs look “normal,” and why mold illness is still so misunderstood in modern medicine. We discuss the difference between mold allergy and mold illness, common mold symptoms, symptoms of mold allergies, what mycotoxins actually are, and how mold exposure can impact everything from brain fog and fatigue to anxiety and inflammation. Ariana also explains how everyone in the same household can present completely differently, how does black mold affect you, and whether mold is dangerous for long-term health. Ariana breaks down colonized mold, the genetic component that can make some people more susceptible to mold illness, and why mold is often referred to as “the great mimicker.” This episode also covers: * Symptoms of mold allergies and how they differ from mold toxicity * Mold illness in children * Proper home testing and why air sampling alone often misses the full picture * Signs mold may be hiding in your home * Urinary mycotoxin testing and key biomarkers for mold illness * The Shoemaker Protocol and Dr. Shoemaker's work * Mold remediation tips and what to look for in a remediator * How to reduce mold exposure while traveling or living in a moldy environment * The truth about “black mold” vs. other toxic molds * Is mold dangerous? Understanding risk factors and susceptibility Whether you're actively navigating mold illness, questioning unexplained symptoms, researching mold exposure, or simply wanting to better protect your family's health, this episode is packed with practical information, validation, and actionable advice. As always, this episode is not intended to replace medical advice, diagnosis, or treatment. Please consult your healthcare provider regarding your individual health concerns. Keep in touch with Ariana: Website: https://www.moldco.com/ Testing: https://www.moldco.com/products YouTube: https://www.youtube.com/@themoldcompany Free Questionnaire: https://access.moldco.com/signs MoldCo LinkedIn: https://www.linkedin.com/company/moldco/ Ariana's LinkedIn: https://www.linkedin.com/in/arianadthacker/ Instagram: https://www.instagram.com/themoldcompany/ Ariana's X: https://x.com/m0ldilocks MoldCo's X: https://x.com/themoldcompany A gift from Ariana: use code MOLDTEST10 for 10% off MoldCo's home dust test If this episode spoke to you, subscribe and leave a review on your favorite podcast platform or share it with a friend! podcasts.apple.com/us/podcast/slig…od/id1542525641 Follow us on Instagram: www.instagram.com/slightlyspiritualpod/ Follow Cindy on Instagram: www.instagram.com/revealingsoul/ Follow Ali on Instagram: www.instagram.com/alitmoresco/

Something feels off even when tests come back normal. Discover the hidden signs of PANS/PANDAS every parent misses as Dr. Nancy O'Hara unpacks sudden symptoms often mistaken for ADHD, anxiety, or autism. Dr. Roseann Capanna-Hodge, expert in Regulation First Parenting™, guides parents through emotional dysregulation and what to do next.Parents often know something is wrong—even when tests come back “normal.” In this powerful conversation with Dr. Nancy O'Hara, we explore the hidden signs of PANS/PANDAS every parent misses, and why so many children are misdiagnosed with ADHD, anxiety, or even autism.The truth? Sudden behavioral shifts, OCD, and physical symptoms may signal immune-driven brain inflammation—not “just behavior.” In this episode, you'll learn what PANS/PANDAS really is, how it affects the brain, and the overlooked signs parents and providers often miss. Why did my child suddenly change behavior overnight?When a child shifts abruptly—from calm to anxious, obsessive, or emotionally reactive—it can feel confusing and scary for parents.Dr. O'Hara explains that this sudden onset is a key marker of PANS/PANDAS, often triggered by infection or immune dysregulation.What parents should know:Sudden onset matters—changes can happen within days to weeksOCD, anxiety, or eating changes may appear quicklyIt's not bad parenting—it's a dysregulated immune responseTriggers may include strep, viruses, mold, or environmental stressorsReal-Life Example: A child who was once easygoing suddenly develops intense fears, refuses foods, or becomes highly anxious after an illness.As I always remind parents, behavior is communication—and sudden shifts deserve deeper investigation.Is OCD in kids always obvious—or can it be hidden?One of the most missed signs of PANS/PANDAS is hidden OCD, especially intrusive thoughts that don't look like typical compulsions.Dr. O'Hara emphasizes that many children suffer silently.Hidden OCD signs include:Intrusive, scary thoughts they can't explainWithdrawal, shutdown, or emotional overwhelmAvoidance of situations without clear reasonShame or embarrassment about thoughtsA child seems “anxious about everything,” but underneath is a looping fear they can't verbalize.This is where misdiagnosis often happens. It may look like generalized anxiety or even ADHD—but it's actually neurological inflammation affecting the brain's fear circuits.Let's be clear: your child is not choosing this. Their brain is overwhelmed.Why are medical tests normal if my child is struggling so much?This is one of the most frustrating experiences for parents—being told everything is “fine” when it clearly isn't.Dr. O'Hara explains that PANS/PANDAS is primarily a clinical diagnosis, not a lab-based one.Key insights:Bloodwork can look completely normalSome children cannot mount detectable immune responsesInflammation may still be present in the brainDiagnosis relies heavily on pattern recognition + historyReal-Life Example: A child with severe behavioral changes has “normal labs,” leading families to feel dismissed—despite clear real-world impairment.This is where validation matters. You're not imagining it.You don't have to figure this out alone.Become a Dysregulation Insider VIP and get your FREE Regulation Rescue Kit:How to Stay Calm When Your Child Pushes Your Buttons and Stop Oppositional Behaviors.Head to www.drroseann.com/newsletter and start your calm parenting journey today.What physical symptoms are easy to miss in PANS/PANDAS?Parents often focus on behavior and miss the body-based clues.Dr. O'Hara highlights that somatic symptoms are frequently overlooked—but incredibly important.Common missed signs:Urinary frequency or urgencyBedwetting after being drySleep disturbances or restless sleepHandwriting changes or regressionSensory overload or motor changesReal-Life Example: A child begins waking frequently at night and having bathroom accidents alongside new anxiety.These symptoms reflect nervous system dysregulation—not defiance or regression without cause.

Therapeutic Guidelines expert group member Lee Fong returns to the podcast to talk to Justin Coleman about the brand-new Kidney and Urinary guidelines. Focusing on GP management, the conversation covers some of the new content, including screening and medication regimens for chronic kidney disease, lower urinary tract symptoms, wetting in children and much more.

Host: Charles Turck, PharmD, BCPS, BCCCP Guest: Petros Grivas, MD, PhD Could emerging biomarkers redefine how we assess response and recurrence risk in muscle-invasive bladder cancer? To find out, Dr. Charles Turck speaks with Dr. Petros Grivas about the key findings from the phase 3 NIAGARA trial. Together, they explore how perioperative durvalumab impacts circulating tumor DNA (ctDNA) clearance and clinical outcomes, including event-free and overall survival. Their conversation also highlights the prognostic value of ctDNA and the potential for urinary tumor DNA to more closely correlate with pathologic complete response. Dr. Grivas is a Professor in the Division of Hematology and Oncology at the University of Washington School of Medicine, as well as the Clinical Research Division at the Fred Hutchinson Cancer Center, where he's also the Medical Director of the International Program and of local and regional outreach.

What if chronic illness was a path towards healing on levels greater than just physical? In this episode of Metabolic Matters, host Christina Mason sits down with Alekha Akkappedi and her longtime best friend, Emily Sullivan, for a powerful, multi-dimensional healing journey. At just 22 years old, pre-med student Alekha's life changed overnight. What began as a simple infection quickly spiraled into a complex web of chronic conditions: POTS, mast cell activation, PCOS, GERD, and connective tissue disease. Left bedridden, her science trained mind begins seeking answers. As she begins to experience healing in modalities outside of her allopathic education, she finds herself asking more questions and embarks on an unexpected career path. Alekha navigates years of uncertainty, traveling on paths that blend science, circadian biology, nutrition, and spiritual practices. Emily shares what it was like to watch her best friend's struggles and triumphs. Her perspective offers insight on the power of friendship and how watching another make healing choices vicariously heals those in close proximity. Alekha and Emily both experience healing as cyclical on many levels. Both agree that HOPE is one of the greatest healers. What unfolds for these two young sages is not just a story of physical recovery but transformation that is intangible, emotional and physical.After almost a decade of research and healing work, Alekha created the ALI Protocol, a comprehensive approach for those dealing with POTS, MCAS and long covid that integrates biology, psychology and energetic practices.

A big paper was published in the Lancet last month that has been circulating in the media with some PRETTY egregious headlines suggesting water isn't that important for kidney stones. Melanie dives into what this paper actually found and helps us understand WHY drinking water remains KEY to kidney stone prevention. Melanie's response on social media to doctors misrepresenting this research Desai AC, Maalouf NM, Harper JD, et al. Prevention of urinary stones with hydration: a randomised clinical trial of an adherence intervention. The Lancet. 2026;407(10534):1171-1181. Borghi L, Meschi T, Amato F, Briganti A, Novarini A, Giannini A. Urinary volume, water and recurrences in idiopathic calcium nephrolithiasis: a 5-year randomized prospective study. J Urol. 1996;155(3):839-843.   Submit a question for Melanie to answer on the podcast! Connect with The Kidney Dietitian! Work with Us! |  Instagram | Facebook | Pinterest | Facebook Group | Newsletter www.thekidneydietitian.org FREE Webinar: The 3-Step Method to Prevent Kidney Stones All information in this podcast is meant for educational purposes only and should not be used in place of advice from a medical professional.

In episode 108 of the medical nursing podcast, we're looking at a set of diseases we see all too often - feline lower urinary tract diseases. Now I say diseases, plural, deliberately - because thinking of FLUTD as a spectrum of diseases, rather than a standalone condition itself, is one of the most important shifts we can make in how we approach it.  I'm going to be bringing you the need-to-know information from the 2025 iCatCare consensus guidelines on the diagnosis and management of lower urinary tract diseases in cats, AND some really useful information from the 2024 AAFP intercat tension guidelines, because as you'll see, the two are far more connected than you might expect. Over the next half an hour or so, we'll discuss how and why FLUTD occurs, how to stabilise and support obstructed patients, how to nurse cats with lower urinary disease, and how we can do more to support these patients long-term, both in and out of the hospital. There's far more we can do with these patients than we might think, and by the end of this episode, you'll feel more confident managing these patients, and able to put more of your skills to use. iCatCare Lower Urinary Disease Guidelines:

Ingenion Medical, run by our guest Ed Cappabianca, is going to change the standard catheter in the UK - The Foley catheter. Urinary catheter-associated infections kill 2,100 people a year and block 1.2 million hospital bed-days. And yet, the Foley catheter - the standard of care - has barely changed in 91 years. Ingenion Medical has built what replaces it.The cymactive™ 2.0R is a CE-marked, patient-controlled urethral catheter with a patented magnetic valve that is already in clinical use across the UK and 15 international markets. It is superior to either standard Foleys or intermittent catheters, and generates revenue today. Ingenion Medical are seeking investors. Here's the Investment case:• Revenue generative, regulatory approved. CE Mark achieved Q1 2024. ISO 13485 renewed October 2025. FDA pre-sub meeting completed.• Commercial traction. Distributor agreements in over 10 countries. NHS Supply Chain at contract award stage. 15 NHS hospitals active or in pipeline.• Profitable at 1,600 patients per month (80 urologists x 20 patients). Breakeven H2 2027. £49m revenue projected 2030.• Exit precedent. Comparable urology acquisitions: Urotronic > Laborie $600m;Neotract > Teleflex $1.1b; Augmenix > Boston Scientific $600m; .• World-class advisors. Advisory board includes: Professor Chris Chapple (former European Association of Urology Secretary General) and Professor Kurt Naber, global authority on urinary tract infections.If you would like the detailed Investor Pitch Deck, go to: ingenion.approvedinvestors.co.ukSummary of PodcastKey TakeawaysThe Problem: Current catheters cause frequent, costly infections (£2k–£3.5k per cycle for the NHS) and severely limit patient mobility and quality of life.The Solution: Ingenion's cymactive catheter is a 30-day, self-voiding device with no external bag, restoring patient dignity and designed to reduce infection risk.Market Validation: The NHS created a new framework channel specifically for SimActive, signaling strong support for its innovation and cost-saving potential.The Ask: Ingenion is raising £2M (for ~10% equity) to fund commercialisation, targeting a future trade sale to a major urology firm for a potential 10x investor return.The Problem with Current CathetersUrinary Retention: A common condition caused by issues like BPH (enlarged prostate), Parkinson's, MS, and spinal cord injuries.Foley Catheter (Indwelling):The 100-year-old standard, anchored by an internal balloon.Creates a "superhighway for bacteria," causing frequent, costly infections.Full cost of ownership for the NHS is ~£800/month per patient.Intermittent Catheters (Single-Use):Used 5–8 times daily, creating significant waste and inconvenience.Account for 90% (£157.5M) of the NHS's £175M annual catheter spend.Patient Impact:Fear of infection and public voiding → social isolation.Reduced fluid intake → dehydration, which can worsen conditions like dementia.The cymactive SolutionInnovation: A 30-day, self-voiding catheter with no external tubes or bags.Mechanism:An internal, patient-controlled magnetic valve.An external magnet opens the valve; removing it allows the valve to close naturally.Infection Defense:The urethra seals over the valve's end, mimicking the body's natural defense against bacteria.Anecdotal evidence suggests reduced infections and restored function.Product Pipeline:Current: cymactive for male urinary retention (CE marked).In Development: Versions for women and for male incontinence.Market Validation & CommercialisationNHS Adoption:The NHS created a new framework channel for cymactive, as it didn't fit existing categories.Ingenion was the sole applicant and signed a 2-year contract on March 12, 2026.Ordering codes are now live for hospitals.Go-to-Market Strategy:Goal: Build awareness among clinicians and patient groups.Method: Target early adopters and use their case studies, shared by the NHS innovation team, to drive broader adoption.Rationale: A randomised control trial was unfeasible because Foley catheter users were unwilling to risk being randomised to the control group.Investment OpportunityThe Ask: £2M for ~10% equity (pre-money valuation: £18M).Exit Strategy: Trade sale to a major urology firm (e.g., Coloplast, Becton Dickinson).Rationale: Leverage a large firm's infrastructure for rapid, global scaling.Target Return: A typical venture capital return of ~10x investment.Investor Profile: High Net Worth (HNW) or Sophisticated Investors.Due Diligence: Pitch deck available at ingenion.approvedinvestors.co.ukThe Next 100 Days Podcast Co-HostsGraham ArrowsmithGraham founded Finely Fettled in 2014 to provide data from The UK High Net Worth Database to marketers targeting affluent and high-net-worth customers. He's the founder of MicroYES, a Partner for MeclabsAI, creating lead generation AI Agents & Workflows and introducing the MeclabsAI Platform. Graham also provides an Answer Engine Optimisation solution to get your website in shape to be found by LLMs.Kevin ApplebyKevin specialises in finance transformation and implementing business change. He's the COO of GrowCFO, which provides both community and CPD-accredited training designed to grow the next generation of finance leaders. You can find Kevin on LinkedIn and at kevinappleby.com

Update Series (2026): Perioperative Management of Urinary Diversion: What Every Urologist Should Know Host: Mark L. Gonzalgo, MD, PhD, MBA Guest: Rohit Reddy, MD Now in its 45th installment, the AUA Update Series is renowned for delivering high-quality lessons to practicing urologists, fellows and residents. All content is developed by internationally recognized experts in urology, making the AUA Update Series the most professional and sought-after self-study program available. Improve your practice and patient care by staying abreast of the latest treatments and surgical techniques in urology. For more information or to subscribe to the AUA Update Series, please visit CME.auanet.org

Urinary incontinence affects more people than you'll ever know - but that doesn't mean it has to affect YOU. Learn why bladder leakage numbers are increasing, and what you can do if this condition is limiting your lifestyle. Core Restore City: Charleston Address: 675 Saint Andrews Boulevard Website: http://www.corerestorecenters.com Phone: +1 986 267 3737 Email: ann@corerestorecenters.com

Do all those supplements claiming to be “natural Adderall” actually do anything, or are they just giving you a much-needed dose of vitamin B? That's the question we're attempting to answer as we continue down the rabbit hole of supplements and ADHD.    In an episode sponsored by the concept of multivitamins, Professor Kristin is covering the different types of vitamin B, what's happening at the molecular level, how vitamin B deficiencies impact the brain and body, and ways you can increase your intake without falling for supplement scams.    Whether you're a liver and onions type of gal, you like to graze on fistfuls of leafy greens, or you prefer to get your nutrients the old-fashioned way via vitamin gummies, increasing your vitamin B can transform your energy levels for the better, no gimmicks required.  Resources: Vitamin B-6 - ScienceDirect Attention-deficit hyperactivity disorder (ADHD) as a pyridoxine-dependent condition: Urinary diagnostic biomarkers - ScienceDirect Vitamins B9 and B12 in children with attention deficit hyperactivity disorder (ADHD): A systematic review: International Journal for Vitamin and Nutrition Research: Vol 94, No 5-6 Neurodevelopmental effects of maternal folic acid supplementation: a systematic review and meta-analysis: Critical Reviews in Food Science and Nutrition: Vol 63 , No 19 - Get Access The Impact of Maternal Folates on Brain Development and Function after Birth - PMC Prenatal Folic Acid Supplements and Offspring's Autism Spectrum Disorder: A Meta-analysis and Meta-regression - PubMed Maternal serum Vitamin B12 and offspring attention-deficit/hyperactivity disorder (ADHD) | European Child & Adolescent Psychiatry Serum Biomarker Analysis in Pediatric ADHD: Implications of Homocysteine, Vitamin B12, Vitamin D, Ferritin, and Iron Levels The Effects of Vitamin Therapy on ASD and ADHD: A Narrative Review | Bentham Science Publishers My Demoiselle crane (Karkare) (Chamkai) Konj Male calling his female

Guest Dr. John Gore and host Dr. Davide Soldato discuss JCO article, "12-Month Results from the CISTO Study Comparing Radical Cystectomy Versus Bladder-Sparing Therapy for Recurrent Non-Muscle Invasive Bladder Cancer," which compares radical cystectomy and bladder sparing therapy for patients with recurrent high-grade non-muscle invasive bladder cancer. Dr. Gore and Dr. Soldato focus on the study's patient-centered approach, eligibility criteria, and quality of life after treatment. TRANSCRIPT The disclosures for guests on this podcast can be found in the show notes. Dr. Davide Soldato: Hello and welcome to JCO After Hours, the podcast where we sit down with authors from some of the latest articles published in the Journal of Clinical Oncology. I am your host, Dr. Davide Soldato, medical oncologist at Ospedale San Martino in Genoa, Italy. Today, we are joined by JCO author Dr. John Gore, urologist at Fred Hutch Cancer Center and professor of urology at University of Washington School of Medicine. Today, we will be discussing the article titled, "Twelve-Month Results From the CISTO Study Comparing Radical Cystectomy Versus Bladder-Sparing Therapy for Recurrent High-Grade Non-Muscle-Invasive Bladder Cancer." Thank you for speaking with us, Dr. Gore. Dr. John Gore: Thank you so much for having me. Dr. Davide Soldato: So, I just want to jump right in. We know that patients who are diagnosed with recurrent high-grade non-muscle-invasive bladder cancer can be treated with two different approaches. So, one is radical cystectomy, and the other is bladder-sparing therapy. I just wanted to understand: what was the gap that you were trying to fill with this study? In particular, one point that is very important is that this study is very centered on the preference of the patients. Why did you choose this endpoint instead of going for more solid oncology-based endpoints? Dr. John Gore: Yeah, so CISTO was a study that was derived really organically from patient engagement. I think as a clinical gap in care, making a decision about when to pursue radical cystectomy for patients with non-muscle-invasive bladder cancer is a tough decision for us as clinicians. We did some engagement work partnered with the Bladder Cancer Advocacy Network and my partner Angela Smith, and found that it is also a huge gap for patients. You know, they are very anxious about recurrences, and the decision about when to take out the bladder is a very difficult one. We did an evidence synthesis and found that evidence guiding this decision is fairly limited. The reason we chose more of a patient-reported endpoint is several-fold. One is that we, as part of our engagement work, also worked with our patient survey network to identify outcomes that were important to patients. Some of those are the same outcomes that we care about as clinicians - recurrence-free survival and metastasis-free survival - but several outcomes came out that were more patient-centered. These were patient-reported outcomes such as the burden on my finances, the burden on my caregiver or loved one, and the ability to return to physical activities that are important to them. Part of what is unique about CISTO is that this was a contract with PCORI where we knew we would only have about 12-month outcomes for the majority of our patients. That is too early to really derive a lot of the clinical outcomes, but we are able to answer that patient-centered question of, "Am I going to be able to return to physical activities that are important to me?" And that was the genesis of that as the primary endpoint. Dr. Davide Soldato: So, who were the patients that were eligible to participate in the CISTO trial? What were the key eligibility criteria? This is very particular to this study because this was actually an observational study. Why did you think that such a pragmatic approach still can inform us on what is the best treatment approach for these patients? Dr. John Gore: The intent of CISTO was not necessarily to focus on the tightly defined BCG-unresponsive patient population. That is a clearly important patient population, but every day we are all faced in our real-world practice with patients with challenging, high-grade recurrences that don't fit neatly into that BCG-unresponsive box. The reason we chose a broader inclusion was to help doctors and patients answer these same questions they have when it doesn't fit nicely into this BCG-unresponsive category. You know, maybe their BCG exposure was two years ago, but now they are having a recurrence after intravesical chemotherapy. That is no less challenging a clinical conundrum, and we wanted to be able to enroll those patients. Other key inclusions were that all of the patients in CISTO had to have BCG at some point, and they had to have recent exposure to some adjuvant instillational or intravenous therapy like pembrolizumab. We also had some exclusions that were important. They couldn't be participating in a phase 2 clinical trial, and they couldn't have had a prior upper tract urothelial cancer. The other point about the observational trial design is I think a really important one. Part of our engagement work also asked patients about their willingness to randomize. There is a ton of literature in our history of trials that failed to accrue well when they were comparing a large-scale surgical intervention with a more conservative management strategy. What we found is only about 10% of patients would be willing to randomize when the clinical comparison is between radical cystectomy and bladder-sparing therapy. So it was very clear that an observational study design was the only way we were going to get evidence to inform clinical care when one of the key comparators was radical cystectomy. And so that is why we utilized the observational trial design. Dr. Davide Soldato: Starting to go deeper into the results, you mentioned before that the endpoint you chose for this trial was really centered on what patients thought was more important to them. In particular, the primary endpoint of the study was physical function as measured by the EORTC QLQ-C30 questionnaire. I just wanted to understand: first, did you have a solid hypothesis regarding how physical function could be impacted by either radical cystectomy or bladder-sparing treatments? And second, what were the key results of the study? Dr. John Gore: We figured that at 12 months after enrollment, given the burden and morbidity of a radical cystectomy, that patients in the radical cystectomy arm would have worse self-reported physical functioning than patients in the bladder-sparing therapy arm. We did hypothesize that some of our secondary outcomes might potentially be better after radical cystectomy, such as recurrence-free survival and potentially some other cancer-specific outcomes, because it is a more definitive management strategy. For our primary endpoint, however, we hypothesized that it would be worse. What we found, and the key finding of our study, is that at 12 months after enrollment, physical functioning was not different between patients undergoing radical cystectomy and patients undergoing bladder-sparing therapy, which is just important in terms of clinical counseling because it just means that you can tell your patients, "Gosh, if we could fast-forward your life six to nine months after this procedure, your physical functioning would be similar to as if you had been able to keep your bladder." Dr. Davide Soldato: And you mentioned that there were some key secondary endpoints of the study, which included both other dimensions of quality of life and also hard clinical outcomes. We mentioned metastasis-free survival, for example. Going a little bit into the key secondary quality of life outcomes, we know that radical cystectomy can impact physical functioning, but we also know that bowel, sexual symptoms, and also genitourinary symptoms might potentially be impacted by this type of treatment. We also know that, especially in a system like the US, financial toxicity can be a significant burden for patients. Considering the two different approaches, was radical cystectomy better also in other key secondary quality of life outcomes, and was financial toxicity different between the two arms? Dr. John Gore: Thank you for highlighting some of the really important secondary outcomes that I think are really important to trying to figure out what's best for your patients. Some of the main ones were some of the bladder cancer-specific quality of life outcomes you highlight. Urinary quality of life was worse at enrollment in patients in the radical cystectomy arm but was no different 12 months after. What is unique about how we measure that is we used an instrument called the Bladder Cancer Index because we're comparing a population of patients who have lost their bladder with a population of patients who have retained their bladder, and there are different considerations by gender. And so that instrument is agnostic to urinary diversion status and gender. We found that bowel function and sexual function were worse in the radical cystectomy arm. It appeared that bowel functioning was getting better to the point of near equivalence at 12 months in the radical cystectomy arm but was still inferior to bladder-sparing therapy, and that probably relates to the fact that we use the bowel as part of the urinary diversion, and that causes some transient disruption in bowel function. Financial toxicity is an outcome we weren't initially planning on having as part of the CISTO study, but based on that patient feedback, we made that one of our key secondary outcomes. That actually demonstrated superiority in the radical cystectomy arm. I think it's important that we remember that when we do bladder-sparing therapy, those patients are predisposed to a number of visits to our office, whether they're for instillational therapies or cystoscopy surveillance visits. Sometimes that involves the patient themselves, and sometimes that involves a caregiver. We live in an area with a very large geographic catchment, so sometimes that involves overnight hotel stays and airfare. It can be a particular burden, as you made mention, especially in our healthcare system. Dr. Davide Soldato: Going back to the quality of life dimensions and especially considering the different treatments, 50% of the patients received radical cystectomy with robotic surgery. Did you look a little bit into whether the type of surgery that they received might potentially impact on these dimensions of quality of life? Dr. John Gore: These are some questions that a lot of urologists have asked us in the surgical arm, related to surgical approach, so robotic versus open, and urinary diversion type. We sometimes reconstruct the urinary tract with an incontinent diversion called an ileal conduit where the urine drains tonically into a bag, and we sometimes do a continent diversion where someone typically will have a neobladder, where you reconstruct a sphere reservoir out of intestines and sew it to the urethra. About 20% of patients in the radical cystectomy arm in CISTO had a neobladder. We have not yet looked at specific surgical factors and some of those outcomes. That is one of the secondary analyses that we have planned, but we have not drilled into how different surgical approach factors can affect some of our outcomes. Fortunately, we have about 200 patients in the radical cystectomy arm, so it's enough patients that hopefully we can look at some of those factors in the future. Dr. Davide Soldato: Going back to the clinical endpoints, you mentioned that several of these were measured. There was metastasis-free survival, cancer-specific survival, and progression-free survival. We now have the data at 12 months. I am just wondering if you can comment on those when comparing the radical cystectomy with the bladder-sparing techniques. Dr. John Gore: I think importantly, bladder cancer-specific survival was very high in both arms, over 95% at one year. So both patient populations do very well in terms of cancer-specific and overall survival at one year. You know, when you take out the bladder, you're taking out a big source of recurrences. Not surprisingly, there was a marked reduction in recurrences in the radical cystectomy arm, so they had better recurrence-free survival. There actually was worse progression-free survival in the radical cystectomy arm, but there is a big asterisk to that. As you noted, it is an observational study, and one of the areas of imbalance in the study is that we had higher cancer severity in the radical cystectomy arm. So there was about a 20% rate of progression at the time of radical cystectomy to muscle-invasive and node-positive disease. Of those progressions, the overwhelming majority of them were progressions at the time of radical cystectomy, which I think speaks to a couple of important factors. Number one is the challenge in staging these patients. Our staging of non-muscle-invasive bladder cancer is very reliant on our resection. And so there is this risk of understaging our patients. Number two is just the challenge of decision making, that we fear losing our window of cure in this patient population, which is why we try to steer some patients toward radical cystectomy, and that progression figure kind of speaks to that. Dr. Davide Soldato: Also, one of the factors that was most common in the patients who received radical cystectomy was the presence of other high-risk features. For example, non-urothelial histology, which I think is something that in clinical practice we tend to fear a little bit in terms of recurrence, and so it might potentially bias a little bit towards proposing more strongly radical cystectomy to the patient. Another thing that I wanted to have a comment on, so this is not really in the paper, but I think it speaks a little bit to how the data will evolve over time. Do you imagine these clinical outcomes changing over time, and do you think that with higher maturity of these endpoints, this study might be even more informative when counseling patients regarding what they are obtaining with a radical cystectomy versus the other type of treatments? Dr. John Gore: You know, I think in this cancer universe, 12-month outcomes are great, but I think we all want to see two-year and five-year outcomes. We're very fortunate to supplement the work that we've done in the initial CISTO study, we're very fortunate that we've gotten supplementary funding from the National Cancer Institute to get long-term outcomes in this patient population. So we are continuing to follow all of our CISTO study patients to get two-year and five-year outcomes. What we expect to find is the accrual of new events in the bladder-sparing therapy arm. About 7% of patients in the bladder-sparing therapy arm underwent cystectomy in the first year, but that number will probably go up either as they have recurrences or progression events. We definitely expect the recurrence-free survival to continue to have superiority in the cystectomy arm, but we probably will see the progression events equilibrate as more progression events accrue in the bladder-sparing therapy arm. Maybe by five years, we hypothesize that we'll see clinical superiority in the radical cystectomy arm. By then, we might also see mortality events that separate bladder cancer-specific survival and overall survival between the two arms potentially. But we don't know. Hypothetically, cystectomy has its own downstream risks. It is a major reconstruction with some metabolic sequelae and renal functional sequelae, and so there may be some general medical events that accrue in the cystectomy arm that are also impactful. Dr. Davide Soldato: One other thing that I think should be complimented on this study is that you also looked at several other endpoints that might be important for patients. For example, anxiety symptoms and depression symptoms. Dr. John Gore: Yeah, I think one of the other key secondary outcomes we looked at were mental health outcomes. We utilized the PROMIS domains of anxiety and depression. Not unexpectedly, our radical cystectomy arm patients exhibited higher anxiety symptoms and higher depression symptoms at enrollment. What we found is at 12 months, they actually had significantly lower anxiety and depression than patients in the bladder-sparing therapy arm. We hypothesized in this paper that that actually relates probably mostly to cancer-specific anxiety. You know, when you experience this cavalcade of recurrences, it just breeds an anxiety about adverse cancer-specific outcomes, and by taking out the bladder, you kind of eliminate this prevalent source of anxiety. We followed up the study with a qualitative piece where we interviewed 50 patients and 20 caregivers. Based on those interviews, and that's just a sample of the patient population, it did seem to be cancer-specific anxiety that was driving a lot of those responses. Dr. Davide Soldato: I would like to end with a methodological consideration on your part because we said that this was an observational study. Frequently we tend to think that observational studies come with a lot of bias, and so we tend to downgrade a little bit the results. But I think that a lot of the merit that goes in the CISTO study that was published in the JCO, and I think it also speaks to the fact that this is very high-quality data, comes with the fact that the methodology behind this study was really robust in terms of informing us. Even with this observational study that, as you said, was the only one that we could perform considering the patient population. So just a comment on your part also to speak to the solidity of the data that was published. Dr. John Gore: Importantly, you know, if you look at ClinicalTrials.gov or other sources, CISTO is the only trial that has radical cystectomy as a major comparator. In many ways, this study is our only source of evidence for radical cystectomy. So we'd rather have flawed observational evidence than no evidence at all. We all experience flaws of our RCTs as well. They tend to be these narrowly defined patient populations that may not match the patient in front of you. So I think there are unrecognized flaws on the other side as well. The way that we try to counterbalance that, and none of these techniques are perfect, but we used a strategy called 'targeted maximum likelihood estimation'. Like many methods, such as propensity scores or instrumental variable analysis, what we're trying to do theoretically is coax randomization from non-randomized data. And TMLE, which is the technique we use, tends to be pretty robust to that. So it's the best available way that we can try to counterbalance the bias based on age and clinical severity between the two patient arms. I also think what's important about this is that even when there are biases, I think we are able to infer those out and still extract meaningful details from the data. So even with the biased data, I think we all glean some really important clinical learnings from it. Dr. Davide Soldato: Absolutely, but I would also say that in terms of observational data, the work that you have done is really something that makes us quite confident about what you found in the CISTO study. So with this, I would like to thank you again for joining us today. Dr. John Gore: Thank you so much, and thank you for highlighting the CISTO study. We are very excited about the data. Dr. Davide Soldato: So Dr. Gore, we appreciate you sharing more on your JCO article titled, "Twelve-Month Results From the CISTO Study Comparing Radical Cystectomy Versus Bladder-Sparing Therapy for Recurrent High-Grade Non-Muscle-Invasive Bladder Cancer." If you enjoy our show, please leave us a rating and review and be sure to come back for another episode. You can find all ASCO shows at asco.org/podcasts. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Guest Disclosure Dr. Gore:Consulting or Advisory Role: Astellas Pharma  

Rich — a leukemia survivor, nurse practitioner, and longtime oncology clinician — to talk about what it's really like to survive cancer, rebuild your life after treatment, and live with long-term side effects.Rich was diagnosed with leukemia at age 28, underwent an allogeneic stem cell transplant at Dana-Farber / Brigham and Women's, and is now a 29-year survivor. His experience as both a patient and provider offers a rare, honest look at cancer survivorship, prostate cancer side effects, sexual health, mental health, and post-traumatic growth.In this conversation, we cover:What it's like to be told you have leukemia in your 20sStem cell transplant and long-term survivalTurning cancer into purpose and becoming an oncology NPCommon prostate cancer side effects (urination, bowel changes, erectile dysfunction)How doctors actually manage these symptomsSexual health after cancer treatmentMental health, grief, and post-traumatic growthHow to rebuild your life after active treatmentThis episode is for patients, survivors, caregivers, and anyone navigating life after a cancer diagnosis.

Update Series (2026) Lesson 5: Long-term Urinary Catheters: Their Role & Management of Complications Now in its 45th installment, the AUA Update Series is renowned for delivering high-quality lessons to practicing urologists, fellows and residents. All content is developed by internationally recognized experts in urology, making the AUA Update Series the most professional and sought-after self-study program available. Improve your practice and patient care by staying abreast of the latest treatments and surgical techniques in urology. For more information or to subscribe to the AUA Update Series, please visit https://cme.auanet.org/URL/US2026

The EV-303 trial that led to the FDA approval of perioperative enfortumab vedotin + pembrolizumab in cisplatin-ineligible bladder cancer patients in now published in NEJM. We discuss the results and ponder potential future changes to treating bladder cancer in the future. Urinary diversion surgeries: https://jamanetwork.com/journals/jamaoncology/fullarticle/2842595

Join the Buff Muff Community and stop letting your bladder run your life!  https://get.buffmuff.com/methodSupport your pelvic and whole body health with Rejeuve https://rejeuve.com/Rejuve is a line of pelvic health and whole body health supporting supplements that are helping women have a daily poogasm, eliminate leaks and prolapse symptoms, and keep their vulvovaginal tissues supple and resilient. Get your Rejeuve Supplements https://rejeuve.com/ and use code Podcast to save 10% off your first order.Thank you so much for listening! I use fitness and movement to help women prevent and overcome pelvic floor challenges like incontinence and organ prolapse. There is help for women in all life stages! Every Woman Needs A Vagina Coach! Please make sure to LEAVE A REVIEW and SUBSCRIBE to the show for the best fitness and wellness advice south of your belly button. *******************I recommend checking out my comprehensive pelvic health education and fitness programs on my Buff Muff AppYou can also join my next 28 Day Buff Muff Challenge https://www.vaginacoach.com/buffmuffIf you are feeling social you can connect with me… On Facebook https://www.facebook.com/VagCoachOn Instagram https://www.instagram.com/vaginacoach/On Twitter https://twitter.com/VaginaCoachOn The Web www.vaginacoach.comGet your Feel Amazing Vaginal Moisturizer Here

Urinary tract infections are one of the most common reasons people with dementia end up in the emergency room. In this video, I talk with Dr. Krieger, an emergency room physician, about why UTIs often look different in dementia and why sudden changes should not automatically be blamed on dementia progression. Dr. Krieger is also the creator of Uraguard, a product designed to help reduce bacterial exposure around the urethra for women with incontinence. We talk about where tools like this may fit into UTI prevention, along with other practical strategies caregivers can use. Learn more about Uraguard here: https://tinyurl.com/uraguard-careblazers-yt

The first women's public toilets in London opened on Bedford St on 11th February, 1852 - attempting to capitalize on the success of George Jennings' ‘monkey closets', used by over 800,000 visitors to the 1851 Great Exhibition. Unfortunately, even though the facility had been fought for by campaigning women's sanitary organizations, middle and upper class Victorian ladies were not yet prepared to pee in public - and the toilets closed a year later. In this episode, Arion, Rebecca and Olly explain where the phrase ‘spending a penny' (probably) comes from; reveal why ‘the urinary leash' came to describe the predicament of women's lives; and investigate why the number of 21st century public toilets continues to fall…  Further Reading: • ‘Pamphlets of the Ladies Sanitary Association' (Wellcome Collection): https://wellcomecollection.org/works?query=%22Ladies+Sanitary+Association.%22 • ‘London's long-term lav affair: A history of public toilets in the capital' (BBC News, 2022): https://www.bbc.co.uk/news/uk-england-london-59785477 • ‘Victorian realities - how did they use the toilet??!' (Prior Attire, 2016): https://www.youtube.com/watch?v=NUHeSTDv_24 Love the show? Support us!  Join 

Dr. Surell Levine graduated from Brown University with a Bachelor of Arts in 2001 and earned her Doctor of Veterinary Medicine from the University of Pennsylvania School of Veterinary Medicine in 2009. Following graduation, she completed a fellowship in Emergency and Critical Care and worked in the Emergency Room and Intensive Care Unit at Massachusetts Veterinary Referral Hospital. She is a certified veterinary medical acupuncturist and an active volunteer with the MSPCA animal shelter. She is also the inventor of the widely used Calm & Cozy Cat Wrap, a patented swaddle designed to make veterinary visits less stressful for cats. Topics covered in this episode: Preview of Dr. Surell's conference lecture on urinary sample collection and case management in house call practice Different styles of house call medicine, showing there's no single "right" way to practice Common urinary issues seen in home visits, including UTIs, cystitis Practical urine collection strategies in the home Using ultrasound as a quick in-home screening tool for urinary red flags Real-world urinalysis interpretation Balancing gold-standard preventive care with client budgets and real-life practice challenges Links & Resources: Calm & Cozy Cat Wrap: https://calmcozycat.com/  Hopkinton Home Vet https://www.hopkintonhomevet.com/  The House Call Vet Academy Resources:  Download Dr. Eve's FREE House Call & Mobile Vet Biz Plan Find out about the House Call Vet Academy online CE course Learn more about the Concierge Vet Mastermind Get your FREE Concierge Vet Starter Kit mini course Learn more about Dr. Eve Harrison Learn more about 1-to-1 coaching for current & prospective house call & mobile vets Learn more about the House Call & Mobile Vet Virtual Conference → Register TODAY for the House Call & Mobile Vet Virtual Conference, February 7th-8th, 2026!!!!!! Music:  In loving memory of Dr. Steve Weinberg.  Intro and outro guitar music was written, performed, and recorded by house call veterinarian Dr. Steve Weinberg.  This podcast is also available in video on our House Call Vet Cafe YouTube channel  P.S. Here's a special gift from me as a huge thank you for being a part of our wonderful House Call Vet Cafe podcast community! ☕️ GET 20% OFF your Four Sigmatic Mushroom Coffee when you order through this link! 4Sig truly is my favorite!!! Enjoy it in good health, my friends!

Millions of Americans are frustrated with their urinary problems. More specifically, the need to urinate multiple times a day and night and leaking urine is frustrating to many people over the age of 45. Fortunately, there have been successful advances in the herbal treatment of common urinary problems. We are excited to share these breakthroughs on the show today. Tracey Seipel, ND, is CEO and founder of Australian-based Seipel Group. Dr. Seipel is a renowned naturopathic doctor, medical herbalist, and clinical nutritionist. Dr. Seipel is also a diabetes educator, researcher, and an award-winning natural products formulator with 35 years of experience in clinical practice.She pioneered the natural urological health category receiving a Nutrition Business Journal award in 2006 for innovation. During the 1990s, Seipel was a leader in establishing standards of education for Australian naturopathic colleges and as an advisor to government boards, including developing nutritional training for Australia Medical Schools. During her research as a product formulator for nutraceutical companies, she uncovered the significant prevalence and underreporting of urinary incontinence in women and then overactive bladder and incontinence in both men and women. Together, this led to her pioneering this natural health category. Understanding the significant health impacts and seeing no other companies willing to take on the challenge of improving bladder control, Seipel developed the initial formulation.Learn more about UROXUROX StudyLearn more about Emerald Labs Bladder Health which contains the branded ingredient UROX. Listeners can save 20% OFF at Emeraldlabs.com when using the code: Forever 

本集特別邀請到 台中榮民總醫院 婦產科暨婦女泌尿專科醫師——謝筱芸醫師，一起深入探討糖尿病對女性骨盆健康的影響。許多糖尿病女性常出現頻尿、急尿、漏尿或反覆泌尿道感染，這些症狀究竟是來自血糖控制不良、神經病變，還是骨盆底功能障礙？本集從臨床實務出發，說明常見泌尿症狀的鑑別診斷重點，並分享婦女泌尿科醫師如何與骨盆復健、內科新陳代謝科及家醫科跨團隊合作，協助病患在藥物治療與生活調整之間取得平衡。節目也特別談到：雖然部分排糖藥物可能增加泌尿道感染風險，但血糖控制不良對泌尿與骨盆健康的影響更為關鍵。如何在診斷、治療與提升病患遵醫囑性之間取得臨床平衡，是照顧糖尿病女性不可忽視的一環。

Chegou o episódio escolhido por vocês! Marcela Belleza e Joanne Alves convidam Carol Millon para conversar sobe 6 clinicagens de inibidores de SGLT2, as gliflozinas:Indicações além do DMRisco de CAD euglicêmicaQuando não usar?⁠Cuidados com doença aguda (sick day) e hipovolemia⁠Cuidados pré-operatórioRisco de fratura e amputaçãoReferências:1. Bailey CJ, et al. Dapagliflozin add-on to metformin in type 2 diabetes inadequately controlled with metformin: a randomized, double-blind, placebo-controlled 102-week trial. BMC Med. 2013;11:43. Published 2013 Feb 20. doi:10.1186/1741-7015-11-432. Bersoff-Matcha SJ, et al. Fournier Gangrene Associated With Sodium-Glucose Cotransporter-2 Inhibitors: A Review of Spontaneous Postmarketing Cases. Ann Intern Med. 2019;170(11):764-769. doi:10.7326/M19-00853. Chang HY, et al. Association Between Sodium-Glucose Cotransporter 2 Inhibitors and Lower Extremity Amputation Among Patients With Type 2 Diabetes. JAMA Intern Med. 2018;178(9):1190-1198. doi:10.1001/jamainternmed.2018.3034 4. Clar C, et al. Systematic review of SGLT2 receptor inhibitors in dual or triple therapy in type 2 diabetes. BMJ Open. 2012 Oct 18;2(5):e001007. doi: 10.1136/bmjopen-2012-001007. PMID: 23087012; PMCID: PMC3488745.5. Das SR, et al. 2020 Expert Consensus Decision Pathway on Novel Therapies for Cardiovascular Risk Reduction in Patients With Type 2 Diabetes: A Report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2020 Sep 1;76(9):1117-1145. doi: 10.1016/j.jacc.2020.05.037. Epub 2020 Aug 5. PMID: 32771263; PMCID: PMC7545583. 6. Fralick M, et al. Risk of amputation with canagliflozin across categories of age and cardiovascular risk in three US nationwide databases: cohort study. BMJ. 2020;370:m2812. Published 2020 Aug 25. doi:10.1136/bmj.m28127. Li D, et al. Urinary tract and genital infections in patients with type 2 diabetes treated with sodium-glucose co-transporter 2 inhibitors: A meta-analysis of randomized controlled trials. Diabetes Obes Metab. 2017;19(3):348-355. doi:10.1111/dom.128258. Neal B, et al. Rationale, design, and baseline characteristics of the Canagliflozin Cardiovascular Assessment Study (CANVAS)--a randomized placebo-controlled trial. Am Heart J. 2013;166(2):217-223.e11. doi:10.1016/j.ahj.2013.05.0079. Nyirjesy P, et al. Evaluation of vulvovaginal symptoms and Candida colonization in women with type 2 diabetes mellitus treated with canagliflozin, a sodium glucose co-transporter 2 inhibitor. Curr Med Res Opin. 2012;28(7):1173-1178. doi:10.1185/03007995.2012.69705310. Perkovic V, et al. Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy. N Engl J Med. 2019;380(24):2295-2306. doi:10.1056/NEJMoa181174411. Rosenwasser RF, et al. SGLT-2 inhibitors and their potential in the treatment of diabetes. Diabetes Metab Syndr Obes. 2013 Nov 27;6:453-67. doi: 10.2147/DMSO.S34416. PMID: 24348059; PMCID: PMC3848644.12. Sridharan K, Sivaramakrishnan G. Risk of limb amputation and bone fractures with sodium glucose cotransporter-2 inhibitors: a network meta-analysis and meta-regression. Expert Opin Drug Saf. 2025;24(7):797-804. doi:10.1080/14740338.2024.237775513. Ueda P,  et al. Sodium glucose cotransporter 2 inhibitors and risk of serious adverse events: nationwide register based cohort study. BMJ. 2018;363:k4365. Published 2018 Nov 14. doi:10.1136/bmj.k436514. Watts NB, et al. Effects of Canagliflozin on Fracture Risk in Patients With Type 2 Diabetes Mellitus. J Clin Endocrinol Metab. 2016 Jan;101(1):157-66. doi: 10.1210/jc.2015-3167. Epub 2015 Nov 18. PMID: 26580237; PMCID: PMC4701850.15. Zhuo M, et al. Association of Sodium-Glucose Cotransporter-2 Inhibitors With Fracture Risk in Older Adults With Type 2 Diabetes. JAMA Netw Open. 2021;4(10):e2130762. Published 2021 Oct 1. doi:10.1001/jamanetworkopen.2021.3076216. Emerson Cestari Marino, Leandra Anália Freitas Negretto, Rogério Silicani Ribeiro, Denise Momesso, Alina Coutinho Rodrigues Feitosa, Marcos Tadashi Kakitani Toyoshima, Joaquim Custódio da Silva Junior, Sérgio Vencio, Marcio Weissheimer Lauria, João Roberto de Sá, Domingos A. Malerbi, Fernando Valente, Silmara A. O. Leite, Danillo Ewerton Oliveira Amaral, Gabriel Magalhães Nunes Guimarães, Plínio da Cunha Leal, Maristela Bueno Lopes, Luiz Carlos Bastos Salles, Liana Maria Torres de Araújo Azi, Amanda Gomes Fonseca, Lorena Ibiapina M. Carvalho, Francília Faloni Coelho, Bruno Halpern, Cynthia M. Valerio, Fabio R. Trujilho,  Antonio Carlos Aguiar Brandão, Ruy Lyra e Marcello Bertoluci. Rastreamento e Controle da Hiperglicemia no Perioperatório – Posicionamento Conjunto da Sociedade Brasileira de Diabetes (SBD), Sociedade Brasileira de Anestesiologia (SBA) e Associação Brasileira para o Estudo da Obesidade e Síndrome Metabólica (ABESO). Diretriz Oficial da Sociedade Brasileira de Diabetes (2025). DOI: 10.29327/5660187.2025-10 , ISBN: 978-65-5941-367-6.17. Singh LG, Ntelis S, Siddiqui T, Seliger SL, Sorkin JD, Spanakis EK. Association of Continued Use of SGLT2 Inhibitors From the Ambulatory to Inpatient Setting With Hospital Outcomes in Patients With Diabetes: A Nationwide Cohort Study. Diabetes Care. 2024;47(6):933-940. doi:10.2337/dc23-112918. Mehta PB, Robinson A, Burkhardt D, Rushakoff RJ. Inpatient Perioperative Euglycemic Diabetic Ketoacidosis Due to Sodium-Glucose Cotransporter-2 Inhibitors - Lessons From a Case Series and Strategies to Decrease Incidence. Endocr Pract. 2022;28(9):884-888. doi:10.1016/j.eprac.2022.06.00619. Umapathysivam MM, Morgan B, Inglis JM, et al. SGLT2 Inhibitor-Associated Ketoacidosis vs Type 1 Diabetes-Associated Ketoacidosis. JAMA Netw Open. 2024;7(3):e242744. Published 2024 Mar 4. doi:10.1001/jamanetworkopen.2024.274420. Fleming N, Hamblin PS, Story D, Ekinci EI. Evolving Evidence of Diabetic Ketoacidosis in Patients Taking Sodium-Glucose Cotransporter 2 Inhibitors. J Clin Endocrinol Metab. 2020;105(8):dgaa200. doi:10.1210/clinem/dgaa20021. Neuen BL, Young T, Heerspink HJL, et al. SGLT2 inhibitors for the prevention of kidney failure in patients with type 2 diabetes: a systematic review and meta-analysis. Lancet Diabetes Endocrinol. 2019;7(11):845-854. doi:10.1016/S2213-8587(19)30256-622. Braunwald E. Gliflozins in the Management of Cardiovascular Disease. N Engl J Med. 2022;386(21):2024-2034. doi:10.1056/NEJMra211501123. Zinman B, Wanner C, Lachin JM, et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. N Engl J Med. 2015;373(22):2117-2128. doi:10.1056/NEJMoa150472024. Neal B, Perkovic V, Mahaffey KW, et al. Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes. N Engl J Med. 2017;377(7):644-657. doi:10.1056/NEJMoa161192525. Wiviott SD, Raz I, Bonaca MP, et al. Dapagliflozin and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med. 2019;380(4):347-357. doi:10.1056/NEJMoa181238926. McMurray JJV, Solomon SD, Inzucchi SE, et al. Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction. N Engl J Med. 2019;381(21):1995-2008. doi:10.1056/NEJMoa191130327. Packer M, Anker SD, Butler J, et al. Cardiovascular and Renal Outcomes with Empagliflozin in Heart Failure. N Engl J Med. 2020;383(15):1413-1424. doi:10.1056/NEJMoa202219028. Anker SD, Butler J, Filippatos G, et al. Empagliflozin in Heart Failure with a Preserved Ejection Fraction. N Engl J Med. 2021;385(16):1451-1461. doi:10.1056/NEJMoa210703829. Heerspink HJL, Stefánsson BV, Correa-Rotter R, et al. Dapagliflozin in Patients with Chronic Kidney Disease. N Engl J Med. 2020;383(15):1436-1446. doi:10.1056/NEJMoa202481630. The EMPA-KIDNEY Collaborative Group, Herrington WG, Staplin N, et al. Empagliflozin in...

Fear isn't just a thought.For many women, fear is a body pattern — and it often lives in the kidneys, adrenals, pelvic floor, and urinary system.In this episode of The Sovereign Sisterhood Movement Podcast (Body Systems + Generational Healing Series), I'm breaking down — in simple language — how your urinary system is actually one of your body's main survival + safety systems.What you'll learn in this episode:-Why anxiety and chronic stress can show up as a kidney/adrenal pattern (not a “weak mindset”)-How generational trauma trains the body to stay on alert (and why it feels like you can't relax even when life is “fine”)-The urinary system basics: kidneys, bladder, urethra, pelvic floor — and what they're doing all day to keep you alive-How cortisol + adrenaline overload the system (and why dehydration can make anxiety louder)-The Root Chakra connection (safety, support, trust, survival) through trauma-informed Kundalini Yoga Therapy-The faith over fear reframe through A Course in Miracles spiritual psychotherapy: how faith can become chemical, not just spiritual-A simple, supportive kidney-nourishing practice + recipe you can start integrating right awayNow here's your Permission (because you might be in the “I didn't even know this was a thing” stage)-If you've been blaming yourself for being “too anxious,” “too tense,” or “unable to rest”…you're not broken.Your body may have been trained, for generations, to live like danger is always around the corner.And the good news is: the body can be re-educated. Safety can be rebuilt. Faith can be embodied. Your nervous system and brain can learn a new normal.Want support doing this work with structure + sisterhood?I'm Veronica Barragán, trauma-informed Kundalini Yoga Therapist and founder of The Sovereign Sisterhood Sanctuary, an online sanctuary for first-time cycle breakers healing rewiring their nervous system + brain from generationla trauma body + mind + spirit.If this episode hit home, your next step is simple:✨ Join us inside the Sanctuary (link below) and start rebuilding safety from the inside out.

Title: Comparative assessment of routine H&E and Mason's Trichrome Stain to Differentiate Normal from Infected Urinary Bladders in the Göttingen Minipig   Authors: Stephanie D. Rivera, MS, HT(ASCP); Anthony Romanello, BS; Ronnie Chamanza, BVSc, MSc, FRC Path, MRCVS, FIATP, Preclinical Sciences & Translational Safety, Johnson & Johnson Innovative Medicine, Spring House, Pa Abstract: The objective of this experiment was to evaluate the difference between normal and infected Göttingen minipig urinary bladder and determine the difficulty of microscopically evaluating infectious urinary bladder. The focus was on the histology of the tissue using routine Hematoxylin and Eosin(H&E) staining and the Masson Trichrome (MT) special stain to demonstrate the morphology of normal and infectious urinary bladder. To improve on the translation between preclinical and clinical studies, the Göttingen minipig model is appropriate to use for research for diseased human bladder treatment because the minipig anatomy and organ system are similar to humans. The procedure was designed to evaluate normal uninfected urinary bladder and bacteria infected (E. coli) urinary bladder by evaluating morphology/cellular changes associated with the resultant inflammatory response in the urinary bladder of the Ellegaard Gottingen Minipig. The H&E-stained urinary bladder tissue section and a Masson Trichrome stained urinary bladder section were used to evaluate control ‘normal' tissue vs infected tissue cellular differences. Optimal microscopic evaluation requires that the urinary bladders are properly fixed and processed. By using proper fixation and diligent histologic practices, all components of the urinary bladder are captured for proper histologic evaluation.

Send us a textIn this episode, Dr. Andrew Beverstock discusses his research on urinary sodium and its relationship with growth in preterm neonates. He shares insights into the importance of sodium for neonatal growth, the methodology of his study, and the unexpected results that challenge existing literature. The conversation also touches on his diverse medical training, mentorship experiences, and his involvement in medical education and point-of-care ultrasound (POCUS). Dr. Beverstock emphasizes the significance of careful population selection in research and outlines his future research directions. Support the showAs always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!

On this month's EM Quick Hits podcast: Deborah Schonfeld on the differential diagnosis and work up of pediatric urinary retention & acute transverse myelitis, Jesse McLaren on his Tryptic Approach to Occlusion MI Diagnosis, Matthew McArthur on recognition and management of post-dural puncture headache, Joseph Yasmeh on Med Mal Cases: Clenched fist injury, Brit Long on IV thrombolysis for minor strokes and Victoria Myers & Lauren Westafer on mentorship and what it means to be a physician leader... Please consider a donation to EM Cases to support high quality Free Open Access Medical Education here: https://emergencymedicinecases.com/donation/

Why do so many indoor cats develop urinary disease? Meet Dr. Allison Kendall, Associate Professor of Internal Medicine at NC State and feline nephrology & urology specialist. In this episode of Purr Podcast, we talk pee, pain, and common causes for urinary probems in cats.

Pre-Order The Forever Strong PLAYBOOK and receive exclusive bonuses: https://drgabriellelyon.com/playbook/Want ad-free episodes, exclusives and access to community Q&As? Subscribe to Forever Strong Insider: https://foreverstrong.supercast.comIn this compilation episode, Dr. Gabrielle Lyon is joined by the top experts in Testosterone and men's health treatments. You'll learn:Why aging alone doesn't drop T levels and why acquisition of conditions like obesity is the real culprit.Why the standard "low T" cutoff is misleading and why you must check your Free Testosterone.How erectile dysfunction is a sensitive marker of overall health and heart risk.The efficacy of Cialis/Viagra for both erections and cardiac protection, and the risks of unchecked influencer advice on steroids.The direct link between muscle mass, exercise, and sexual function—and why the penis is the "first to go" when overall health declines.Chapter Markers:0:00 - Testosterone is a Brain Hormone0:40 - Debunking the Myth: Male Menopause (Andropause) Doesn't Exist1:33 - The Dangers of Unchecked Influencer Advice on Testosterone3:07 - Defining Testosterone Deficiency: Symptoms vs. Signs5:10 - The Arbitrary Number: Why Guidelines Disagree on Low T8:29 - Free Testosterone: The Most Reliable Indicator of Male Health15:28 - TRT vs. Steroids: Defining the Line and Risks18:59 - The Real Risks of TRT: Infertility and Hematocrit22:36 - The Shocking Backstory: Challenging the Prostate Cancer Myth26:40 - Erectile Dysfunction (ED) and Lifestyle Modification29:21 - Shockwave Therapy for ED: The Science and the Cash Business33:53 - Penile Tissue Atrophy and Venous Leak37:25 - The Role of Muscle Mass, Sarcopenia, and Sexual Function39:41 - The Single Best Marker for Male Health: Erectile Function42:02 - The Science of Cialis and Viagra (PDE5 Inhibitors)45:49 - The Viagra Story: From Heart Drug to ED Cure50:50 - Tadalafil (Cialis) as a Triple-Threat Drug (Cardiac, Urinary, Sexual)53:57 - The Role of Testosterone in Female Sexual Function55:20 - Hypogonadism: Diagnosis, Treatment, and Fertility RiskAbout the guests: Dr. Abraham Morgentaler is an Associate Clinical Professor of Urology at Harvard Medical School and founder of Men's Health Boston. He is an internationally recognized expert in men's health, particularly known for his pioneering work in testosterone therapy. Dr. Morgentaler is credited with reversing the long-held belief that testosterone therapy causes prostate cancer and is the author of several books on men's health. YouTubeLinkedInT4L EducationX/Twitter Dr. Tobias Kohler is the co-founder of the Erectile Restoration Outcomes Study (EROS) penile implant registry. In addition to his clinical and research activities, Dr. Kohler is active in education, providing mentorship to residents and fellows.Mayo Clinic ResearchGateLinkedIn

Send us a textOver 200 million people worldwide suffer from incontinence but few seek treatment or education. Urinary incontinence is not age related and is manageable and treatable without surgery. Want more education and resources: nafc.org  Support the showSeniorSupportStrategies.com when you need guidance navigating senior care or how to create your own Aging in Place strategy.

Urinary (and yes, bowel) leakage isn't “just part of getting older”—it's a signal from your core and pelvic floor. In this straight-talk episode, physical therapist Christina Walsh, co-founder of Tighten Your Tinkler, joins me to dismantle the shame around pelvic health and lay out a functional path forward that goes far beyond “just do more Kegels.” We cover what's really driving leaks, pressure, prolapse, urgency, and painful sex in midlife; how breath, posture, fascia, and daily toileting habits influence symptoms; when conservative care is enough—and when devices, pessaries, or surgery may be appropriate. Christina also shares practical first steps you can start today (hello, decompression and diaphragmatic breathing), plus how to talk with your partner without pushing through pain.What you'll learnWhy leaking is common—but not normal—and what it's trying to tell youThe limits of isolated Kegels and what a functional approach looks likeHow breathing, posture, sitting, and constipation ramp up pelvic pressureStaging prolapse (1–4), what's realistic to “functionally heal,” and red-flagsPainful sex in midlife: estrogen, lubrication, tone, and boundaries that helpFascia's surprising role (yes, your bladder “talks” to your neck)Links & resourceshttps://www.tightenyourtinkler.com/  (listener code Michele for $50 off)https://www.instagram.com/tighten.your.tinkler/ Tighten Your Tinkler free quiz https://www.surveymonkey.com/r/tinklerquizIf this helped, share it with a friend, rate the show, and hop on my weekly newsletter for midlife health, fitness, and no-BS motivation._________________________________________1:1 health and nutrition coaching or Faster Way - Reach me anytime at mailto:mfolanfasterway@gmail.com If you're doing “all the right things” and still feel stuck, it may be time to look deeper. I've partnered with EllieMD, a trusted telehealth platform offering modern solutions for women in midlife—including micro-dosed GLP-1 peptide therapy—to support metabolic health and longevity. https://elliemd.com/michelefolan - Create a free account to view all products. ✨ Sign up for my weekly newsletter: https://michelefolanfasterway.myflodesk.com/i6i44jw4fq

As little as 3000 steps per day can slow progression to Alzheimer's Disease; Self-reports of memory impairment soaring among young people; New study vindicates unprocessed red meat—and even often-vilified processed red meat—for cancer and overall health. Prostate artery embolization (PAE) offers new non-invasive option for men's age-related urinary problems; Targeting the mitochondria and the microbiome for Parkinson's Disease; Popular prostate and hair loss prevention drugs linked to depression and suicide—while Cialis for urinary symptoms may stave off cardiovascular disease; Discovery that a safe, cheap medication may increase survival after breast cancer surgery. 

Urinary tract infections — or UTIs — aren't the most glamorous topic, but they're incredibly important, and we just don't talk about them enough. If you've ever had one, you'll know how miserable they can be: the burning, the stinging, those endless trips to the loo, the pain, and that bone-crushing fatigue. They can really knock you sideways.For many women, UTIs become more common — and more stubborn — during perimenopause and menopause.In this episode, I'm joined by the brilliant Helen Lake, a specialist urology nurse, to help us understand why UTIs happen, why they mustn't be ignored, and what you can do about them — from medical treatments to nutrition and supplements.Helen explains everything you need to know about identifying, understanding, and managing UTIs — and hopefully banishing them for good. We cover the key symptoms, prevention strategies like staying hydrated and double-voiding, why test results aren't always conclusive, and when antibiotics are needed. We also look at the role of beneficial bacteria, cranberry and D-mannose, vaginal moisturisers, topical oestrogen, and how to advocate for yourself with your GP.If you've found this episode helpful, please share it with a friend who might benefit too. And if you love The Happy Menopause podcast, I'd be so grateful if you could leave a five-star rating and a quick review on Apple Podcasts — or wherever you like to listen.And don't forget to subscribe, so you don't miss out on upcoming episodes. These small steps make a huge difference to the algorithm, and help more women find the show.After all, every woman deserves to have a happy menopause.Check out the full Show Notes for this episode on my website www.well-well-well.co.uk/podcast, where you'll find all the relevant links and references for each guest. Learn how to build your own menopause diet to manage your symptoms with my book The Happy Menopause: Smart Nutrition to Help You Flourish. And if you're tired of feeling tired and grappling with brain fog, check out my new book: The Happy Menopause Guide to Energy; Nutrition to Rejuvenate Your Brain & Body. It's available in all the usual places.

~Chat opens 1 hour before stream~Here is the link to the Williams Waiver https://www.hillandponton.com/wp-content/uploads/2025/05/Waiver-example.pdfVA Disability Calculator is here https://www.hillandponton.com/va-disability-calculator/Struggling to get the benefits you know you deserve? Get a free case evaluation now! - https://www.hillandponton.com/free-case-evaluation?utm_source=youtube&utm_medium=organic-video&utm_campaign=description&utm_id=Livestream+ShowJoin in our Live VA Disability Q&A Session in which we answer your questions live. We can't get to every single question so we will answer them as they come in. If you have any questions about the VA Disability Benefits process you can ask the question in the comment section when we go live and a little earlier. We are nationwide VA Accredited Disability Lawyers. We can't wait to answer your questions!For a FREE Case Evaluation go here: https://www.hillandponton.com/free-ca...Visit our website at https://www.hillandponton.com/?utm_so...Like us on Facebook at www.facebook.com/HillandPontonFor questions please email us at Info@hillandponton.comSpeakers: TBAThe content of this YouTube channel is provided for informational purposes only and is not intended to constitute legal advice. You should not rely upon any information contained on this YouTube channel for legal advice. Viewing this YouTube channel is not intended to and shall not create an attorney-client relationship between you and Hill and Ponton, PA. Messages or other forms of communication that you transmit to this YouTube channel will not create an attorney-client relationship and thus information contained in such communications may not be protected as privileged. Hill and Ponton, PA does not make any representation, warranty, or guarantee about the accuracy of the information contained in this YouTube channel or in links to other YouTube channels or websites. This YouTube channel is provided "as is," does not represent that any outcome or result from the viewing of this channel. Your use viewing of this YouTube channel is at your own risk. You enjoy this YouTube channel and its contents only for personal, non-commercial purposes. Neither Hill and Ponton, PA, nor anyone acting on their behalf, will be liable under any circumstances for damages of any kind.

Urinary incontinence and sexual dysfunction are common side effects of prostate cancer treatment, but both are manageable. Dr. Lindsay Hampson explains the types of incontinence—stress, urge, mixed, and overflow—and how identifying the cause guides treatment. Management strategies include pelvic floor physical therapy, medications, and surgical options like slings or artificial urinary sphincters. For sexual dysfunction, approaches range from oral medications and vacuum devices to injections and implants. Dr. Michael Rabow also highlights the side effects of androgen deprivation therapy, including fatigue, depression, hot flashes, and cardiovascular risk. He outlines evidence-based strategies—like exercise, cognitive behavioral therapy, and medications—to help preserve well-being and quality of life during treatment. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40869]

Urinary incontinence and sexual dysfunction are common side effects of prostate cancer treatment, but both are manageable. Dr. Lindsay Hampson explains the types of incontinence—stress, urge, mixed, and overflow—and how identifying the cause guides treatment. Management strategies include pelvic floor physical therapy, medications, and surgical options like slings or artificial urinary sphincters. For sexual dysfunction, approaches range from oral medications and vacuum devices to injections and implants. Dr. Michael Rabow also highlights the side effects of androgen deprivation therapy, including fatigue, depression, hot flashes, and cardiovascular risk. He outlines evidence-based strategies—like exercise, cognitive behavioral therapy, and medications—to help preserve well-being and quality of life during treatment. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40869]

Urinary incontinence and sexual dysfunction are common side effects of prostate cancer treatment, but both are manageable. Dr. Lindsay Hampson explains the types of incontinence—stress, urge, mixed, and overflow—and how identifying the cause guides treatment. Management strategies include pelvic floor physical therapy, medications, and surgical options like slings or artificial urinary sphincters. For sexual dysfunction, approaches range from oral medications and vacuum devices to injections and implants. Dr. Michael Rabow also highlights the side effects of androgen deprivation therapy, including fatigue, depression, hot flashes, and cardiovascular risk. He outlines evidence-based strategies—like exercise, cognitive behavioral therapy, and medications—to help preserve well-being and quality of life during treatment. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40869]

Urinary incontinence affects millions of women, yet many continue to suffer in silence due to stigma or the misconception that it's just a normal part of aging. Bladder control issues can impact women of all ages, and they are highly treatable, and there are real solutions that can help. On this episode of the Healthier You Podcast, Dr. Ashlee Williams welcomes Dr. Nwamaka Fadahunsi, a board-certified urologist at Kaiser Permanente, to discuss the causes of urinary incontinence and the many tools available to treat it. Dr. Fadahunsi explains the differences between stress and urge incontinence, debunks common myths, and offers practical guidance on what women can do at home. She also outlines the full range of treatment options, including physical therapy, medications, and outpatient procedures, helping women regain control and confidence without relying on pads or assuming surgery is the only answer.  Learn more about Nwamaka Fadahunsi, MD 

In this very special 100th episode of the Cat Café Podcast, Dr. Susan and Dr. Jolle take a cozy walk down memory lane — catnip lattes in hand — to celebrate a century of cat conversations!

Urinary incontinence is more common than you think. It's rarely talked about. Dr. Nigel Bayer sheds light on this often-ignored issue, offering real solutions to help women restore confidence and improve their quality of life. In this episode, we explore: The root causes of urinary incontinence—and why conventional advice like Kegels or medication often falls short. The Iron Clad Bladder System, an innovative approach using neuroplasticity and nervous system retraining for lasting results. Practical, holistic strategies to improve urinary health naturally without surgery, drugs, or fear of leaks. It's time to take back control. Tune in and discover a new path to freedom! About Dr. BrayerDr. Nigel Brayer, a nationally recognized expert in natural medicine and the creator of the -Iron Clad Bladder System, a groundbreaking, drug-free approach that combines modern neurology and traditional Chinese medicine to heal urinary incontinence. With over 27 years of experience, he has helped countless women overcome this life-altering condition by addressing both the physical symptoms and the deeper neurological and emotional roots of the issue. About TheresaA wife and a mother to two children and grandmother, Theresa Alexander Inman is a Parenting Coach, Board Certified Behavior Analyst, Infant Toddler Development Specialist, Autism Spectrum Disorder Clinical Specialist. Introduced to behavior analysis in 2007 after years in the juvenile justice system.Her goal is to improve the lives of children and families by helping them strategize child develop skills to prevent or reduce the effects of possible delays while having fun! She also served as a panelist on the first annual Autism World Summit.Theresa is also an author, having published ⁠⁠⁠⁠⁠⁠⁠⁠⁠“Pathways to Early Communication”⁠⁠⁠⁠⁠⁠⁠⁠⁠ in 2022.Connect with Theresa today!• Instagram | ⁠⁠⁠⁠⁠⁠⁠⁠⁠Theresa Inman⁠⁠⁠⁠⁠⁠⁠⁠⁠• LinkedIn | ⁠⁠⁠⁠⁠⁠⁠⁠⁠Theresa Inman⁠⁠⁠⁠⁠⁠⁠⁠⁠• BabyBoomer.org | ⁠⁠⁠⁠⁠⁠⁠⁠⁠Theresa Inman⁠⁠⁠⁠⁠⁠⁠⁠⁠• YouTube | ⁠⁠⁠⁠⁠⁠⁠⁠⁠Parenting with Confidence⁠⁠⁠⁠⁠⁠⁠⁠⁠• Tiktok | ⁠⁠⁠⁠⁠⁠⁠⁠⁠ https://www.tiktok.com/@parentcoachtheresa• Spotify via Anchor.fm | ⁠⁠⁠⁠⁠⁠⁠⁠⁠Parenting with Confidence ⁠⁠⁠⁠⁠⁠⁠⁠⁠Website: https://www.theresaalexanderinman.com/About Parenting on the SpectrumRaising autistic children comes with unique joys, challenges, and learning moments. Join host Theresa as she explores the diverse experiences of parenting kids on the spectrum. Each episode features expert insights, real-life stories, and practical strategies to help you navigate this journey with understanding, compassion, and strength. Whether you're a parent, caregiver, or ally, this podcast is your go-to resource for fostering connection and celebrating neurodiversity. Please share, comment, rate, and download! Be blissful! Theresa

Dr. Lindsay Hampson discusses urinary incontinence and sexual dysfunction following prostate cancer treatment, emphasizing that both are common and treatable. She explains the different types of incontinence—stress, urge, mixed, and overflow—and outlines how understanding the cause helps guide treatment. Options include pelvic floor physical therapy, medications, surgical interventions like slings or artificial sphincters, and supportive devices. Dr. Hampson also reviews effective strategies for managing erectile dysfunction, such as oral medications, vacuum devices, injections, and penile implants. She highlights the importance of shared decision-making and reassures patients that even small symptoms can significantly affect quality of life and deserve attention. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 40814]

Send us a textHave you ever wondered why urinary issues seem to affect women differently than men? The answer lies in our unique anatomy and hormonal makeup — factors that make female urinary health both fascinating and complex.Dr. Holly Thacker takes listeners on a comprehensive journey through the most common urologic conditions affecting women during Urology Awareness Month. From the annoying but potentially dangerous urinary tract infections to the embarrassing reality of pelvic organ prolapse that affects up to one in eight women, this episode breaks down what's happening and why."Everyone needs a bladder that works," Dr. Thacker emphasizes as she explores how bladder health connects to overall wellness and quality of life. She tackles taboo topics with medical precision while offering practical advice for prevention and management. You'll learn why maintaining pelvic floor strength matters even if you've never been pregnant, how hormonal changes dramatically affect urologic health, and why sexual function is inextricably linked to bladder health.Subscribe to the Speaking of Women's Health Podcast wherever you listen to podcasts and visit speakingofwomenshealth.com for more resources on taking charge of your health.Support the show

In this episode of The Menopause and Cancer Podcast, we're joined by Dr Carys Sonnenberg — GP, menopause specialist, and women's health expert — for a practical, empowering workshop all about bladder health.We ask the questions many of us wonder but rarely say out loud:What's normal when it comes to bladder habits?How often is too often to wee?Urinary tract infections and treatmentsProlapse and what helpsDr Carys breaks it all down for us — from understanding how cancer treatment, menopause, and pelvic floor changes can affect bladder function, to simple and effective things you can do to feel more confident and in control.We also explore what can help, including:Pelvic floor exercisesLifestyle strategiesHormone-free treatmentsMedications that may be suitable for cancer survivorsEpisode Timestamps:00:00 Intro04:04 Understanding Bladder Health Issues07:24 Discussing Sensitive Health Symptoms12:27 Pelvic Floor and Bladder Health15:10 Urinary Health and Hygiene Tips19:11 Managing Acute & Recurrent UTIs21:34 Managing Recurrent Urine Infections24:54 Managing Bladder Urges & Incontinence33:20 Individualised Pelvic Floor Treatment34:59 Cancer, Intimacy, and Body Image44:46 Pelvic Floor Exercise Misconceptions50:01 Overcoming Pelvic Floor ChallengesBuy my book here: Navigating Menopause After Cancer: https://www.amazon.co.uk/Navigating-Menopause-After-Cancer-comprehensive/dp/1068499907You can find Dr Sonnenberg here https://rowenahealth.co.uk/These are resources Dr Sonnenberg mentions: https://thepogp.co.uk/resources/booklets/https://squeezyapp.com/ Connect with us:For more information and resources visit our website: www.menopauseandcancer.org Or follow us on Instagram @menopause_and_cancerJoin our Facebook group: www.facebook.com/groups/menopauseandcancerchathub

Contributor: Travis Barlock MD Educational Pearls: Meningitis retention syndrome is a relatively novel and rare clinical condition Aseptic meningitis + acute urinary retention One study reports an incidence of about 8% in patients with acute aseptic meningitis Clinical presentation Typical meningeal symptoms including fever, stiff neck, and headache Urinary retention occurs about one week after initial symptoms Potential pathophysiology Immune-mediated dysfunction of the central nervous system Detrusor muscle underactivity from inflammation of the spinal cord Management Supportive care Bladder decompression References Hiraga A, Kuwabara S. Meningitis-retention syndrome: Clinical features, frequency and prognosis. J Neurol Sci. 2018;390:261-264. doi:10.1016/j.jns.2018.05.008 Pellegrino F, Funiciello E, Pruccoli G, et al. Meningitis-retention syndrome: a review and update of an unrecognized clinical condition. Neurol Sci. 2023;44(6):1949-1957. doi:10.1007/s10072-023-06704-0 Summarized & Edited by Jorge Chalit, OMS4 Get your tickets to Tox Talks Event, Sept 11, 2025: https://emergencymedicalminute.org/events-2/ Donate: https://emergencymedicalminute.org/donate/  

Episode 202: BPA OverviewWritten by Cameron Carlisle, MSIV, Ross University School of Medicine. Comments by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice._____________________Arr: Welcome to another episode of Rio Bravo qWeek. My name is Hector Arreaza, I'm an associate program director and faculty in the Rio Bravo Family Medicine Residency Program. Today my co-host is Cameron Carlisle, who is a 4th-year medical student finishing his last rotation of med school. Welcome, Cameron, please introduce yourself.Arreaza: What are we talking about today, Cameron?Cam: Dr. Arreaza, did you know you're probably carrying around a chemical in your body that mimics estrogen? In fact, a 2004 CDC study found over 92% of Americans had detectable levels of Bisphenol A (BPA) in their urine. Today's topic is BPA.BPA is everywhere: receipts, water bottles, canned foods, baby bottles, and even our dental fillings. It's one of the most ubiquitous endocrine-disrupting chemicals (EDCs), which interferes with the body's hormone systems. That's why today's episode is about making the invisible visible. Our goals for today's podcast:Break down what BPA isShow how it affects the human bodyExplain how you and your patients can limit exposureEmpower both clinicians and the public with real, practical informationArreaza: Thanks for clarifying BPA today. It seems like we always have to learn about a new carcinogen or toxic substance that we are exposed to. I remember when I was a child, Yellow #5 became very concerning for the general public but it is still being used in our foods. So, it's good you are talking about this. What Is BPA?Cam: Bisphenol A (BPA) is an industrial chemical used since the 1950s, primarily in polycarbonate plastics and epoxy resins. It makes plastic clear, and is often found in:Water bottlesCanned food liningsBaby bottles (pre-2012)Takeout containersCash register receiptsDental sealantsArreaza: So, I've seen the “BPA-free” labels many times, and today I'm glad you are going to shed some light about it.Cam: What's alarming is that BPA leaches out of these products, especially when exposed to heat, acidity, or repeated use. A Harvard study found that people who drank from plastic bottles for just one week had a 69% increase in urinary BPA levels (Carwile & Michels, 2009).Arreaza: That's a lot of people 69%. Section 3: What happens when BPA gets into our body? How BPA Works in the BodyCam: BPA is classified as an endocrine disruptor, meaning it can bind to estrogen receptors and mimic or block natural hormone functions.It affects:Reproductive systems (both male and female)NeurodevelopmentThyroid signalingPancreatic β-cell functionMetabolism and fat storageEven low-dose exposure can disrupt cellular function. BPA acts as a xenoestrogen (foreign estrogen) and has been shown to alter DNA methylation, leading to epigenetic changes that persist across generations (Manikkam et al., 2013).Arreaza: So, BPA can cause epigenetic changes that can be inherited. BPA can persist for generations in your offspring.BPA's Health Impacts – What the Research SaysHere's where it gets serious. Let's go system-by-system:1. Reproductive HealthFemales: Linked to PCOS, infertility, and early puberty (Peretz et al., 2014).Males: Reduced sperm count and motility; altered testosterone levels.2. Pregnancy and Birth OutcomesIncreased risk of preterm birth, gestational diabetes, and low birth weight (Snijder et al., 2013).Studies show BPA crosses the placenta, directly affecting the fetus.3. Neurological DevelopmentAssociated with ADHD, anxiety, and impaired executive function in children exposed in utero (Mustieles et al., 2015).4. Metabolism and DiabetesBPA exposure is linked to insulin resistance, obesity, and type 2 diabetes, even at low doses (Lang et al., 2008).5. CancerAnimal and human data link BPA to increased risk of breast and prostate cancer via estrogenic mechanisms.6. MortalityA 2020 JAMA study found individuals with higher BPA levels had a 49% increased risk of all-cause mortality compared to those with lower levels (Gao et al., 2020).Arreaza: You are scaring me. I wonder what my BPA level is in my blood. Actually, BPA can be detected in urine. This is the most common approach for population-level biomonitoring, because BPA and its metabolites are mostly excreted in urine. Studies have found that BPA is present in most people, even up to 85–99% in large cohorts. Cam: That's literally everyone. Sources of BPA ExposureLet's talk about things we use every day:Thermal receipts (like from Target or Starbucks): BPA can transfer onto your skin and be absorbed, especially if your hands are wet or lotioned.Canned soups: One study showed that eating canned soup daily for five days led to a 1000% increased urinary BPA levels (Carwile et al., 2011).Plastic water bottles left in the car on hot days or plastic food trays for microwaving = chemical leaching.Baby bottles and pacifiers (pre-2012): primary concern for newborns.Arreaza: So, Cameron, you were exposed to BPA as a baby.Cam: Here's the jaw-dropper: We ingest up to 5 grams of plastic per week, roughly the weight of a credit card (WWF, 2019; University of Newcastle). This includes microplastics like BPA, which enter through food, water, and air.Arreaza: So, it translates into 40 lbs of plastic in a lifetime, by age 70. What can we do as family physicians?Family Medicine and Preventive CareAs family physicians, we are at the frontlines of prevention. Our role includes:Anticipatory guidance: during prenatal visits, well-child visits, and chronic disease managementScreening opportunities: ask about storage habits, microwave use, and receipt handlingEnvironmental health counseling: AAFP recommends addressing endocrine disrupting chemicals (EDCs) when relevant to a patient's concerns.It's not just about treating diabetes or obesity. It's about recognizing that environmental exposure may be a root cause.Arreaza: Prevention is my favorite topic!Cam: One helpful clinical practice:Arreaza: What else can we do to reduce BPA exposure?Practical Steps to Reduce BPAHere's what patients and doctors alike can do today:Switch to BPA-free products, but be careful, as replacements like BPS or BPF may also be harmful (Rochester & Bolden, 2015).Avoid microwaving or dishwashing plastic containers.Use digital receipts.Filter tap water using carbon filters, which can reduce microparticle ingestion.Choose fresh produce over canned goods when possible.Also, wash your hands after handling receipts, especially before eating or touching your face.Arreaza: What is our government doing to protect us?Public Health and Policy UpdatesRegulations are slowly catching up:The FDA banned BPA in baby bottles and sippy cups in 2012.The European Union has stricter limits, and France banned BPA in all food packaging in 2015.California's Proposition 65 requires BPA warning labels.Arreaza: Proposition 65, passed by direct voter initiative in 1986, “WARNING: This product contains chemicals known to the State of California to cause cancer and birth defects or other reproductive harm.”Arreaza: The FDA is planning to phase out petroleum-based food dyes (certified color additives) from the American food supply – marking a significant milestone in the efforts to protect the public. Cam: Many products still contain BPA analogs (BPS, BPF), which are not yet well-regulated.This is where clinician advocacy matters, where we can guide public opinion and support legislative change.Arreaza: So, millions of pounds of toxic substances are produced by many industries in the US. As physicians, we have to stay informed and update our patients.Cameron: How can we wrap up this episode?Conclusion and TakeawaysBPA is a hormone disruptor hiding in plain sight.People are exposed to BPA every day, but small lifestyle changes can dramatically reduce it.Family medicine has a role in education, prevention, and advocacy.Let's all be part of the solution for our health and future generations. Stanley (tumblers) are not sponsoring this episode, and we did not receive any money from them. Arreaza: That's it for today's episode of Rio Bravo qWeek. If you enjoyed this episode, share it with a colleague or medical student who may need to know about BPA. I'm Dr. Arreaza, signing off.Cameron: Hopefully, in the future I will talk to you about more endocrine disrupting chemicals. Thanks for listening._____________________Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Carwile, J. L., & Michels, K. B. (2009). Urinary bisphenol A and obesity: NHANES 2003–2006. Environmental Research, 111(6), 825–830.Carwile, J. L., et al. (2011). Canned soup consumption and urinary bisphenol A: A randomized crossover trial. JAMA, 306(20), 2218–2220.Centers for Disease Control and Prevention (CDC). (2004). Fourth National Report on Human Exposure to Environmental Chemicals.Gao, X., et al. (2020). Urinary bisphenol A and mortality risk. JAMA Network Open, 3(8), e2011620.Lang, I. A., et al. (2008). Association of urinary bisphenol A with medical disorders and laboratory abnormalities in adults. JAMA, 300(11), 1303–1310.Manikkam, M., et al. (2013). Epigenetic transgenerational inheritance of disease. PLOS ONE, 8(1), e55387.Mustieles, V., et al. (2015). Bisphenol A and neurodevelopmental outcomes in children. Environmental Health Perspectives, 123(7), 689–695.Peretz, J., et al. (2014). Bisphenol A and reproductive health. Environmental Health Perspectives, 122(8), 775–786.Rochester, J. R., & Bolden, A. L. (2015). Bisphenol S and F: A systematic review. Environmental Health Perspectives, 123(7), 643–650.Snijder, C. A., et al. (2013). Fetal growth and prenatal exposure to bisphenol A. Environmental Health Perspectives, 121(3), 393–398.World Wildlife Fund (WWF). (2019). No Plastic in Nature: Assessing Plastic Ingestion from Nature to People.University of Newcastle (Australia). (2019). Human Consumption of Microplastics.Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/.

Solifenacin is a bladder antimuscarinic medication most commonly used for overactive bladder (OAB) with symptoms of urinary frequency, urgency, and urge incontinence. Like other agents in its class, understanding the pharmacology can help anticipate potential side effects, drug interactions, and downstream prescribing problems. Mechanism of Action Solifenacin selectively blocks muscarinic M3 receptors in the bladder detrusor muscle. Inhibiting these receptors reduces involuntary bladder contractions, increases bladder capacity, and delays the urge to void. While M3 selectivity may theoretically reduce side effects compared to nonselective antimuscarinics, in clinical practice, many anticholinergic effects still occur. Adverse Effects Because muscarinic receptors are present throughout the body, solifenacin can lead to a range of anticholinergic adverse effects: Dry mouth – among the most common, can be significant enough to cause dental issues with long-term use. Constipation – especially problematic in older adults; severe cases may require hospitalization. Blurred vision – due to impaired accommodation. Cognitive impairment – increased risk in older adults, particularly with cumulative anticholinergic burden. Urinary retention – paradoxical worsening in patients with bladder outlet obstruction. Drug Interactions CYP3A4 inhibitors (e.g., ketoconazole, clarithromycin, ritonavir) can increase solifenacin plasma concentrations, raising the risk of side effects. Other anticholinergics (e.g., diphenhydramine, tricyclic antidepressants, other bladder antimuscarinics) can result in additive toxicity and higher anticholinergic burden. QT-prolonging drugs (e.g., amiodarone, certain fluoroquinolones) may have additive cardiac risk since solifenacin has been associated with QT prolongation in rare cases. Prescribing Cascade Examples Constipation → Laxative initiation – A patient starts solifenacin for OAB and develops severe constipation, leading to chronic use of stimulant laxatives like senna or bisacodyl. Dry mouth → Mouth rinse prescription – Dry mouth is treated with saliva substitutes or prescription rinses, instead of reassessing the anticholinergic therapy. Cognitive decline → Donepezil initiation – In older adults, cognitive impairment may be mistaken for dementia progression, leading to cholinesterase inhibitor prescribing—directly counteracting the anticholinergic effects of solifenacin. Solifenacin can be an effective treatment for OAB, but the risk of adverse effects and prescribing cascades—especially in older adults—cannot be ignored. Healthcare professionals should regularly review the indication, monitor for anticholinergic burden, and look for opportunities to deprescribe when appropriate.

Urinary tract infections (or UTIs) are more than a nuisance-they can be recurring and painful. Join our registered dietitians Melanie Beasley and Britni Vincent in our newest episode of Dishing Up Nutrition as they unravel the connection between your diet, your microbiome, and these infections. Listen now for expert insights regarding what makes UTIs such a frequent issue, and explore how specific foods and supplements can aid in prevention, relief, and recovery.