SUFU podcast

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

Speaker: Alana M. Murphy, MD

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

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

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

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

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

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

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

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