<
How to cite: Sorensen, Mathew. “Innovative Office-based Kidney Stone Treatment.” September 2024. Accessed Nov 2024. https://grandroundsinurology.com/functional-urology-discussion/
Functional Urology Discussion – Summary
Brian J. Flynn, MD, and Alan J. Wein, MD, PhD (Hon), FACS, discuss the evolution of functional urology.
In this 16-minute discussion, Dr. Wein emphasizes the holistic approach to functional urology, which encompasses all measures to restore normal bladder function, whether through medication, pelvic floor therapy, or surgery. Of note is his stance against dividing male and female urology, advocating for an integrated approach that addresses dysfunction across genders.
Dr. Wein and Dr. Flynn discuss the overlap between storage and voiding dysfunctions, like stress and urge incontinence, which often coexist. Dr. Wein shares insights on how treating one issue can sometimes alleviate the other, though the relationship remains unclear. He stresses the importance of a unified, simplified approach to diagnosis and treatment.
Other colleagues attending the discussion provided perspective and emphasized collaborative, team-based approaches to functional urology. A urogynecologist highlighted how gynecologists primarily manage female pelvic health and storage issues, while a pediatric urologist underscored the importance of standardized nomenclature and communication across specialties.
Clinical studies on these technologies indicate a shift toward managing smaller stones and residual fragments more proactively, potentially avoiding more invasive interventions. Dr. Sorenson shares that both treatments are well-tolerated, with minimal side effects. As these innovations advance, they could enable quicker interventions for small stones and residual fragments in clinic or emergency settings, suggesting a redefined goal in kidney stone management: focusing on preventing symptomatic events and minimizing surgical interventions.
About The 1st International Functional and Reconstructive Urology Update (IFRUU):
The International Functional and Reconstructive Urology Update is a multi-day meeting focused on functional and reconstructive urology (FRU). FRU is a rapidly expanding subspecialty with the vision to improve the lives of all patients with urinary disorders. The IFRUU conference aims to equip practitioners with the tools to manage patients with functional urologic disorders effectively. The inaugural IFRUU conference took place from August 28-30, 2024 in Denver, Colorado.
For further educational activities from this conference, visit our collection page.
ABOUT THE AUTHOR
Brian J. Flynn, MD, is a professor of surgery/urology and fellowship director in Functional and Reconstructive Urology (FRU) at the University of Colorado, Anschutz Medical Center, Division of Urology, in Denver, Colorado. Dr. Flynn earned his medical degree from Temple University in Philadelphia, Pennsylvania. He completed a six-year residency in urology at Geisinger Medical Center in Danville, Pennsylvania, and a one-year fellowship in female urology and reconstructive urology at Duke University in Durham, North Carolina. He is board-certified in urology and female pelvic medicine and reconstructive surgery. Dr. Flynn earned his Bachelor of Science in biomedical engineering from the University of Rochester in Rochester, New York.
Dr. Flynn’s focus is in functional and reconstructive urology with an active
practice in male/female urinary incontinence, voiding dysfunction, urethral stricture disease, and robotic bladder/ureteral reconstructive surgery. He is a national leader in the use of minimally invasive surgical techniques and robotics for the treatment of urinary incontinence, bladder neck contracture, urethral stricture, and ureteral obstruction. He has developed new techniques for AUS, ProACT, bladder neck
reconstruction, and suprapubic catheter placement.
Dr. Flynn has authored numerous clinical papers, surgical videos, and textbook chapters. He has also presented internationally on surgical management of urethral stenosis with an emphasis on non-transecting techniques, post-prostatectomy incontinence, genitourinary fistula, and ureteral stricture disease.
Alan J. Wein, MD, PhD (hon), FACS, is Professor of Clinical Urology and Director of Business Development and Mentoring at the Desai Sethi Institute of Urology at the University of Miami Miller School of Medicine. He is Emeritus Professor of Urology/Surgery and Emeritus Chief of Urology and Program Director of the Perelman School of Medicine at the University of Pennsylvania.
Dr. Wein received his undergraduate degree from Princeton University and completed medical school, surgery, basic research, and urology training at the University of Pennsylvania (Penn). After serving in the army following his training, he returned to Penn where he ultimately became Chief of Urology and Director of the Residency Program (for 38 and 44 years, respectively). Dr. Wein holds an honorary PhD from the University of Patras, Greece and was conferred an honorary professorship by the Institute of Urology, Russian Ministry of Health.
Dr. Wein’s primary interests include the physiology and pharmacology of the lower urinary tract, evaluation and management of urinary incontinence and all types of lower urinary tract and pelvic floor dysfunction; problems with prostate enlargement and obstruction; and the evaluation and management of prostate, bladder, and kidney cancer. He has received numerous awards and honors for excellence in the field of urology and has been recognized nationally and internationally through his many affiliations and professional memberships. These include the American Association of Genitourinary Surgeons (AAGUS), the Clinical Society of Genitourinary Surgeons (CSGUS); the American Surgical Association; the Society of Surgical Oncology; the Society of Urologic Oncology (where he is a founding member); the Society of Pelvic Surgeons; Society of Urodynamics, Female Pelvic Medicine, and Urogenital Reconstruction (SUFU); the International Continence Society (ICS); Société Internationale d’Urologie (SIU); the American Urological Association (AUA); the European Association of Urology (EAU); and the Royal Society of Medicine.
Dr. Wein’s most notable awards include the Urodynamics Society Lifetime Achievement Award; the F. Brantley Scott Award of the American Foundation for Urologic Diseases; the Hugh Hampton Young Award of the AUA; the Ferdinand C. Valentine Award of the New York Academy of Medicine; the National Association for Continence Continence Care Champion Award; Lifetime Achievement Awards from SUFU, the ICS, and the SIU; the Ellis Island Medal of Honor; and the Keyes Medal by the AAGUS, which is recognized as the greatest individual citation in the specialty, awarded for outstanding contributions in the advancement of urology. Most recently, an annual mentorship award in his name has been commissioned by SUFU and another by the division of urology at Penn. Dr. Wein has authored or co-authored over 1,000 papers and book chapters, held multiple editorial positions on scientific journals and has edited or co-edited over 35 books. He is currently the editor-in-chief of Neurourology and Urodynamics and Urology Case Reports. Dr. Wein was editor-in-chief of the ninth, 10th, and 11th editions of Campbell-Walsh Urology, the gold standard textbook in the field and the name of the 12th and succeeding editions has been changed to Campbell-Walsh-Wein Urology to reflect his contributions to the field. Two chairs have been raised and named in his honor in the division of urology, department of surgery at the University of Pennsylvania Perelman School of Medicine.
