Brian S. Christine, MD

Brian S. Christine, MD

Urology Centers of Alabama

Birmingham, Alabama

Dr. Christine attended Emory University School of Medicine in Atlanta, Georgia, and then went on to complete his urology residency at the University of Alabama at Birmingham. He practiced general urology for five years, treating urologic cancers, kidney stones, female urology, and male sexual dysfunction. Over a decade ago, Dr. Christine decided to sub-specialize in prosthetic urology and men’s sexual health. At present, his internationally-recognized practice is centered on treating erectile dysfunction, Peyronie’s disease, premature ejaculation, radical prostatectomy-induced urinary incontinence, and low testosterone, as well as on providing male genital aesthetic surgery. In addition to his work as a clinician, Dr. Christine is heavily involved in the medical community and is committed to urologic education. He is Fellowship Director and Director of Prosthetic Urology and Men’s Sexual Health at Urology Centers of Alabama. He frequently hosts urologists from around the world and allows them to observe his surgeries. He is a member of the Sexual Medicine Society of North America, the International Society of Sexual Medicine, the European Association of Urology, and the International Continence Society.

Talks by Brian S. Christine, MD

Climacturia After Radical Prostatectomy: What is It? Why is It? How Do We Treat It?

Climacturia After Radical Prostatectomy: What is It? Why is It? How Do We Treat It?

Posted by | Nov 2024

Brian S. Christine, MD, Brian S. Christine, MD, addresses the overlooked issue of climacturia in men who have undergone radical prostatectomy.

In this 19-minute talk, Dr. Christine outlines both conservative and surgical management strategies for climacturia. Simple approaches include bladder emptying before intercourse and the use of constriction rings, pharmacologic treatments, and surgical options like suburethral slings. For patients with severe erectile dysfunction requiring penile implants, he discusses an innovative approach using a Mini Jupette sling.

Dr. Christine emphasizes the need for better preoperative counseling on climacturia and highlights the range of available treatment options tailored to individual patient needs, from conservative measures to advanced surgical interventions.

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Treatment of Male Stress Urinary Incontinence

Treatment of Male Stress Urinary Incontinence

Posted by | Apr 2024

Brian S. Christine, MD, provides guidance on the assessment and treatment of stress urinary incontinence (SUI) after radical prostatectomy. Dr. Christine begins by discussing the pelvic support changes that happen in men post-prostatectomy, the relationship between the loss of pelvic support and incontinence, and the different mechanisms behind moderate and severe SUI.

Dr. Christine encourages urologists to assess each post-prostatectomy patient presenting with SUI symptoms using a thorough work-up to determine SUI mechanism and severity, an awake cystoscopy to visualize the function of the external sphincter, and a Standing Cough Test. He explains that these three steps in SUI assessment allows the attending physician to ensure that the treatment will match the severity and mechanism of the patient’s incontinence.

He then explores the process of selecting the optimal treatment between the two principal surgical options for treating male SUI: the male sling and the artificial urinary sphincter. Dr. Christine reiterates the importance of tailoring the therapy based on the information gathered during the assessment, and advises urologists to visit surgeon educators on-site and develop their surgical placement skills.

Dr. Christine concludes by exploring the treatment of recurrent SUI in men who have been previously treated for SUI. He provides guidance on treating men with a prior male sling and men with a malfunctioning or affected artificial urinary sphincter.

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Best Treatment for Male Incontinence: Sling

Posted by | Feb 2021

In the first part of this urologic debate, Brian S. Christine, MD, Director of Prosthetic Urology and Men’s Sexual Health at Urology Centers of Alabama in Birmingham, argues that the sling is the best treatment for post-prostatectomy stress urinary incontinence in men. He goes over how to select the right candidates for a sling, the pre- and post-operative procedural steps, and the resulting success rate. Dr. Christine notes that slings are best used in patients with mild to moderate stress urinary incontinence as determined by a severity grading system. He considers two options for determining incontinence severity, the pad test and the standing cough test, observing that the latter is preferable given that it is done in-office versus by the patient at home. Dr. Christine then provides a detailed explanation of the surgical steps and technique using an AdVance XP male sling. He concludes that the sling, when used on the ideal candidate with a standing cough test grade of 0, 1, or 2, results in a post-operative success rate of 82-83% of patients who are dry or pad-free. Alexander Gomelsky, MD, FACS, argues in favor of using an artificial urinary sphincter in the second part of the debate here.

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Use of Social Media in Men’s Health Urologic Practice

Posted by | Jan 2021

Brian S. Christine, MD, a urologist and Fellowship Director and Director of Prosthetic Urology and Men’s Sexual Health at the Urology Centers of Alabama in Birmingham, discusses the use of social media in men’s health urologic practices. He begins by discussing older mediums and why they are no longer effective at getting the word out, as well as the limitations of word of mouth. He goes on to talk about why leveraging social media platforms is important for reaching the widest possible audience and attracting new patients. Dr. Christine then explains what has worked for him and his practice and what has not. He emphasizes the importance of creating a personal website that is separate from the practice that can be linked to all of one’s social media accounts. He also highlights the social media platform that has been the most effective for him: Youtube. Youtube is particularly helpful because it allows users to upload high-quality educational videos; the majority of Dr. Christine’s new patients that seek him out on their own do so after watching one of his surgical videos. Dr. Christine then gives advice about how to be successful on Youtube and pitfalls to avoid when making videos. He offers specific tips about how to make the same kind of high-quality videos that appear on his Youtube channel. Finally, he observes that the biggest roadblock is not making the commitment to begin.

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