Brian J. Flynn, MD

Brian J. Flynn, MD

University of Colorado, Anschutz Medical Center

Denver, Colorado

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.

Talks by Brian J. Flynn, MD

FRU Discussion

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.

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Functional and Reconstructive Urology: A New Subspecialty or Rebranding

Brian J. Flynn, MD, defines functional and reconstructive urology and its place in future and existing urological practices. Dr. Flynn introduces functional and reconstructive urology as an area that focuses on disorders related to urinary and pelvic floor dysfunctions, such as urinary incontinence, pelvic organ prolapse, and overactive bladder.

Dr. Flynn discusses the historical context of functional and reconstructive urology, explaining how aspects of functional urology and reconstructive urology have been present in urology for decades. He acknowledges that while the conditions treated are not new, the emphasis on a multidisciplinary approach and the incorporation of advanced diagnostics and therapeutic techniques justifies viewing functional and reconstructive urology as a distinct subspecialty, rather than a form of alternative medicine.
Dr. Flynn concludes by illustrating how functional and reconstructive urology impacts patient care and quality of life. He provides authoritative sources for continuing education in functional and reconstructive urology.

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Posterior Urethral Stenosis: BNC after BPH Surgery

Brian J. Flynn, MD, discusses bladder neck contracture, its frequency, causes, and management options. This 10-minute presentation begins with an overview of bladder neck stenosis terminology, emphasizing its iatrogenic nature primarily resulting from surgical interventions on the prostate, such as transurethral procedures. Flynn highlights the importance of understanding patient history and conducting thorough evaluations, including uroflow studies, post-void residual measurements, and cystoscopy.

Different surgical techniques for reconstruction are covered, with photographs, videos, and illustrations aiding the discussion. Dr. Flynn also reviews preventive measures to avoid subsequent complications, emphasizing precise surgical techniques, including careful incision placements and energy application to minimize damage. Flynn shares personal experiences with cases, highlighting the importance of accurate diagnosis and treatment planning.

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Male SUI: Passive/Adjustable Devices

Brian J. Flynn, MD, delves into the categorization and management of devices for male stress incontinence, focusing on both passive and active options.

In this 20-minute presentation, he discusses passive devices, such as the advanced sling and newer adjustable slings like ARGUS and ATOMS, which offer various solutions for managing low-to-moderate leakage in non-radiated patients. He also introduces active devices, particularly the artificial urinary sphincter (AUS), but cautions that cognitive and dexterity issues often develop over time in long-term users. This has spurred interest in creating adjustable AUS devices that reduce the need for manual operation, potentially leading to fewer complications like urethral erosion.

Dr. Flynn then transitions to sharing a ProAct implantation technique, providing images and videos of procedures. He gives step-by-step instructions, beginning with optimal operating room setup. To provide the best learning opportunity, he also shares images of poor device placement and discusses correction, stressing the importance of learning from the mistakes of others.

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Pain Management Advice for Urologists in the Wake of the Opioid Crisis

Brian J. Flynn, MD, discusses the opioid crisis in the United States, and the role of urologists in taking action against this growing problem. Dr. Flynn begins by highlighting factors that contribute to the opioid epidemic’s growth, with a specific focus on Colorado. He drives home the urgency behind addressing this epidemic by emphasizing the ubiquity of opioid related deaths across all ages, genders and socio-economic strata.

Dr. Flynn argues that the problem lies specifically in prescribing opioids in far excess post-surgery, as most patients take only a fraction of what is prescribed, with extra pills then being distributed to, and consumed by, non-patients. He underlines the correlation between the number of opioids prescribed and the number of opioid related deaths.

Dr. Flynn examines the role of Urology in prescribing opioids relative to other fields of medicine in prescribing opioids, finding that urologists land somewhere in the middle in terms of prescribing opioids to patients. He looks at different urology surgeries and recommends alternatives to opioids to address patients post-op pain.

Dr. Flynn concludes with a review of the ALTO project from Colorado that aims to offer alternatives to fentanyl whenever possible. He provides practical solutions to address the opioid epidemic at the physician level, but recognizes that changes at multiple levels of practice and legislature are needed to address it effectively on a national scale.

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