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.

Disclosures:

Clinical investigator for Cook Myosite, Boston Scientific, and Uromedica

Talks by Brian J. Flynn, MD

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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Antibiotic Stewardship for Procedures and Patients with Recurring Infections

Brian J. Flynn, MD, presents guidance on effective UTI management while minimizing antibiotic resistance. Dr. Flynn begins with an overview of recurring UTI pathogenesis and diagnosis.

Dr. Flynn then addresses common treatment options for recurrent UTI management, like Fosfomycin. He reviews the common first-line antibiotics, highlighting the importance of short-duration antibiotics after non-antibiotic treatments have failed.

Dr. Flynn then delves into other prophylactic strategies for treating recurrent UTIs. He discusses prophylactics relating to cleanliness, specific cranberry products, water intake, and methanamine hippurate.

Dr. Flynn concludes by addressing the social and psychological impact of recurrent UTIs, particularly in post-menopausal women. He stresses the importance of discussing contributing factors frankly, but empathetically, with patients to achieve the desired treatment outcome.

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Expanding the Surgical Options for Primary and Recurrent Male Stress Incontinence

Brian J. Flynn, MD, evaluates current and upcoming surgical options for treating primary and recurrent male stress incontinence. He begins by reviewing the medical, social, and urethral characteristics of male stress urinary incontinence (SUI) surgical candidates.

Dr. Flynn then evaluates the risks and benefits of male perineal slings (MPS), artificial urinary sphincters (AUS), and adjustable continence therapy (ACT) devices. He notes that, presently, the least effective surgical option also has the least risk of complications for the patient.

Dr. Flynn concludes by presenting examples of patients with various levels of male SUI and how MPS, AUS, and ACT apply to each case. He reiterates that focusing on patient quality of life is paramount in the successful treatment of male SUI.

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New Horizons in Robotic Reconstructive Urology

Brian J. Flynn, MD, discusses the emerging field of robotic reconstructive urology, shedding light on its emergence as a distinct specialty within the medical community.

In this 20-minute presentation, Dr. Flynn covers current trends and perspectives on robotic reconstructive urology from the Society of Genitourinary Reconstructive Surgeons, barriers to adoption, implementation strategies, and practical examples of robotic reconstructive surgery in sacrocolpopexy and vesicovaginal fistula repair.

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