Alexander Gomelsky, MD, FACS, presented “Current Diagnosis and Management of Female Stress Incontinence” virtually during the Innovations in Urologic Practice 2020 virtual conference in September 2020.

How to cite: Gomelsky, Alexander. “Current Diagnosis and Management of Female Stress Incontinence” September 26th, 2020. Accessed Dec 2020. https://grandroundsinurology.com/current-diagnosis-and-management-of-female-stress-incontinence/

Summary:

Alexander Gomelsky, MD, FACS, B.E. Trichel Professor and Chair in the Department of Urology at LSU Health Shreveport, discusses current guidance regarding the diagnosis and surgical management of female stress incontinence (SUI). He frames his presentation around the 2017 AUA/SUFU Guidelines which, while based on more high-level evidence than prior guidelines, still use an index patient who does not match the majority of women urologists are likely to see for SUI. Dr. Gomelsky particularly focuses on this limitation, noting for instance that doing urodynamic testing, which does not appear to be useful for index patients, can help urologists meet the particular needs of non-index patients (e.g., women of advanced age, women with high BMIs, women suffering from recurrent/persistent SUI, women who have had prior surgery for SUI, etc.). He further discusses both the benefits and adverse events associated with different available surgical therapies for treating SUI, emphasizing that while mesh for transvaginal repair of pelvic organ prolapse has been banned, evidence still supports mesh placed abdominally for pelvic organ prolapse, as well as midurethral slings for SUI.

About the Innovations in Urologic Practice 2020 virtual conference:
Presented by co-chairs Mohit Khera, MD, MBA, MPH, and Michael Coburn, MD, FACS, the Innovations in Urologic Practice conference provides a detailed review and commentary on multiple genitourinary and urologic diseases. Among the featured oncological topics are bladder cancer and immunotherapies, as well as upper tract cancer management, prostate cancer, including state-of-the-art imaging, focal therapy, and MRI. Experts also discuss new tools and techniques for nephrectomy and treating advanced renal cell carcinoma. In terms of general urological approaches, the conference also includes pelvic reconstruction and trauma, men’s health topics like male infertility and sexual dysfunction, and ways to diagnose and treat infections in the urology patient. Dr. Gomelsky presented this talk virtually at this year’s conference.