Brian J. Flynn Archives

FRU Discussion

Posted by Brian J. Flynn, MD | Sep 2024

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.

Posterior Urethral Stenosis: BNC after BPH Surgery

Posted by Brian J. Flynn, MD | Apr 2024

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.

Male SUI: Passive/Adjustable Devices

Posted by Brian J. Flynn, MD | Apr 2024

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.

New Horizons in Robotic Reconstructive Urology

Posted by Brian J. Flynn, MD | Jun 2023

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.

Posterior Urethral Stenosis (PUS) After Prostate Cancer Therapy

Posted by Brian J. Flynn, MD | Nov 2022

In this 21-minute video, Brian J. Flynn, MD, Co-Director of Female Pelvic Medicine and Reconstructive Surgery, Reconstructive Urology, and associate professor at the University of Colorado, discusses Posterior Urethral Stenosis (PUS) after prostate cancer therapy and the existing and developing techniques used to address it. He then examines the various treatments used for PUS, such as dilation or transurethral incision (TUI), and considers the advantages and disadvantages of each technique.