GSM, UTI Discussion
Suzette E. Sutherland, MD, MS, URPS, presented “Bladder Microbiome and Recurrent UTIs: Preventing...
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Suzette E. Sutherland
SUI – AUA/SUFU Guidelines 2017 — Amendment 2023
Suzette E. Sutherland, MD, MS, URPS, discusses the AUA and SUFU guidelines for evaluating and treating stress urinary incontinence (SUI). In this five-minute talk, Dr. Sutherland reviews the five key components for evaluating a patient with SUI and discusses indications for advanced diagnostic tools such as cystoscopy and urodynamics.
Dr. Sutherland’s discussion continues with the Guideline’s treatment options, both non-surgical (pessaries, vaginal inserts, and pelvic floor muscle exercises), and surgical (bulking agents, midurethral slings). The recent amendment to the guidelines now allows clinicians to offer single-incision slings alongside retropubic and transobturator slings for patients, reflecting their comparable safety and effectiveness.
Implantable Tibial Nerve Stimulation (iTNS): Revi
Suzette E. Sutherland, MD, MS, URPS, focuses on implantable tibial nerve stimulation (ITNS) for treating overactive bladder and urinary incontinence. In this 17-minute presentation, she introduces the Revi device featured in the OASIS trial.
After discussing the Revi device’s benefits, Dr. Sutherland reviews the implantation procedure and the 12-month data from the OASIS trial, which show promising results. The device is considered safe, with no serious adverse events reported. Minor issues such as discomfort were easily resolved with reprogramming, a feature of note with this device.
Sutherland emphasizes the importance of ease of use, safety, and flexibility in choosing ITNS devices. As more implantable devices enter the market, factors like surgical complexity, reprogrammability, battery replacement needs, and ongoing support will determine their success.
Bladder Microbiome and Recurrent UTIs: Preventing Those Nasty Buggers
Suzette E. Sutherland, MD, MS, URPS, addresses the role of the microbiome in recurrent urinary tract infections (UTIs). She begins this 26-minute presentation by reviewing the bladder microbiome, noting that microbes support immune function and maintain the integrity of the bladder lining. She then transitions to prevention and treatment of the condition.
Non-antibiotic prevention strategies are discussed, focusing on hydration, cranberry supplements, estrogen, and probiotics. Probiotics are emphasized for their role in reducing UTI recurrence, but Sutherland stresses the importance of proper diagnosis and judicious antibiotic use to avoid contributing to antibiotic resistance. Catheter-associated UTIs are also addressed, with a preference for clean intermittent catheterization and bladder irrigation with gentamicin in severe cases. Overall, Dr. Sutherland advocates for a conservative, evidence-based approach, using antibiotics only when necessary to preserve the efficacy of these crucial medications.
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