Fiona C. Burkhard, MD, presented “Management of Neurogenic Lower Urinary Tract Dysfunction: Surgical Options with Reference to the Guidelines” during the 43rd Annual Ralph E. Hopkins Urology Seminar on January 31, 2024, in Jackson Hole, Wyoming.
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How to cite: Burkhard, Fiona C. “Management of Neurogenic Lower Urinary Tract Dysfunction: Surgical Options with Reference to the Guidelines.” January 31, 2024. Accessed Sep 2024. https://grandroundsinurology.com/management-of-neurogenic-lower-urinary-tract-dysfunction-surgical-options-with-reference-to-the-guidelines/
Management of Neurogenic Lower Urinary Tract Dysfunction: Surgical Options with Reference to the Guidelines – Summary
Fiona C. Burkhard, MD, discusses the surgical management of neurogenic lower urinary tract dysfunction (NLUTD). Dr. Burkhard begins with an overview of the prevalence of NLUTD, its patterns related to spinal cord injury (SCI), and treatment goals. She summarizes guidelines from the European Association of Urology (EAU), the American Urological Association (AUA), and the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) regarding the surgical management of NLUTD.
Dr. Burkhard then describes clam ileocystoplasty, and shares data on the procedures’ success in stabilizing renal function and preventing anatomical deterioration. She cautions that lifelong follow-up is essential. Dr. Burkhard shares quality-of-life (QoL) data showing improvement after augmentation.
She addresses additional EAU, AUA, and SUFU guidelines on urinary diversion before highlighting data on sex differences in bladder management, symptoms, and satisfaction after SCI. Dr. Burkhard addresses reflux prevention, bladder outlet, and catheterization issues.
Dr. Burkhard summarizes her lecture by emphasizing that, while variations exist in the grading of recommendations, overall recommendations for treatment are similar across guidelines. She reiterates the importance of the patient’s perspective and lifelong follow-up in highlighting the advantages of surgical management.
About The 43rd Annual Ralph E. Hopkins Urology Seminar:
The Ralph E. Hopkins Urology Seminar is a multi-day meeting focused on training urologists in the latest in assessing, diagnosing, and treating urologic conditions in the clinical setting. Updates are provided on urologic cancers, stone disease, urologic reconstruction, female urology, infertility, sexual function, emerging surgical techniques, and general urology. The 43rd iteration of the meeting took place from January 31st to February 2nd, 2024, in Jackson Hole, Wyoming.
For further educational activities from this conference, visit our collection page.
ABOUT THE AUTHOR
Fiona C. Burkhard is chairwoman for Female Urology, Reconstructive Urology and Neurourology at the Department of Urology and Extraordinaria ad personam for Functional Urology at Bern University.
She completed her medical studies and doctoral thesis at the University of Zurich. She trained as an urologist in Bern under Prof. Urs Studer and in 1997/98 spent 18 months at the Southwestern Medical School in Dallas, Texas for a “Fellowship in Female Urology and Voiding Dysfunction”. In 2001 she completed her urological training including board certification in operative urology. She is also board certified in Female Urology and Neurourology. From 2011-2019 she was a (the first female urologist) member of the scientific office of the European Association of Urology (EAU). In 2011 she was invited to join the incontinence guidelines group of the EAU, which she chaired from 2014 until 2019.
Her main interests are bladder dysfunction including bladder substitution. Together with Prof. K. Monastyrskaia and funded by the Swiss National Science Foundation for over 10 years her research has focused on the molecular mechanisms of bladder dysfunction and potential clinical application.
