International Functional and Reconstructive Urology Update Archives

Urodynamics Review

Posted by Stephen R. Kraus, MD, MBA, FACS | Feb 2025

Stephen R. Kraus, MD, MBA, FACS, provides a comprehensive review of urodynamics, discussing key concepts and practical applications in evaluating lower urinary tract function. This 14-minute presentation emphasizes the importance of understanding both the storage and emptying phases of bladder function.

Dr. Kraus details how dysfunction can arise from a bladder issue, an outlet problem, or both. Specific examples are given and complex cases are also included. Kraus notes results from various tests, such as those for stress incontinence, overactive bladder, and neurogenic bladder, help guide the use of urodynamics in clinical practice. He highlights the need for careful interpretation of test results to ensure accurate diagnosis and treatment planning.

Post-Vasectomy Pain Syndrome

Posted by Jeffrey C. Morrison, MD | Feb 2025

Jeffrey C. Morrison, MD, addresses post-vasectomy pain syndrome (PVPS) following vasectomy. In this 11-minute presentation, he highlights the significant challenge PVPS presents to patients and clinicians, emphasizing that a broad differential and comprehensive workup, including physical exams and diagnostic tests, is essential.

Although the cause of PVPS remains uncertain, Dr. Morrison discusses possible contributing factors, such as neuropathic, obstructive, or immune-driven etiologies. He presents treatments, both conservative approaches like scrotal support and anti-inflammatory medications, and options like neuromodulator therapy, pelvic floor physical therapy, and acupuncture.

Dr. Morrison also discusses treatment for those who require additional management, such as spermatic cord block, and surgical options, including microdenervation and vasectomy reversal.

Emerging Therapies: Autologous Derived Muscle Cells

Posted by Christopher E. Wolter, MD | Jan 2025

Christopher E. Wolter, MD, discusses using autologous muscle-derived cells as a promising treatment for stress urinary incontinence.

In this 7-minute talk, Dr. Wolter reviews the steps for the therapy procedure, which involves procuring muscle cells through a minimally invasive biopsy, expanding the cells in culture, and re-injecting them into the patient. He notes that stress urinary incontinence is considered an ideal target for this therapy.
Wolter shares the promising results from Initial studies, including a pilot trial in 2008. Later trials using higher doses of injected cells demonstrated even better outcomes. He also references the MYOCYTE trial, a large multicenter, multi-institutional randomized study, which suggested that patients with previous stress incontinence treatments, such as slings, respond better to the therapy.

Optimizing Physical Wellbeing for Providers

Posted by Paul D. Maroni, MD | Jan 2025

Paul D. Maroni, MD, shares personal insights on maintaining health and well-being while balancing the demands of a medical career. This 20-minute discussion centers on ten key strategies to avoid burnout and improve overall wellness.

Maroni begins by categorizing health pillars into five main areas: sleep, nutrition, fitness, emotional and stress management, and the role of medications and supplements. He gives advice on maintaining a healthy work-life balance, adopting behavior changes, and seeking regular medical checkups. Dr. Maroni encourages colleagues to be proactive in their health, set small achievable goals, and approach wellness with the same dedication they apply to patient care.

Anterior Urethroplasty – Bulbar (A Primer For Part-Time Plumbers)

Posted by Ryan P. Terlecki, MD, FACS | Jan 2025

Ryan P. Terlecki, MD, FACS, emphasizes key elements for success in urethral surgery, focusing on preoperative planning, technical precision, and effective patient management.

A central message in this 11-minute presentation is to set realistic patient expectations while acknowledging that success is never guaranteed even with advanced surgical techniques. Terlecki compares conservative endoscopic management with surgical options, emphasizing that surgical planning requires careful consideration of anatomy, patient history, and the specifics of the stricture.

Dr. Terlecki stresses meticulous preparation, including the importance of standard protocols. Preoperative collaboration with anesthesia and other specialties is encouraged, along with video primers to prepare team members. Intraoperative decisions, such as when to transition from endoscopic to open surgery, are highlighted as critical moments requiring flexibility. He stresses that surgeons should stay calm under pressure and stick to their plan, even when faced with unexpected challenges.