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Articles

“Our results show that by using NeuroSAFE, nearly twice as many men don’t have to face potentially life-changing loss of erectile function after prostate surgery,” says Professor Greg L. Shaw. 

NeuroSAFE procedure for RARP leads to improved erectile function

The use of pre-diagnostic MRI was 3.8% in 2012, which increased to 32.6% in 2019.

Study finds geographic disparities in MRI use in prostate cancer

"The striking CR rates observed in these early cohorts are highly encouraging, particularly for BCG-unresponsive NMIBC patients who currently have limited treatment options," says Paul D. Anderson, MBBS, FRACS. 

RAG-01 elicits complete responses in NMIBC

"Provided that we will confirm the efficacy data long-term, there is an opportunity to spare, de-escalate a bit, the treatment in select patients, and to expose the patient with inferior risk of developing severe [adverse] effects," says Andrea Necchi, MD.

Perioperative outcomes support benefit of TAR-200 plus cetrelimab in MIBC

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Clinical Focus

Jason Hafron, MD; Aaron D. Berger, MD; Arpeet Shah, MD

Medical Crossfire® in Adjunctive Testing: Charting a New Course in Prostate Cancer Risk Assessment

® Assistant Editor Janelle Hart spoke with 

, about the presentation, “Feasibility and efficacy of transvaginal onabotulinumtoxinA chemodenervation of the trigone for the third line treatment of refractory overactive bladder,” which was given at the Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction Winter Meeting. Dobberfuhl is a urologist at Stanford Hospitals and Clinics and an assistant professor of urology at the Stanford University School of Medicine in California.

“This technique is feasible, it is very well tolerated, and there’s not much of a complication rate, so it appears to be very safe,” says Amy D. Dobberfuhl, MD, MS.

Dr. Dobberfuhl discusses novel onabotulinumtoxinA treatment for refractory OAB

 She discusses the stigmas associated with overactive bladder, and how urologists can take the burden off of primary care physicians to educate patients who have this condition. Rogers is a urologist who specializes in incontinence at Sansum Clinic in Santa Barbara, California.

“We need to improve the fact that 75% of these patients are untreated [or] unmanaged and frustrated,” says Alexandra Rogers, MD.

Destigmatizing Urology: Dr. Alexandra Rogers discusses OAB

. He discusses urinary incontinence in male and female patients and how this condition can trigger major anxieties and avoidance behaviors. Seth is a consultant urological surgeon at St. George’s University hospital, London, UK.

“As health care professionals, we've got…an incredibly important role and responsibility with regards to increasing awareness and education, and then really trying to address the barriers and bring down the barriers,” says Jai Seth, MD.

Destigmatizing Urology: Dr. Seth discusses urinary incontinence

® Assistant Editor Janelle Hart spoke with J

. He discusses onabotulinumtoxinA injection programs as a treatment for urinary incontinence and the bleeding risk associated with these injections for patients who also take blood thinners. Seth is a consultant urological surgeon at St. George’s University hospital, London, UK.

“We're not saying a blanket stop for all patients, but I think we do need to be taking each patient as an individual in terms of their backgrounds,” says Jai Seth, MD.

Dr. Seth assesses the bleeding risk of Botox treatments in patients who take blood thinners

The 52-week study plans to enroll 16 patients across 4 sites in the US.

Trial launches of gene therapy vector for neurogenic bladder due to spinal cord injury

The ARID II trial is assessing the safety and effectiveness of the device in men who are scheduled to undergo robotic-assisted radical prostatectomy.

FDA greenlights pivotal trial of Voro Urologic Scaffold for postprostatectomy SUI

Overall, 84.2% of patients achieved a 50% or greater reduction in urgent leaks.

Pivotal study data show efficacy of percutaneous SNM device for UUI 

Overall, 85% of respondents indicated they experienced frequent bladder leaks. 

Survey data highlights substantial impact of postpartum incontinence

At 24 months, 79% of patients experienced a response to therapy, and 56% achieved at least a 75% reduction in UUI episodes.

Published OASIS data show durable efficacy of Revi System for UUI

, Grace Khaner and Melissa A. Laudano, discussed a study of prescribing patterns for the β-3 agonist vibegron (Gemtesa) for the treatment of overactive bladder.

For the study, which was presented at the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction 2025 Winter Meeting in Rancho Mirage, California, Khaner, Laudano, and their coauthors looked at prescribing data in a Medicare Part D claims data set.

“We found that the location that prescribers were registered in, as well as their fellowship training, was significantly associated with higher vibegron prescription rates,” said Khaner, a medical student at Albert Einstein College of Medicine in Bronx, New York.

In a recent interview with Urology Times®, Grace Khaner and Melissa A. Laudano, discussed a study of prescribing patterns for the β-3 agonist vibegron (Gemtesa) for the treatment of overactive bladder

Investigators characterize vibegron prescribing patterns for OAB

The investigators also found that prescribers who were located in urbanized areas prescribed vibegron at higher rates.

“I think a contributing factor that underlies all of this is that subspecialists in general are more concentrated in urban areas, and so the higher prescription rates that we see of vibegron in these urban areas might indicate that people in less rural areas just don't have as much access to prescribers who would be comfortable giving these medications out. It's possible that PCPs [primary care physicians] are the main prescribers in these less urbanized areas, just given the general distribution of health care professionals and so these variables kind of work in tandem, where it's likely that there might be less education regarding vibegron prescriptions or just new medications for overactive bladder in general, which can make it difficult for all patients to have access to these medications, depending on who their main access to health care is,” Khaner said.

Laudano added, “There also may be the possibility that in some of the rural areas that there may be less access to vibegron due just to availability/stocking in pharmacies, which may dissuade some of those providers from prescribing this medication. Our hope is that now that we see the excellent results associated with vibegron, that we may have more access for patients across the board.” Laudano is an attending physician and an associate professor of urology at Montefiore Medical Center and Albert Einstein College of Medicine.

1. Khaner G, Malviya N, Clearwater W, Laudano M. Prescribing patterns for vibegron, a selective beta3 agonist, used in the treatment of overactive bladder. Presented at: Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction 2025 Winter Meeting. February 26-March 1, 2025. Rancho Mirage, California. Abstract NM113

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"We found that the location that prescribers were registered in, as well as their fellowship training, was significantly associated with higher vibegron prescription rates,” says Grace Khaner.

Six-month data evaluating a battery-free percutaneous sacral neuromodulation (pSNM) device indicated that 84.2% of patients implanted achieved a 50% or greater reduction in urgent leaks.

The data on Neuspera’s pSNM device were presented at the 2025 Winter Meeting of the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) in Rancho Mirage, California, and were shared in a news release from Neuspera Medical.

®, study investigator Colin Goudelocke, MD, was asked how he envisioned the integration of Neurspera's pSNM into the current treatment paradigm for urge urinary incontinence, and what he saw as key factors that might influence its adoption among urologists and patients. He commented that in contrast to previous years, when there was dearth of treatments for overactive bladder, today, “It's almost an embarrassment of riches.”

“I'd always rather have too many choices, too many tools in the toolbox, rather than too few,” Goudelocke added.

Colin Goudelocke, MD, discusses Neuspera's percutaneous sacral neuromodulation device.

Expert outlines advantages of batteryless sacral neuromodulation device

However, having so many options raises the question of which treatment is appropriate for which patient, he said. For a device such as Neuspera’s pSNM, which is much smaller due to its lack of a battery, patients who might particularly benefit include those with lower body mass index and who are more active, Goudelocke noted.

“I sometimes have patients who are really, really active, and they'll get hit by something or struck by something at the site of their generator, and that can cause some discomfort or pain,” he said.

Goudelocke also commented that Neuspera’s system might be appealing to patients who want to take an active role in their treatment. In contrast, “There probably are patients that do want just a “set it and forget it” neuromodulator, and this is not going to be the right thing for them,” he said.

Another consideration is cosmesis. “There are patients who want to know, ‘am I going to see it when I’m in a changing room or changing clothes? Is it going to show through a bathing suit’”? Goudelocke said.

On the clinician side, Goudelocke highlighted the benefit of not having to put a generator in when implanting the device.

“For someone that might be looking at getting into sacral neuromodulation, and has had some reluctance in the past, this does simplify the procedure somewhat…and I think that might be attractive to some people,” Goudelocke said.

1. Neuspera Medical announces landmark six-month clinical trial results for the first battery-free percutaneous sacral neuromodulation (pSNM) system for urgency urinary incontinence management. News release. Neuspera Medical Inc. February 26, 2025. Accessed February 28, 2025. https://www.prnewswire.com/news-releases/neuspera-medical-announces-landmark-six-month-clinical-trial-results-for-the-first-battery-free-percutaneous-sacral-neuromodulation-psnm-system-for-urgency-urinary-incontinence-management-302385607.html

“For someone that might be looking at getting into sacral neuromodulation, and has had some reluctance in the past, this does simplify the procedure somewhat," says Colin Goudelocke, MD.

Emmanuel Chartier-Kastler, MD, PhD, shares the background and key findings from the study, “First in woman implantation of the new artificial urinary sphincter Uroactive (Uromems): Preliminary data at 12 months post-activation follow-up of the first patient.” 

Emmanuel Chartier-Kastler, MD, shares initial data on UroActive System in women with SUI

, shares the background and key findings from the study, “First in woman implantation of the new artificial urinary sphincter Uroactive (Uromems): Preliminary data at 12 months post-activation follow-up of the first patient.” These data were presented at the Society of Urodynamics, Female Pelvic Medicine, & Urogenital Recontruction (SUFU) 2025 Winter Meeting in Rancho Mirage, California.

Chartier-Kastler is a professor of urology and chairman of the department at Hôpital Pitié Salpétrière at Sorbonne Université in Paris, France.

Could you describe the background/rationale of this study?

Artificial urinary sphincter is part of the armamentarium for the treatment of stress urinary incontinence in women who suffer sphincter deficiency. The legacy device, AMS 800 from Boston Scientific, past AMS, [has been] used [for] more than 35 years, at least in France, because it's marketed and leveled for that. We, at least in my department, but also in routine practice in France and some countries in Europe implant it in women who are suffering severe incontinence and who are bothered by incontinence when they walk, when they stand up, or when they suffer some irritable urgency. This device, AMS 800 is a very good device, as there is a need for pump in the major labia and there is a fixed pressure with the pressure regulating balloon.

The new device we are presenting at this SUFU meeting, [is] an electronic one. The male study has been done, the pilot study. We did also the pilot study in women. I will present the first woman with more than 1-year follow-up with this electronic device, including a cuff, exactly as with the legacy device. The control of the pressure and the control of the voiding phase is made through a control unit which is placed at the abdominal level, subcutaneously. The patient will be able to void using a patient remote control to open the curve, which will spontaneously open when they push on the button, and the system will close by itself when the time of voiding phase is finished. This is exactly the same device as we use for the pilot study in men, but in women, the main challenge is that the cuff has to be implanted around the bladder neck. The bladder neck dissection is a challenging dissection in some patients who suffered past surgeries. We are used to do it since a long time, because we used a previous device. When you know how to dissect bladder necks, the implantation of this device is not easy, but it's quite easy to learn and to do and the patient is able to become quickly dry, not wearing a pad anymore.

I will present the result of the first woman who has been implanted with this new device, I would say it's worldwide, the first patient who has been implanted with an electronic device which has been activated and followed at least 1 year. This patient, she was suffering tremendous incontinence, with 4 pads per day and 125 grams of leaks at the 1-hour pad test, which is a way to evaluate the severity of incontinence. After implantation, which went well without any injury of the bladder neck or the bladder or the vagina, she has been activated at 6 weeks. After activation, she started to be dry and not to leak anymore, so she doesn't wear any more pads.

Now, at 1 year, the 1-hour pad test has been done again, as it's part of the protocol, and she suffered 4 g of incontinence on this test, opposed to 125 g at the beginning. She's voiding using the patient remote control. She is able to use a specific programming of the system, where at night she pushes on the lying down button. It means that at night, she reduced the pressure inside the system to protect the urethra. When she wakes up in the morning, she starts again to use daytime pressure to be fully dry in everyday activities.

This transcript was AI generated and edited by human editors for clarity.

“Now, at 1 year, the 1-hour pad test has been done again, as it's part of the protocol, and she suffered 4 g of incontinence on this test, opposed to 125 g at the beginning,” says Emmanuel Chartier-Kastler, MD, PhD. 

Colin Goudelocke, MD, describes the advantages of a batteryless neurostimulator evaluated in the study “Treatment of OAB symptoms using Neuspera’s ultra-miniaturized system: 6-month results of the SANS-UUI phase II study"

Smaller size, patient control advantages of neurostimulator for OAB

 describes the advantages of a batteryless neurostimulator evaluated in the study “Treatment of OAB symptoms using Neuspera’s ultra-miniaturized system: 6-month results of the SANS-UUI phase II study,” which was presented at the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction 2025 Winter Meeting. Goudelocke is a urologist with Ochsner Health Center in Covington, Louisiana.

Compared to the published data for traditional SNM, what specific aspects of the patient experience do you believe are most impactful in terms of improved adherence and long-term satisfaction?

This is an ultra-small device. It's the smallest, I think. You can imagine if you're subtracting out the largest part of the device, it's not surprising that it's smaller. [The lack of] a battery makes it ultra small. That's really important. As someone who really believes in sacral neuromodulation therapy, I don't want to lead people astray. Most patients are very happy with traditional sacral neuromodulation. But there are issues, there are problems, and for that subset of the population, most of the issues that we do see with neuromodulation, frankly, they're usually with the generator. Most infections that I see are generator site infections. Most of the pain that patients experience is at the side of the generator. A lot of times we have movement; we sometimes call it "twiddler syndrome," where people will tend to, if the pocket is a little bit bigger than the battery, they can actually twist that battery around. They kind of twiddle with it. I think that that term was actually coined in people doing the same with their pacemakers, but it's true sometimes in sacral neuromodulation. Most of the issues that patients experience, frankly, they tend to be with the battery. So to the extent that this device might remove some of those issues, that's really going to be impactful.

Second, it's kind of interesting, because in 1 approach to sacral neuromodulation, some devices have sort of taken an approach where we really want to sort of remove the patient as much as possible, sort of almost the "set it and forget it" version of this. Can we make it as hands off for the patient as possible? Because it's an externally driven device, and because the patient is actually applying it to their skin, on average, for about 2 hours per day, the patients are really involved in the therapy. I don't see that as a bug. I actually see that as a benefit. Patients are actually in control of their therapy. They're actually, in their mind—and I think there's some reality this—they're administering their therapy every day. I think there are some advantages to that patient control, to a patient actually being able to direct her therapy or to direct his therapy. That may actually be borne out by the data. This is interesting, and I think this is a little bit of speculation on my part, but as I said before, this therapy, I think, looks really good in compare comparison to other sacral neuromodulation trials. We saw about an 84% response rate. For me, that's sort of what I would expect from a clinical trial of a sacral neuromodulator. Of those respondents, so of that 84%, 84% are what they are characterizing as "super responders," meaning they had at least 75% improvement.Most of our clinical trials, we define a 50% improvement in symptoms. They're giving this this new category of 75% improvement as super responders. And the 84% is a really high number. Furthermore, 42% of patients were dry. This is very interesting. I enrolled patients in this clinical trial. I didn't have any access, obviously, to all of the data. I just knew, until this was published, I just knew my patients. But I kept noticing, and in fact, in my conversations with the people that were running the trial, I kept noting, I said, it's really interesting. I have some patients who have responded, I have some patients who haven't responded. And again, my response rates in my own patients that I implanted seemed pretty in line with this, but I kept noticing that the patients that are getting better seem to me like they're getting a lot better. The ones who didn't respond didn't respond, and I understand that, but the ones who were responding were really, really better, way better than 50%. I kept making the comment, "I'll be really interested to see when these data come out, whether or not that's the experience across the entire group," and that seems to be the case here. Purely speculative, but I'm really kind of curious. Is it something about that? Is there something about the patient having control over her therapy, the patient being able to feel like "I'm doing this to myself, and I'm getting better, and I'm feeling this stimulation." I think it's a really interesting question. This study is in no way meant to answer that kind of question. But I think it's really, really intriguing that in a study where patients have all of this control, we have this higher rate of "super responders," which I think is really interesting.

"[The lack of] a battery makes it ultra small. That's really important," says Colin Goudelocke, MD.

Colin Goudelocke, MD, discusses the significance of the findings of the study “Treatment of OAB symptoms using Neuspera’s ultra-miniaturized system: 6-month results of the SANS-UUI phase II study"

Batteryless neurostimulator found efficacious at 6-month follow-up

 discusses the significance of the findings of the study “Treatment of OAB symptoms using Neuspera’s ultra-miniaturized system: 6-month results of the SANS-UUI phase II study,” which was presented at the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction 2025 Winter Meeting. Goudelocke is a urologist with Ochsner Health Center in Covington, Louisiana.

You mentioned the pSNM system offers "consistent relief." Can you describe the stability of the therapeutic effect over the 6-month study period?

Let's be honest, so 6 months, right? Anytime we talk about overactive bladder, this is a disease that we don't have a cure for, so we always need to think about these patients over their lifetime. These are relatively early data. Obviously, I think we're all going to be very eager to see what happens to these patients over time. How are they doing in a year and as we're implanting this, who will be implanting this in clinical practice? How are these patients going to do over the long term? I'm certainly interested to see the patients that I implanted as part of the clinical trial, how are they doing at a year and beyond? However, I think 6 months is important for me as a practitioner, as a provider, someone who's seeing patients every day, because a lot of the issues that I see in sacral neuromodulation tend to pop up in 6 months. Most of the time when I'm seeing infections at the battery site—luckily, that's not too often—but when we do see infections at the battery site, that's usually going to be well inside of 6 months. Patients who have displeasure with the battery, or patients who have a rechargeable device that when they're starting to get a little frustrated with recharging sometimes, or even those patients, when we we tend to see some lack of efficacy over time, or some decrease in efficacy over time, I think most of those problems, at least in my anecdotal experience, those tend to happen at6 months. So even though this is relatively early in the course of someone who's going to have overactive bladder for the rest of his or her life, I do think there's something that's really important about 6 months, and it's certainly why I think the data are relevant to my practice.

"I think we're all going to be very eager to see what happens to these patients over time," says Colin Goudelocke, MD.

Colin Goudelocke, MD, gives an overview of the study “Treatment of OAB symptoms using Neuspera’s ultra-miniaturized system: 6-month results of the SANS-UUI phase II study."

Colin Goudelocke, MD, on 6-month data for batteryless neurostimulator

 gives an overview of the study “Treatment of OAB symptoms using Neuspera’s ultra-miniaturized system: 6-month results of the SANS-UUI phase II study,” which was presented at the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction 2025 Winter Meeting. Goudelocke is a urologist with Ochsner Health Center in Covington, Louisiana.

Please provide an overview of this study and its notable findings.

This is the 6-month data of a new type of sacral neuromodulator that was created by a company called Neuspera. Most of the people in this space know that sacral neuromodulation has been around for a long time. Traditionally, a sacral neuromodulator is composed of 2 things, and that's the lead, the wire that actually stimulates the sample nerve, and then that's usually attached to a battery, or what is sometimes called the generator, which is typically, these days, buried in the fat around the upper part of the buttocks or the lower part of the waist. That's what we've all known as neuromodulation for a long time. And there have been some different iterations of that. Over time, that battery has shrunk down. I remember when I really first started doing this, a number of years ago, the battery was huge, and then it got a little bit smaller as battery technology got better, and then we even moved on to rechargeable batteries that were very small, and with the idea that we could decrease some of the negative aspects of that. This device is really unique. It gets rid of the battery altogether. The ultimate in making the battery really, really small is, well, what if we didn't have a battery at all? So it's very innovative in that way. It still has the lead. We still have to have a portion of it that sits next to the sacral nerve. But what they've done is they've actually integrated into that everything that you need, and so rather than having an internal power source that's supplied by a battery that might need to be either recharged every couple of weeks or changed every 10 or 15 or 20 years, the power source actually comes from an external source. It's externally driven, and so they have a small disc that you put on top of the device, so over the skin, and it's able to power that stimulation during that time. And, of course, there's a garment that that disc sits in, so you don't have to sit there holding it with your hand. You can walk around with it. You can clean the house or read a book or watch television or do whatever you want to do. That's the unique idea behind this, it's battery free, externally powered, and so it only requires a single incision. Normally, we make 2 incisions in order to place a neuromodulator: one incision for the for the lead, and then a second incision for the battery, no battery, so only a single lead, and you're also doing this in just a single step.This was a trial looking at efficacy, tolerability, all of those sorts of things. What we're talking about today is the 6-month data on that, and it's impressive. We'll get into the details of it, I'm sure, as we go through other questions. But essentially, this is what we've come to expect from sacral neuromodulation. At 6 months, 84% of patients respond, having at least a 50% reduction in their urgency incontinence episodes. I've been doing single neuromodulation for a long time. I've been either involved or reading about neuromodulation trials. This is kind of what you expect. This is the response that we would expect from that. It's very exciting. Those of us who do this a lot, we always feel like the more tools that we have in our toolbox, the better we're able to service our patients, because everybody who walks in the door doesn't need the same thing, and if I have different options for different people, I think I can do a lot more good for a lot more people.

"At 6 months, 84% of patients respond, having at least a 50% reduction in their urgency incontinence episodes," says Colin Goudelocke, MD.

Vanita Gaglani, RPT, gives advice to men with post-prostatectomy incontinence or prostatitis

A physical therapist’s advice for men with post-prostatectomy incontinence

gives advice to men with post-prostatectomy incontinence or prostatitis. Gaglani is a registered physical therapist and owner of Vanita’s Rehab in Melbourne, Florida. She was interviewed at the 2025 Desai Sethi Urology Institute Urology on the Beach meeting in Miami Beach, Florida.

What advice would you give men who have post-prostatectomy incontinence or prostatitis?

I would say, talk to each other. Talk to other men about it. You are not the only one leaking. Think about how many Depends and diapers and pads are sold. Think about how many different type of products are there. Depends advertises on TV that you can play with your grandchildren. So this concept that "I am the only one leaking," and "it's an embarrassing thing," it is not. It is not a stigma. It can be overcome with the help of a therapist and a doctor. So seek help. Do not feel that you cannot do anything about it. Same with the men who have pelvic pain: persist. Find a doctor who will listen to you and find a more holistic approach, along with the medication approach.

"I would say, talk to each other. Talk to other men about it. You are not the only one leaking," says Vanita Gaglani, RPT.

William Furuyama, MD, shares the take-home message from the Urology paper “Social Vulnerability is Associated with Worse Urinary Incontinence and Quality of Life in Women.”

William Furuyama, MD, on community factors’ influence on urinary incontinence

paper “Social Vulnerability is Associated with Worse Urinary Incontinence and Quality of Life in Women.” Furuyama is a urology resident at Vanderbilt University Medical Center in Nashville, Tennessee.

What is the take-home message for the practicing urologist?

I think, a lot of times, people with urinary incontinence or overactive bladder wonder why those things are happening to them. I think that's a very common question; the etiology of someone's illness or disease. Having a broader understanding of why someone might be experiencing the disease process or symptoms that they're coming in with is really meaningful and helpful, both to patients and to physicians and providers who are trying to counsel patients on what's going on with their bodies. Being able to talk about the social environment, talk about psychosocial stress, talk about these kinds of things, and their influence on these conditions can be really powerful and meaningful to people.

I think this paper certainly has a number of limitations. It's a retrospective study; it's a survey. It's a big survey, but certainly it's prone to the biases associated with that. But I think for me, it leads more to additional questions than to a specific intervention that we can use. I think it really begins to implicate the social environment and neighborhoods in the pathology of overactive bladder and makes me curious more about how those relationships happen for people and sort of the through line there, and whether interventions upstream in the neighborhood could actually impact people's experience with urinary incontinence.

“Having a broader understanding of why someone might be experiencing the disease process or symptoms that they're coming in with is really meaningful and helpful, both to patients and to physicians,” says William Furuyama, MD.

William Furuyama, MD, discusses the Urology paper “Social Vulnerability is Associated with Worse Urinary Incontinence and Quality of Life in Women.” 

Investigators explore social vulnerability and urinary incontinence

The abstract mentions targeted policy interventions. Based on your findings, what specific types of interventions at the community level do you believe would be most effective in mitigating the burden of UI in socially vulnerable populations?

I think targeting things that make communities more vulnerable would be reasonable things to target to try and affect disease practices. I also think that targeting these things would affect urinary incontinence, because we know a lot of these things are associated with worse disease severity. But I think thinking about things like trying to ensure that people have access to housing, trying to help people with educational attainment, trying to make sure that people have access to reliable transportation, I think all will make our communities healthier, not just from a urologic perspective, but in general. And I think we know that trying to reduce the amount of social stress in an environment is helpful for people with incontinence or, I guess the study points toward that. I don't think that we know that definitively, but I think this study points to trying to focus on the social environment as a site of intervention through those sorts of things.

"I think targeting things that make communities more vulnerable would be reasonable things to target to try and affect disease practices," says William Furuyama, MD.

Vanita Gaglani, RPT, discusses her books on post-prostatectomy incontinence and prostatitis

Vanita Gaglani, RPT, discusses books on post-prostatectomy incontinence and prostatitis

discusses her books on post-prostatectomy incontinence and prostatitis. Gaglani is a registered physical therapist and owner of Vanita’s Rehab in Melbourne, Florida. She was interviewed at the 2025 Desai Sethi Urology Institute Urology on the Beach meeting in Miami Beach, Florida.

You have written books regarding post-prostatectomy incontinence as well as prostatitis. Could you provide a brief summary of these works?

[One of my books is about] radical prostatectomy and overcoming incontinence in several weeks. It encompasses everything. It shows all the exercises, but it also talks about how to increase your bladder capacity, why you should drink water, how drinking water does not make you leak more; it actually makes you leak less, how doing more exercises will actually make you leak more.

The reason that we focus on not doing a lot of exercises initially is because the pelvic floor is small, like your hand. Your hand muscles are small. If you keep squeezing your hand muscles, then what will happen is that at a point, you will not be able to hold anything. Similarly, if you do too many Kegels, it will create a problem that the pelvic floor won't have the strength to hold it. The second important thing in the book is how the bladder works. I encourage men to not have drinks or bladder aggravants, and to focus on alkaline or neutral foods to decrease bladder spasms. The reason that happens is,imagine if a person has had a cut on the hand and it is sutured, and then if you put lemon juice on it, it goes into a spasm. Similarly, when people drink soda after surgery, the bladder goes into a spasm, and then the urine will get pushed out, because the job of the kidneys is to remove toxic material, and soda is very toxic, along with several other bladder aggravants. The book focuses on a holistic approach, along with exercise, and it is focused on nutrition, hydration, behavior modification, and exercise. All 4 components are required for a man to get dry. You cannot just do Kegel exercise or only drink a lot of water or just do body mechanics. They all have to be combined together in a sequence, and that is what the book focuses on.

My second book is on pelvic pain or prostatitis. It is focused on a holistic approach and stretches and mindfulness exercises. It is more of a self-help book A person can sit at home and do all these stretches and exercises. It also requires following certain nutritional protocol and behavioral protocol, as well as body mechanics. Prostatitis is a very unique condition in men. It is not something men talk about very frequently, because it is something that is not talked about often in public. lt is very difficult for a man to go and say, "my rectum is hurting," or "my scrotum is hurting," or "I have got penile pain and I cannot sit for a long time," or "I cannot bike," or "I cannot stand for a long time." This book helps them to know that they are not the only ones having this problem. There are a lot of young men who have this problem, and it absolutely impinges on their social life, because they just kind of isolate themselves.

"My second book is on pelvic pain or prostatitis. It is focused on a holistic approach and stretches and mindfulness exercises," says Vanita Gaglani, RPT.

Panelists conclude their discussion by reflecting on key learnings and sharing advice for patient-centric management in overactive bladder (OAB) treatment.

Enhancing Patient-Centric Management in OAB in 2024 and Beyond

 So it seems like you both have really patient-centric management in regards to all the therapies, specifically for in -practice treatments, such as Botox therapy. Any advice you'd give to some of our colleagues listening here, what could they do? to enhance that patient experience that may be something simple? I know, Dr. Eilber, you actually mentioned you modified things recently, but I'll have each of you say what things could they do?

 I think the two things that people really fear are the catheterization, and that they will happen the middle of the night. So I think it's the same as when we're young. giving those post -procedure instructions, you say there is, and the patients get their first injection, of course, there is a risk of retention. It is very low. However, it doesn't happen instantaneously. We'll see you at two weeks. And if you're retaining a lot then, we can teach you how to empty your bladder. If you feel you're struggling more and more, call us, we'll see you sooner. But I can tell them in good conscience, I've never had anybody go into a cube retention. you know, within that timeframe because of that. And so I think that's really what people fear is that they're going to go into acute retention, no one's going to be around. And that's not really how it works.

 And Dr. Benson? Yeah, two things. The first, get it out of the operating room, if you can, and move it to your office.

Panelists conclude their discussion by reflecting on key learnings and sharing advice for patient-centric management in overactive bladder (OAB) treatment, specifically focusing on effective communication and overlooked aspects of patient care. They offer guidance to other providers on enhancing patient experiences, particularly with procedures like Botox. The episode wraps up with each expert sharing their final thoughts and anticipations for advancements in OAB treatment in 2024, highlighting their commitment to addressing patient needs in this evolving field.

OAB and Incontinence

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