Pearls & Perspectives: The Evolving Landscape of Female Pelvic Health, With Annah J. Vollstedt, MD

Welcome back to Pearls & Perspectives!

In this episode of Pearls & Perspectives, host Amy Pearlman, MD, sits down with Annah J. Vollstedt, MD, during the 2026 American Urological Association Annual Meeting in Washington, DC to explore the evolving landscape of female pelvic health and lower urinary tract dysfunction. Vollstedt offers her perspective on emerging technologies, current treatment paradigms, and where the field may be headed next.

A significant focus of the discussion centers on advances in neuromodulation for overactive bladder and urinary urgency symptoms. Vollstedt highlights the growing role of implantable tibial nerve stimulation devices, which provide patients with an alternative to frequent office-based treatments and can be managed largely from home. She discusses real-world patient experiences with these technologies, noting meaningful symptom improvement for many individuals while emphasizing the importance of setting realistic expectations. The conversation also touches on how these devices fit within a broader treatment framework that may include oral medications, behavioral strategies, and other minimally invasive interventions.

Pearlman and Vollstedt also examine the continued value of pelvic floor physical therapy as a foundational component of care. Although logistical barriers can sometimes limit patient participation, Vollstedt explains why pelvic floor therapy often enhances outcomes regardless of whether patients pursue medications, botulinum toxin injections, or neuromodulation. The discussion underscores the importance of individualized treatment plans that account for patient preferences, access to care, and symptom burden.

Looking toward the future, Vollstedt reflects on the limitations of the traditional distinction between stress urinary incontinence and urgency urinary incontinence. While these categories continue to guide diagnosis and treatment, she notes that many patients experience symptoms along a continuum, making management decisions more complex. As research continues to advance, Vollstedt shares her hope that future therapies will better address the overlap between these conditions and provide more comprehensive solutions for patients living with mixed urinary symptoms.