Treating incontinence in certain patient populations, such as the elderly and the obese, can present unique challenges for clinicians. Three experts in female urology will share several cases illustrating some of these challenges during a Second Opinion Cases session Monday afternoon titled Urinary Incontinence, which will begin at 2 p.m. in Ballroom East of the Boston Convention and Exhibition Center. The 30-minute discussion will feature challenging cases in the management of urinary incontinence.
Gopal H. Badlani, MD, professor of Urology and Vice Chair of Clinical Affairs at Wake Forest University and Baptist Medical Center, will moderate the session.
“These are common situations clinicians face in the office and need to be prepared to address,” Dr. Badlani said. “Using current clinical guidelines and the expertise of the panelists, we’ll show attendees how to navigate these types of cases.”
One case involving an elderly woman with incontinence will highlight several unique challenges that must be addressed before deciding on a treatment approach.
“There may be mobility issues to consider. Clinicians also need to consider any medications the patient is taking and any restrictions to medications per the Beers Criteria,” Dr. Badlani said. “When it comes to treatment, can you apply the current standard guideline options of Botox® and neuromodulation in the elderly? There are special issues you have to worry about in the elderly, such as the urinary retention rate with Botox®, but there’s limited published literature in this area.”
The panelists will also discuss how obesity can be a complicating factor in an otherwise typical incontinence case.
“Every treatment option is potentially complicated by obesity, so deciding how to proceed requires some careful thought,” Dr. Badlani said. “Do you insist that the patient participate in the treatment by losing weight or do you treat immediately? We’re fortunate to have such a talented group of panelists to look at these questions.”
Dr. Badlani will be joined on the panel by Una Lee, MD, a practicing urologist at Virginia Mason Medical Center; Nissrine Nakib, MD, Director of Female Urology and Urodynamics at the University of Minnesota; and Fiona Burkhard, MD, associate professor at University Hospital in Bern, Switzerland.
As the panelists work through the diagnosis and management for each case scenario, attendees will be asked to participate in the evaluation through audience response questions. The discussion will also include a review of the guidelines and the algorithm for treating refractory overactive bladder.
“I hope the audience understands that this session is about them,” Dr. Badlani said. “This is a great opportunity for attendees to practice their diagnosis and problem solving skills with expert diagnosticians. We may not come away with perfect answers because these are difficult cases, but attendees will see how the experts work through the problems.”