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Urology Specialty Updates

May 2016

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— Cynthia Fok, MD, MPH

Makeup of microbiome tied to urgency incontinence

A new study sheds light on the role of the urinary microbiome in urgency incontinence in adult women, an element of the disease pathology that has not been well understood. University of Minnesota Health physician Cynthia Fok, MD, MPH, and colleagues hypothesized that the microbiome’s characteristics at baseline might relate to patients’ responses to treatment with oral medication. To examine this question, she and her colleagues collected urine samples from healthy women and from women with urinary urge incontinence, drawing samples at baseline and at weeks 4 and 12 of treatment with solifenacin. They found that the diversity and composition of these patients’ urinary microbiome was indeed greater at baseline than that of healthy women’s. Response to solifenacin was also significantly more likely among women with fewer bacteria and a less diverse microbiome at baseline. Nonresponders had a more diverse microbiome that often included bacteria not typically found in responders. The study appears in the International Urogynecology Journal.

Computational model furthers study of incontinence treatments

A computational model of a patient’s pelvis, devised by University of Minnesota Health physician researchers, may help improve surgical approaches to treating stress urinary incontinence in women. Urethral hypermobility, a major cause of the condition, is often addressed through placement of a mid-urethral sling, considered the gold standard in surgical treatment. The introduction of single-incision slings, however, has prompted debate about comparative outcomes of the approaches. To investigate single incision slings, Nissrine A. Nakib, MD, and colleagues conducted a dynamic biomechanical analysis using a computational model of the female pelvis, developed from a female volunteer’s high-resolution MRIs. The computational model revealed that a sling implanted at the bladder neck resulted in overcorrection, while when implanted at the mid-distal urethral location, it provided sufficient correction with minimal risk of overtightening. The computational modeling used in this study can also be used to advance pre urgery planning and sling design as well as to enhance understanding of surgical risk factors. The data from this study appear in the Journal of Biomechanical Engineering.

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— Nissrine A. Nakib, MD

M Health urologist named 2016 “Rising Star”

Nissrine A. Nakib, MD, a University of Minnesota Health urologist, has been named to Mpls.St.Paul Magazine’s Top Doctors Rising Star list for 2016 in the category of urology. Selected through a peer-nomination process, the honorees are physicians who have been fully licensed to practice medicine for no more than 10 years. Identified candidates are grouped into 44 specialties and evaluated on a variety of factors, including professional achievement, research contributions, and disciplinary history. The highest-ranked physicians based on the surveys, research, and panel review are selected as Rising Star honorees.

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Improving Quality of Life for Women with Pelvic Organ Prolapse

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Robot-Assisted Sacrocolpopexy Returns Patient to Active Lifestyle

After conservative measures failed, a patient opts for a surgical intervention. The robotic-assisted procedure led to full resolution of symptoms and allowed her to resume her strenuous running regimen.

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