AUA2021 Day 2 eNews - 091121

AUA DAILY NEWS INSIDE SATURDAY. SEPTEMBER 11, 2021 Trial results suggest advancements in treatment for female incontinence I nvestigators revealed findings to impact the treatment of patients with urologic conditions in Friday’s abstract session, “PD06-01: Urodynamics/ Lower Urinary Tract Dysfunction/ Female Pelvic Medicine: Female Incontinence: Therapy I.” Highlights from three of the 12 abstract presentations included a look at emerging cell therapy, refractory incontinence and exercise. Emerging cell therapy for urologic indications Melissa R. Kaufman, MD, PhD, FACS, presented results of “A Double-blind, Randomized, Controlled Trial Comparing Safety and Efficacy of Autologous Muscle Derived Cells for Urinary Sphincter Repair (AMDC-USR) with Placebo (PBO) in Women with Stress Urinary Incontinence (SUI).” Dr. Kaufman is principal investigator and chief, division of reconstructive urology and pelvic health, at Vanderbilt University Medical Center in Nashville. The Phase III clinical trial investigated the safety and efficacy of the intrasphincteric injection of a single dose of 150 × 106 autologous muscle-derived cells (AMDC-USR) for urinary sphincter repair versus placebo in women with stress urinary incontinence (SUI). “AMDC-USR is a unique technology as a biologic for stress incontinence treatment. It’s targeted for delivery to the external sphincter,” Dr. Kaufman said. Administering AMDC-USR is a minimally invasive in office procedure. “The mechanism is hypothesized to engraft to the muscle at the injection site, forming new striated muscle and improving muscle function,” Dr. Kaufman said. The randomized, placebo- controlled Phase 3 study enrolled 297 women who were randomized TRAINING MODELS AND TECHNIQUES 3 GUIDELINES AND BEYOND 4 YOUNG UROLOGISTS FORUM 6 VALUE OF CARE 11 ADVANCED PRACTICE PROVIDERS 12 SENDING THE RIGHT MESSAGE 13 Don’t Miss Here are just a few of the Saturday sessions you won’t want to miss. 7 – 9 a.m. PDT Avoiding Medical Malpractice in the Age of EMR 7:30 – 8 a.m. PDT Panel Discussion: Artificial Intelligence Applications in Urology 8 – 9 a.m. PDT When Disaster Strikes: Preventing and Managing Nightmares in Urology 9:30 – 11:30 a.m. PDT Health Services Research: Value of Care: Cost and Outcomes Measures II 11:30 – 11:40 a.m. PDT UCF Presidential Lecture: Presentation of Global Humanitarian Award Recipient 11:40 a.m. – 12:20 p.m. PDT COVID-19 Vaccine: A Journey to a Post-Pandemic World 1 – 3 p.m. PDT Sexual Dysfunction & Transgender 2 – 4 p.m. PDT Guidelines and Beyond: Case Based Approach to Non-Muscle Invasive Bladder Cancer Tips and tricks for managing refractory overactive bladder T he new 2019 American Urological Association/ Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction guideline provides first-, second- and third-line evidence-based treatment approaches for the diagnosis and treatment of non- neurogenic overactive bladder (OAB). First-line therapies include behavioral therapy, dietary modification and physical therapy. Second-line therapies include antimuscarinics, a subtype of anticholinergic drugs that block cholinergic receptors, and beta-3 agonists. Third-line therapies include OnabotulinumtoxinA (Botox), percutaneous tibial nerve stimulation (PTNS), and sacral neuromodulation (SNS), which is designed to help control OAB symptoms with a surgically implanting neurostimulator and lead to stimulate the sacral nerve electrically to control OAB symptoms with mild electrical pulses. Although insurance companies may require patients to fail two medications before trying a third- line therapy, “the guidelines are not an algorithm,” said Kathleen Chizuko Kobashi, MD, FACS, a presenter in Friday’s instructional course, “Refractory Overactive Bladder: How to Select Third- Line Therapies and Optimize Outcomes.” “If patients say they’re not taking medication, you can jump to a third-line therapy,” said Dr. Kobashi, who is head of the section of Urology and Renal Transplantation at Virginia Mason Medical Center in Seattle. With Sandip Vasavada, MD, who serves as the Urologic Director, Center for Female Urology and Reconstructive Pelvic Surgery, at Cleveland Clinic within the Glickman Urological Institute, and as professor of surgery (urology) at the Cleveland Clinic Lerner College of Medicine and has a joint appointment with the Women’s Health Institute, and David Ginsberg, MD, FPMRS, professor of clinical urology at the Keck School of Medicine at the University of Southern California, Dr. Kobashi discussed how and when to select the most appropriate third-line therapies for patients with refractory OAB to see TIPS AND TRICKS page 13 see TREATMENT page 4