There was a vibrant new program this year at the American Urological Association (AUA) Annual Meeting 2015! The program was titled Second Opinion Cases and it brought together over twenty prominent urology experts from around the world who took a close second look at eight different clinical cases. These selected popular cases covered male incontinence, chronic pelvic pain syndrome, difficult stone cases, prostate cancer, refractory overactive bladder and female incontinence, noninvasive bladder cancer, small renal masses, penile reconstruction, erectile dysfunction, and implants. Cases were selected on hot topics in the urology world today and the program did not disappoint ? the room was packed with standing room only very quickly!

Each panel covered the two of the most common scenarios that an urologist would see in their everyday practice and they discussed the typical evaluation and management of the patient along with covering some of the ongoing controversies in the field. All cases had three of the key opinion leaders for each subspecialty and they provided their perspective on these common disorders and management issues. Each session was very engaging and interactive with the audience! Each case was presented along with a list of possible treatments options and attendees were encouraged to text in their vote as to how they would have managed the case in their own practice. The results were compiled and displayed in real time after the speakers presented their opinions. From the poll results it became apparent that the audience consisted of both a large group of more aggressive practicing urologists and a large group of more conservative practicing urologists so there was not always a consensus on the treatment!

My favorite session was refractory overactive bladder and female incontinence which was led by Doctor Gary Lemack and discussed by Doctor David Ginsberg and Doctor Ariana Smith. Women with urinary incontinence are a very significant part of most urology practices today and their problems can be among the most challenging so I was excited that this topic was included in the Second Opinion Cases program! In this session, they discussed some of the more common questions and concerns for treating women who did not respond well to their initial treatment attempts. Urologists tend to see urinary incontinence patients once they have been referred by primary care physicians when the initial treatment ? usually medication or pelvic floor exercises ? was not effective. This discussion covered the current guidelines for urinary incontinence and then they focused on the more general questions of evaluating patients with both stress and urge urinary incontinence.  This included where and how medications and technologies can be best used to most efficiently treat patients.

This program was definitely one of the most popular at the conference, and I anticipate it will be in the program again next year!

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