2025 Urogynecology for the Advanced Practice Provider-Burning and Stinging: Lower Urinary Tract Pain and Recurring Urinary Tract Infections

Video Transcription

Video Summary

The video addresses several urological issues, beginning with clarification about reimbursement policies for percutaneous tibial nerve stimulation (PTNS) and transitioning into discussions around urinary tract pain and infections, including recurring urinary tract infections (UTIs), painful bladder syndrome (PBS), and interstitial cystitis (IC). One major highlight was the detailed explanation of PTNS insurance protocols and the necessity of documenting improvements midway through treatment cycles.<br /><br />The conversation then shifted to diagnosing and managing lower urinary tract pain, focusing on the prevalence of hot-potato syndrome, where different specialists often don't take full responsibility for complex cases. The speaker outlined criteria for diagnosing symptomatic urinary tract infection, emphasizing the importance of culture-proven evidence.<br /><br />During the discussion on recurring UTIs, the speaker stressed the impact on patient care due to fragmented treatment approaches, outlining the importance of obtaining urine cultures to guide therapy and avoid misuse of antibiotics, which contributes to resistance.<br /><br />Interstitial cystitis (IC) and PBS were described as challenging to treat due to varied symptoms and the overlapping nature of different conditions. Breaking down sub-categories of IC, the emphasis was placed on identifying triggers, understanding flares, and the absence of a definitive treatment. The speaker encouraged a multi-disciplinary approach, utilizing a range of interventions including physical therapy, intravesical treatments, and patient education to manage symptoms.<br /><br />Finally, the discussion introduced a new antibiotic, gefditapin, highlighting its promise in treating UTIs with fewer side effects, though caution was advised against overuse to prevent bacterial resistance development. The talk encouraged listeners to keep current with advancing therapies and involve patients in their treatment plans to improve outcomes.

Asset Subtitle

Irritative lower urinary tract infections (frequent urination, nociceptive urgency, dysuria) are usually attributable to recurrint urinary tract infection or painful bladder syndrome (PBS). This presentation will review the evaluation and initial management options for these conditions; particular emphasis will be placed on differential diagnosis or recurrent UTI versus PBS and initial management options for each of these challenging conditions.

Objectives:

Identify similarities and differences in clinical manifestations of PBS versus recurrent urinary tract infections.
Formulate an approach for differential diagnosis and management of PBS versus recurrent UTI.
Discuss management options for recurrent UTIs and PBS.

Speakers - Mikel Gray, PhD, FNP, PNP, CUNP, CCCN-AP, FAANP, FAAN

Keywords

urological issues

percutaneous tibial nerve stimulation

urinary tract infections

painful bladder syndrome

interstitial cystitis

hot-potato syndrome

urine cultures

antibiotic resistance

multidisciplinary approach

gefditapin

patient education