In this special Urology on the Beach edition of Pearls & Perspectives, host Amy Pearlman, MD, sits down with Raveen Syan, MD, FPMRS, to discuss the rapidly evolving landscape of female pelvic medicine and reconstructive surgery, with a focus on overactive bladder, voiding dysfunction, and patient-centered innovation.Syan shares how she designs real-world case discussions that mirror the longitudinal nature of urologic care, emphasizing that many patients require ongoing management rather than one-time fixes. She reflects on what she learns from moderating expert panels, including how leaders in the field evaluate emerging technologies, interpret new data, and individualize decisions around medical vs procedural therapies.The conversation highlights the steady pace of innovation in urogynecology, from onabotulinumtoxinA and sacral neuromodulation to improvements in device technology and implantable neuromodulation options. Syan explains how updated American Urological Association/ Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction guidelines now allow clinicians to move directly to minimally invasive therapies without requiring medication trials, a shift that better aligns with patient preferences and avoids the adverse-event burden of anticholinergics.They also explore why so many patients with urinary incontinence remain untreated, pointing to lack of awareness, stigma, and limited screening in primary care. Syan underscores the importance of education and outreach, particularly in underserved populations, and notes that patients today are increasingly informed and engaged in shared decision-making.The episode closes with a personal reflection on surgeon wellness, the value of developing interests outside of medicine, and how embracing discomfort through new hobbies can build resilience—both in life and in the operating room.

Ask this episode

“What did the council decide on item 42?” — answered with the speaker and the moment.

Transcript

Related