What Is Bladder Fulguration For UTI? Dr. Philippe Zimmern (Part 1)

Despite the recent increase in awareness of bladder fulguration, Dr. Zimmern explains that this procedure has actually been around for a long time. While it seems to be common practice for urologists to utilize this technique in the treatment of bladder tumors and migration of ulcers, Dr. Zimmern points out the lack of research on the technique for chronic UTI treatment.
It was this lack of data that motivated Dr. Zimmern to start his journey in this field, primarily seeking to understand what fulguration really does to the body and when it should be used. He talks about research conducted by microbiologist Dr. Scott J. Hultgren, who used an animal model to understand what happens to bacteria in the bladder and how it gets incorporated into the tissue. This research got Dr. Zimmern thinking about his patients who kept coming to him with UTIs with no clear source of infection.
Dr. Zimmern shares how he uses cystoscopy to look for inflammation and lesions in the bladder which could indicate an infection site. As part of a research team in Dallas in Texas, he took biopsies of these areas and examined them using complex technology called fluorescence in situ hybridization (FISH). This exciting research allowed Dr. Zimmern to see where the bacteria had been hiding in the bladder tissue, ultimately providing insight into why infections kept recurring.
There doesn’t appear to be a known link between UTIs and bladder cancer. If there is ever a question about whether the patient is facing inflammation versus cancer, biopsies would usually be recommended at that stage to be on the safe side. However, generally, bladder cancer is uncommon, especially in women.
Dr. Zimmern explains that fulguration is typically an option for people who have started to build up resistance or allergies to antibiotics, and therefore have a harder time treating their infections.
With regard to the procedure itself, bladder fulguration is performed under anesthesia typically within around 30 minutes. A small electrode is used to apply a very low current to any infection sites in the bladder, burning them off. Any visible area in the bladder can be fulgurated, but in complex cases where the majority or all of the bladder requires fulguration, repeat procedures may be necessary.
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About Dr. Zimmern
Philippe Zimmern, M.D., is a Professor of Urology at UT Southwestern Medical Center and the recipient of the Felecia & John Cain Distinguished Chair for Women’s Health in Urology. His expertise covers urinary incontinence, prolapse, and UTI.
After two Urology trainings and a fellowship at UCLA, Dr. Zimmern joined the faculty at UT Southwestern in 1995. He is a past President of the Society for Urodynamics and Female Urology. Dr. Zimmern co-directs a two-year endowed fellowship program in female pelvic medicine and reconstructive surgery. He has been a visiting professor in many countries, co-authored nearly 400 publications, 29 surgical movies, and 67 book chapters, and co-edited four textbooks on FPMRS topics. He is FPMRS certified and a member of FACS. He received the inaugural Leaders in Excellence Award at UT Southwestern (2019).
Check out the playlist for the entire interview: • Dr. Philippe Zimmern
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About Live UTI Free
Live UTI Free is a patient advocacy and research organization. We do not endorse specific treatment approaches, clinicians or diagnostics methods. The content of this video does not provide medical advice. It is intended for informational purposes only. The medical and/or nutritional information is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen. liveutifree.com/
Post-production: Melissa Wairimu / kreativlee_