What Type Of Patient Might Bladder Fulguration Help? Philippe Zimmern, M.D. (Part 2)

Typically, Dr. Zimmern waits about six months after an initial bladder fulguration procedure to determine the success of the procedure and decide if repeat procedures are needed. Cystoscopy is used to determine the endoscopic success or failure, i.e., whether any visible lesions remain. Because the bladder is a wet environment, the scabs can take a lot longer to heal than scabs on the skin.
He stresses that successful fulguration doesn’t necessarily equal a completely infection-free future. This may be especially true for people with chronic conditions like diabetes or weakened immune systems, e.g., due to having chemotherapy.
If cystoscopy at six months post-fulguration identifies visible lesions, it may be necessary to wait another three months or more to see if the lesions progress. Lesions may clear up enough to not warrant additional fulguration, or otherwise repeat procedures may be required. Dr. Zimmern shares that in some extreme cases, the decision whether to remove the bladder may be considered. However, he stresses that this decision is taken incredibly rarely.
Generally, Dr. Zimmern advises against fulguration of the bladder neck and urethra. This is because any scarring from the procedure could lead to stricture, which would make it difficult to empty the bladder. Scarring elsewhere in the bladder forms only a superficial scar on the bladder surface, which is far less likely to cause problems.
Dr. Zimmern shares that some people may feel a kind of burning sensation and/or urinary frequency and urgency after fulguration, but most of his patients say that they don’t feel much pain. More research is needed to be certain, but this reduced sensation could be a benefit of the nerves being damaged during fulguration. Despite the generally mild symptoms post-fulguration, Dr. Zimmern recommends people take some time off work to heal. He also recommends avoiding driving if possible, in the days or weeks following the procedure.
Even in some of the most severe cases of bladder damage, Dr. Zimmern tries everything he can to help. Fulguration is usually an option in these cases, but it is worth considering that the procedure would be more complex and take longer than normal.
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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).
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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/
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