BFAM Member Spotlights

Meet the members of the Stanford Medicine Black Faculty Affinity Meetings (BFAM), a network created through OFDD's Community Support Initiative. BFAM is intended to provide networking and social engagement opportunities for Stanford Medicine faculty across all clinical lines and departments.

Ekene A. Enemchukwu, MD, MPH

Urology

Director of Diversity, Equity and Inclusion, Dept of Urology
Director of Urology at Stanford Pelvic Health Center, Stanford Health Care

Research Interests
Refractory overactive bladder, health disparities in underserved populations, shared decision making

Full Stanford Profile

Associate Professor of Urology and, by courtesy, of Obstetrics and Gynecology (Urogynecology)

enemche@stanford.edu

Bio

Dr. Enemchukwu received her undergraduate degree from Duke University. She subsequently earned her combined degree in Medicine (MD) and Public Health (MPH) at the University of North Carolina School of Medicine and Gillings School of Global Public Health. She completed her General Surgery and Urology training at Vanderbilt University Medical Center. She then went on to complete a prestigious fellowship in Female Pelvic Medicine & Reconstructive Surgery with concurrent training in Male Voiding Dysfunction and Neurourology at NYU Langone Medical Center in New York City. She specializes in medical and minimally invasive surgical management of pelvic floor disorders, including pelvic organ prolapse (cystocele, rectocele, vaginal vault prolapse, and uterine prolapse repairs), female genitourinary fistula, overactive bladder, urinary incontinence, mesh complications, refractory fecal incontinence, and urethral stricture disease (including graft reconstruction). She performs open, robotic, endoscopic, and laser surgery. She is a health services researcher with interests in the areas of urinary incontinence and refractory overactive bladder syndrome- specifically in the areas of improving health equity through access to care, reducing barriers to treatment adherence, and shared decision making in vulnerable populations (underserved, low income, frail/elderly, neurogenic lower urinary tract dysfunction). Additionally, she is an expert in OAB related-quality of life, patient outcomes, and patient satisfaction. She has authored numerous manuscripts and conducted invited lectures as well as television and radio interviews on the topic of overactive bladder. COVID-19 has presented unparalleled challenges for our most vulnerable patient populations at Stanford Medicine. As the medical director of the Stanford Multidisciplinary Pelvic Health Center, she has the unique opportunity to advance Stanford Medicine’s mission of improving health equity not in the area of pelvic floor disorders but also by training the next generation of doctors at Stanford School of Medicine.

Publications

Sociodemographic Disparities in Oral Pharmacotherapy Class Utilization Among Medicare Part D Beneficiaries with Overactive Bladder in the United States. Urology Enemchukwu, E. A., Sinclair, S., Mohamud, H., Zhang, C. A., Anger, J. T., Scales, C. D. 2024 More

Abstract

OBJECTIVES: To describe the prevalence of frailty among Medicare beneficiaries with overactive bladder (OAB), analyze oral therapy patterns, and examine potential disparities in treatment.METHODS: This retrospective cohort study utilized the 20% Research Identifiable File Medicare Part D prescription claims dataset (2013-2018). Using the Claims-Based Frailty Index (CFI), Medicare beneficiaries ≥65 years old with OAB were categorized as not frail (CFI <0.15), prefrail (0.15 ≤CFI <0.25), and frail (CFI >0.25). Logistic regression models assessed associations between frailty and pharmacotherapy utilization.RESULTS: Among 111,761 patients (15.8% of the OAB cohort) receiving oral pharmacotherapy (anticholinergic oral medications or mirabegron), 71% were women, 83% were White, and 11.9% were frail. After controlling for age, co-payments and dual eligibility status, frail status (OR 1.16; 95% CI [1.09 - 1.24]), urology (OR 2.05 (95% CI [1.94 - 2.16]) or gynecology (OR 1.74; 95% CI [1.6 - 1.9]) prescribers and residing in the Southern United States (OR 1.53; CI [1.49 - 1.61]) were associated with higher likelihood of mirabegron utilization. Black (OR 0.79; 95% CI ([0.74 - 0.85]) and American Indian/Alaska Native (OR 0.54, 95% CI ([0.39 - 0.74]) patients were less likely to utilize mirabegron than White beneficiaries.CONCLUSION: Frail beneficiaries and those with urology and gynecology prescribers showed higher likelihoods of beta-3 agonist utilization. Despite adjustments, Black and AI/AN patients were less likely to fill mirabegron prescriptions, suggesting disparities in treatment. Our findings highlight the need for policies, interventions, and initiatives to promote equitable OAB oral therapy utilization in vulnerable populations.

View details for DOI 10.1016/j.urology.2024.07.006

View details for PubMedID 39029804
The AUA/SUFU guideline on the diagnosis and treatment of idiopathic overactive bladder. Neurourology and urodynamics Cameron, A. P., Chung, D. E., Dielubanza, E. J., Enemchukwu, E., Ginsberg, D. A., Helfand, B. T., Linder, B. J., Reynolds, W. S., Rovner, E. S., Souter, L., Suskind, A. M., Takacs, E., Welk, B., Smith, A. L. 2024 More

Abstract

The purpose of this guideline is to provide evidence-based guidance to clinicians of all specialties on the evaluation, management, and treatment of idiopathic overactive bladder (OAB). The guideline informs the reader on valid diagnostic processes and provides an approach to selecting treatment options for patients with OAB through the shared decision-making process, which will maximize symptom control and quality of life, while minimizing adverse events and burden of disease.An electronic search employing OVID was used to systematically search the MEDLINE and EMBASE databases, as well as the Cochrane Library, for systematic reviews and primary studies evaluating diagnosis and treatment of OAB from January 2013 to November 2023. Criteria for inclusion and exclusion of studies were based on the Key Questions and the populations, interventions, comparators, outcomes, timing, types of studies and settings (PICOTS) of interest. Following the study selection process, 159 studies were included and were used to inform evidence-based recommendation statements.This guideline produced 33 statements that cover the evaluation and diagnosis of the patient with symptoms suggestive of OAB; the treatment options for patients with OAB, including Noninvasive therapies, pharmacotherapy, minimally invasive therapies, invasive therapies, and indwelling catheters; and the management of patients with BPH and OAB.Once the diagnosis of OAB is made, the clinician and the patient with OAB have a variety of treatment options to choose from and should, through shared decision-making, formulate a personalized treatment approach taking into account evidence-based recommendations as well as patient values and preferences.

View details for DOI 10.1002/nau.25532

View details for PubMedID 39010271
Reply: The AUA/SUFU Guideline on the Diagnosis and Treatment of Idiopathic Overactive Bladder. The Journal of urology Cameron, A. P. 2024: 101097JU0000000000004074 More

View details for DOI 10.1097/JU.0000000000004074

View details for PubMedID 38855949
Recommendations of the SUFU/AUGS/ICS Female Stress Urinary Incontinence Surgical Publication Working Group: A common standard minimum data set for the literature. Neurourology and urodynamics Rovner, E., Chermansky, C., Costantini, E., Dmochowski, R., Enemchukwu, E., Ginsberg, D. A., Heesakkers, J., Menefee, S., Nadeau, G., Rardin, C., Zimmern, P. 2024 More

Abstract

Relevant, meaningful, and achievable data points are critical in objectively assessing quality, utility, and outcomes in female stress urinary incontinence (SUI) surgery. A minimum data set female SUI surgery studies was proposed by the first American Urological Association guidelines on the surgical management of female SUI in 1997, but recommendation adherence has been suboptimal. The Female Stress Urinary Incontinence Surgical Publication Working Group (WG) was created from members of several prominent organizations to formulate a recommended standard of study structure, description, and minimum outcome data set to be utilized in designing and publishing future SUI studies. The goal of this WG was to create a body of evidence better able to assess the outcomes of female SUI surgery.The WG reviewed the minimum data set proposed in the 1997 AUA SUI Guideline document, and other relevant literature. The body of literature was examined in the context of the profound changes in the field over the past 25 years. Through a DELPHI process, a standard study structure and minimum data set were generated. Care was taken to balance the value of several meaningful and relevant data points against the burden of creating an excessively difficult or restrictive standard that would disincentivize widespread adoption and negatively impact manuscript production and acceptance.The WG outlined standardization in four major areas: (1) study design, (2) pretreatment demographics and characterization of the study population, (3) intraoperative events, and (4) posttreatment evaluation, and complications. Forty-two items were evaluated and graded as: STANDARD-must be included; ADDITIONAL-may be included for a specific study and is inclusive of the Standard items; OPTIMAL-may be included for a comprehensive study and is inclusive of the Standard and Additional items; UNNECESSARY/LEGACY-not relevant.A reasonable, achievable, and clinically meaningful minimum data set has been constructed. A structured framework will allow future surgical interventions for female SUI to be objectively scrutinized and compared in a clinically significant manner. Ultimately, such a data set, if adopted by the academic community, will enhance the quality of the scientific literature, and ultimately improve short and long-term outcomes for female patients undergoing surgery to correct SUI.

View details for DOI 10.1002/nau.25445

View details for PubMedID 38837735
Recommendations of the SUFU/AUGS/ICS Female Stress Urinary Incontinence Surgical Publication Working Group: A Common Standard Minimum Data Set for the Literature. Urogynecology (Philadelphia, Pa.) Rovner, E., Chermansky, C., Costantini, E., Dmochowski, R., Enemchukwu, E., Ginsberg, D. A., Heesakkers, J., Menefee, S., Nadeau, G., Rardin, C. R., Zimmern, P. 2024 More

Abstract

INTRODUCTION AND OBJECTIVES: Relevant, meaningful, and achievable data points are critical in objectively assessing quality, utility, and outcomes in female stress urinary incontinence (SUI) surgery. A minimum data set female SUI surgery studies was proposed by the first American Urological Association guidelines on the surgical management of female SUI in 1997, but recommendation adherence has been suboptimal. The Female Stress Urinary Incontinence Surgical Publication Working Group (WG) was created from members of several prominent organizations to formulate a recommended standard of study structure, description, and minimum outcome data set to be utilized in designing and publishing future SUI studies. The goal of this WG was to create a body of evidence better able to assess the outcomes of female SUI surgery.METHODS: The WG reviewed the minimum data set proposed in the 1997 AUA SUI Guideline document, and other relevant literature. The body of literature was examined in the context of the profound changes in the field over the past 25 years. Through a DELPHI process, a standard study structure and minimum data set were generated. Care was taken to balance the value of several meaningful and relevant data points against the burden of creating an excessively difficult or restrictive standard that would disincentivize widespread adoption and negatively impact manuscript production and acceptance.RESULTS: The WG outlined standardization in four major areas: 1) study design, 2) pretreatment demographics and characterization of the study population, 3) intraoperative events, and 4) post-treatment evaluation, and complications. Forty-two items were evaluated and graded as: STANDARD - must be included; ADDITIONAL - may be included for a specific study and is inclusive of the Standard items; OPTIMAL - may be included for a comprehensive study and is inclusive of the Standard and Additional items; UNNECESSARY/LEGACY - not relevant.CONCLUSIONS: A reasonable, achievable, and clinically meaningful minimum data set has been constructed. A structured framework will allow future surgical interventions for female SUI to be objectively scrutinized and compared in a clinically significant manner. Ultimately, such a data set, if adopted by the academic community, will enhance the quality of the scientific literature, and ultimately improve short and long-term outcomes for female patients undergoing surgery to correct SUI.

View details for DOI 10.1097/SPV.0000000000001538

View details for PubMedID 38838689

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BFAM Member Spotlights

Ekene A. Enemchukwu, MD, MPH

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