UCSD DEPARTMENT RESEARCH REPORT 2013 OF SURGERY DIVISION OF UROLOGY

UCSD DEPARTMENT OF SURGERY RESEARCH REPORT 2013 DIVISION OF UROLOGY 1 CONTENTS Message from the Chief | Christopher J. Kane, MD………..…………………………………...
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UCSD DEPARTMENT OF SURGERY

RESEARCH REPORT 2013

DIVISION OF UROLOGY

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CONTENTS Message from the Chief | Christopher J. Kane, MD………..………………………………………………………….…………..3 Faculty, Fellows, Residents, and Staff ......................................................................................................... ..5 Faculty Profiles - Urology………………………………………………………………………………………………………………..………8 Michael E. Albo, MD | Professor and Vice Chief ................................................................................... 8 Jill C. Buckley, MD | Associate Professor ............................................................................................ 10 Ithaar H. Derweesh, MD | Associate Professor .................................................................................. 11 T. Mike Hsieh, MD | Assistant Professor............................................................................................. 13 Christina Jamieson, PhD | Assistant Professor.................................................................................... 15 A. Karim Kader, MD, PhD | Associate Professor ................................................................................. 17 Christopher J. Kane, MD | Professor and Chief................................................................................... 19 C. Lowell Parsons, MD| Professor Emeritus........................................................................................ 21 J. Kellogg Parsons, MD, MHS|Associate Professor ............................................................................. 22 Kyoko Sakamoto, MD | Associate Professor ....................................................................................... 24 Joseph D. Schmidt, MD| Professor Emeritus ...................................................................................... 26 Roger L. Sur, MD|Associate Professor ................................................................................................ 27 Faculty Profiles - Pediatric Urology ............................................................................................................. 29 Nicholas M. Holmes, MD, MBA|Professor and Chief of Pediatric Urology ........................................ 29 Madhu Alagiri, MD|Associate Professor ............................................................................................. 30 George Chiang, MD|Associate Professor ............................................................................................ 31 George W. Kaplan, MD| Professor ...................................................................................................... 33 Sarah Marietti Shepherd, MD | Assistant Professor ........................................................................... 34 Publications 2012-2013 .............................................................................................................................. 35

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DIVISION OF UROLOGY MESSAGE FROM THE CHIEF | CHRISTOPHER J. KANE, MD, FACS UCSD Urology continues to strengthen the synergy between our clinical practices and basic and translational research as evidenced by our designation as a clinical department of the UC San Diego Health System in March 2013. Many exciting developments have happened over the past two years, including the addition of two new faculty: Dr. Hsieh joined Urology in 2012 and we now offer a Men’s Health program in male fertility and sexual health; Dr. Buckley joined us in 2013 to practice complex urinary reconstruction, currently the only surgeon in San Diego specializing in this area. We established the UC San Diego-Kaiser Endourology/Laparoscopic Fellowship and reinstated the annual Prentiss Lecture Series as part of our Visiting Professor Grand Rounds Program. Our first speaker in 2013 was Peter R. Carroll, MD, MPH, the Ken and Donna Derr-Chevron Distinguished Professor and Chair of Urology at UC San Francisco. Our achievements have been recognized nationally by a continued uptick in U.S. News & World Report rankings – UCSD Urology was ranked #22 for 2013-2014, the highest position in the program's history. We have been ranked in the top 50 nationally four times in the past six years, which is a great statement about our collective progress in building a distinguished and outstanding department. We are headed in the right direction.

Our mission is to provide the highest quality compassionate care, research and training. We have significantly enhanced collaborations with world-class basic scientists at UCSD and nationally. Discoveries by our faculty include patenting the only FDA-approved oral therapy for interstitial cystitis/painful bladder syndrome, and the first clinical trial ever performed to examine the effect of diet on bladder cancer. Urology physicians are also helping to develop pioneering scarless surgery techniques at the Center for the Future of Surgery. Our faculty explore the risk factors, prognostic factors and clinical and pathologic details that correlate with outcomes for men and women with urologic malignancies. Some recent observations and discoveries include: the stage and size migration of kidney cancer in the United States and how that has impacted survival from kidney cancer; the role of partial kidney removal, rather than complete kidney removal, for kidney cancer patients to prevent anemia, acidosis, cardiovascular disease and sexual dysfunction; and the role of ethnicity and obesity on prostate cancer severity and outcomes. We have also contributed to the understanding of prostate-specific antigen velocity, specific biopsy results, prostate volume and nerve sparing on prostate cancer outcomes.

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Our multidisciplinary approach led to the development of two specialized treatment centers. The Women’s Pelvic Medicine Center is the only multidisciplinary center in the region dedicated to women’s pelvic floor disorders, and one of only five medical centers in the nation that belong to the NIH-funded Urinary Incontinence Treatment Network and Pelvic Floor Disorders Network. The Comprehensive Kidney Stone Center uses the most modern and minimally invasive techniques available. The Center has a dedicated metabolic program designed to determine the cause of kidney stones, and is also focused on prevention. In addition, faculty in the Pediatric Urology Section at Rady Children’s Hospital-San Diego are creating a comprehensive database to further surgical outcome research in the care of pediatric patients, and are conducting clinical trials to investigate novel forms of medications for children with neurogenic bladder. Future plans for the Department of Urology include our ability to provide state-of-the-art care to more patients when the Hospitals for Advanced Surgery and Cancer Care are completed in 2016. Both are part of the new UC San Diego Jacobs Medical Center, the largest hospital project in Southern California. UCSD surgeons have pioneered innovations in robotic technology, miniaturized microsurgery, singleincision laparoscopy and natural orifice transluminal surgery. Our new operating rooms are designed to accommodate these lifesaving techniques while promoting surgical safety. The Hospital for Advanced Surgery is designed for what we do today and for what we predict we will do in the future. The following pages provide a summary of our current research projects. We are grateful to the community partners and philanthropists who support our mission. The achievements noted here would not be possible without them. For more information on UCSD Urology patient care, visit: health.ucsd.edu/urology For more information on the Department of Urology, visit: urology.ucsd.edu

2013 Prentiss Lecture: Drs. C. Lakin, SA Cohen, D. Sisul, P. Carroll, H. Mirheydar, N. Patel, C. Kane and E. Godebu

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DIVISION OF UROLOGY FACULTY, FELLOWS, RESIDENTS AND STAFF FACULTY Christopher J. Kane, MD, FACS

Professor and Chief of Urology, Interim Chair of Surgery

Michael E. Albo, MD, FACS

Professor and Vice Chief

Jill C. Buckley, MD, FACS

Associate Professor

Ithaar H. Derweesh, MD

Associate Professor

T. Mike Hsieh, MD

Assistant Professor

Christina Jamieson, PhD

Assistant Professor

A. Karim Kader, MD, PhD, FRCSC

Associate Professor

Charles M. Lakin, MD

Associate Professor

C. Lowell Parsons, MD, FACS

Professor Emeritus

J. Kellogg Parsons, MD, MHS, FACS

Associate Professor

Kyoko Sakamoto, MD

Associate Professor

Joseph D. Schmidt, MD, FACS

Professor Emeritus

Roger L. Sur, MD

Associate Professor

FACULTY- PEDIATRIC UROLOGY Nicholas M. Holmes, MD, MBA

Professor and Chief of Pediatric Urology

Madhu Alagiri, MD

Associate Professor

George Chiang, MD

Associate Professor

George W. Kaplan, MD, FACS

Professor

Sarah Marietti Shepherd, MD

Assistant Professor

FELLOWS Gina Cambareri, MD

Pediatric Urology Fellow, 2013-15

Seth D. Cohen, MD

Sexual Medicine Fellow, 2013-14

Hak J. Lee, MD

Society of Urologic Oncology Fellow, 2013-15

Michael A. Liss, MD

Society of Urologic Oncology Fellow, 2012-14

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Puneeta Ramachandra, MD

Pediatric Urology Fellow, 2011-13

David Wenzler, MD

Endourology Laparoscopic Fellow, 2013-14

RESIDENTS Seth A. Cohen, MD

Chief Resident (July 2013- June 2014)

Caroline Colangelo, MD

Chief Resident (July 2012- June 2013)

Elana Godebu, MD

Resident

Marc Holden, MD

Resident

Ryan Kopp, MD

Chief Resident (July 2012- June 2013)

Michelle McDonald, MD

Resident

Hossein Mirheydar, MD

Resident

Unwanaobong Nseyo, MD

Resident

Sam Park, MD

Resident

Nishant Patel, MD

Resident

Omer Raheem, MD

Resident

David Sisul, MD

Chief Resident (July 2013- June 2014)

Stephen Unterberg, MD

Resident

Jason Woo, MD

Resident

CLINICAL STAFF Lorna Bautista, RN

Nurse, Hillcrest Clinic

Neremiah Castano, NP

Nurse Practitioner, Moores Cancer Center

Marianne Chenoweth, RN

Nurse, Chancellor Park

Theresa Diaz, RN

Nurse, Moores Cancer Center

Gloria Delmios, RN

Nurse, Hillcrest Clinic

Dora Downey, NP

Nurse Practitioner, Hillcrest Clinic

Flo Flockhart

Medical Assistant, Hillcrest Clinic

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Ivanka Kodzic

Administrative Assistant, Hillcrest Clinic

Beth Manderson, RN

Nurse, Moores Cancer Center

Elana Musser

Kidney Stone Center Dietician

Arcelli Tabago, RN

Nurse, Hillcrest Clinic

RESEARCH ASSOCIATES, VISITING SCHOLARS & STUDENTS Sulabha Argade, PhD

Research Associate

Zoltan Berecz

Undergraduate Research Student

Takeshi Hirata, MD

International Visiting Scholar, Japan

Seung Chol Park, MD

International Visiting Scholar, South Korea

Timothy Shaw

Undergraduate Research Student

Angela Wang

Undergraduate Research Student

Hana Yoon, MD

International Visiting Scholar, South Korea

Fenghal Zhou, MD

International Visiting Scholar, China

Wei Zhou, MD

International Visiting Scholar, China

RESEARCH & ADMINISTRATIVE SUPPORT STAFF Darlene Vergara

Operational Administrator

Ramona Aragon

Executive Assistant

Sarah Brant

Executive Assistant

Peggy Jean Ealson

Administrative Assistant

Shari Farrimond

Executive Assistant

Adela Lopez

Residency Program Coordinator

Song Wang, MS

Database & Statistical Applications Development Manager

Angela Ribant

Administrative Assistant

Eileen Silva

Senior Editor

Jessica Thompson

Executive Assistant

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DIVISION OF UROLOGY MICHAEL E. ALBO, MD, FACS | PROFESSOR AND VICE CHIEF •

Urinary Incontinence



Voiding Dysfunction



Female Pelvic Medicine and Reconstructive Surgery



Neurourology and Urodynamics

I am involved in research on both the national and regional levels. My focus is on the medical and surgical treatments for urinary incontinence and pelvic floor disorders in women, lower urinary tract symptoms and urinary incontinence in men, and neurogenic bladder in both men and women. I am the principal investigator for the UCSD clinical site in the Urinary Incontinence Treatment Network, a multicenter, nationwide National Institutes of Health (NIH) clinical research program. UCSD is one of nine centers in the national program, whose purpose is to determine the most effective ways of evaluating and treating patients with urinary incontinence. I am also a co-investigator in the Pelvic Floors Disorder Network, a multi-institutional clinic trials network funded by the NIH to conduct research on female pelvic floor dysfunction. Additionally, I am the principal investigator at UCSD for a number of industry-sponsored studies in the fields of urinary incontinence, neurourology and voiding dysfunction.

RESEARCH ACTIVITIES AND PROJECTS •





NIH Clinical Trials o Urinary Incontinence Treatment Network (UITN): The goal of this network is to study urinary incontinence by designing and performing high quality studies. o Pelvic Floor Disorders Network (PFDN): The goal of this network is to study clinical and health aspects of pelvic floor disorders in women by designing and performing high quality studies. Industry Clinical Trials o A Multicenter, Long-Term Follow-up Study of the Safety and Efficacy of Two Dose Levels of BOTOX® (Botulinum Toxin Type A) Purified Neurotoxin Complex in Patients with Urinary Incontinence Due to Neurogenic Detrusor Overactivity Basic Science o Neurogenic bladder – exploring nerve transfer techniques to improve lower urinary tract function in patients with spinal cord injury.

SELECTED PUBLICATIONS 1. Albo ME, Richter HE, Brubaker L, Norton P, Kraus S, Zimmern P, Chai TC, Zyczynski H, Diokno AC, Tennstedt S, Nager C, Lloyd LK, FitzGerald MP, Lemack GE, Johnson HW, Leng W, Mallett V, Stoddard AM, Menefee S, Varner RE, Kenton K, Moalli P, Sirls L, Dandreo KJ, Kusek JW, Nyberg LM, and Steers W for the Urinary Incontinence Treatment Network. Burch colposuspension versus fascial sling to reduce urinary stress incontinence. N Engl J Med. 2007; 356:2143-55. 2. Burgio KL, Kraus SR, Menefee S, Borello-France D, Corton M, Johnson HW, Mallett V, Norton P, FitzGerald MP, Dandreo KJ, Richter HE, Rozanski T, Albo M, Zyczynski HM, Lemack GE, Chai TC, Khandwala S, Baker J, Brubaker L, Stoddard AM, Goode PS, Nielsen-Omeis B, Nager CW, Kenton K, Tennstedt SL, Kusek JW, Chang TD, Nyberg LM, Steers W; Urinary Incontinence Treatment Network. Behavioral therapy to enable

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women with urge incontinence to discontinue drug treatment: a randomized trial. Ann Intern Med. 2008; 149(3):161-169. 3. Richter HE, Albo ME, Zyczynski HM, Kenton K, Norton PA, Sirls LT, Kraus SR, Chai TC, Lemack GE, Dandreo KJ, Varner RE, Menefee S, Ghetti C, Brubaker L, Nygaard I, Kandwala S, Rozanski TA, Johnson H, Schaffer J, Stoddard AM, Holley RL, Nager CW, Moalli P, Mueller E, Arisco AM, Corton M, Tennstedt S, Chang TD, Gormley EA, Litman HJ. Urinary Incontinence Treatment Network. Retropubic versus transobturator midurethral slings for stress incontinence. N Engl J Med. 2010; 362(22):2066-76. 4. Brubaker L, Norton PA, Albo ME, Chai TC, Dandreo KJ, Lloyd KL, Lowder JL, Sirls LT, Lemack GE, Arisco AM, Xu Y, Kusek JW; Urinary Incontinence Treatment Network. Adverse events over two years after retropubic or transobturator midurethral sling surgery: findings from the Trial of Midurethral Slings (TOMUS) study. Am J Obstet Gynecol. 2011;205(5):498.e1-6. 5. Brubaker L, Richter HE, Norton PA , Albo M, Zyczynski HM, Chai TC, Zimmern P , Kraus S, Sirls L, Kusek JW, Stoddard A, Tennstedt S , Gormley EA. Urinary Incontinence Treatment Network. Five Year Continence Rates: Satisfaction and adverse events of Burch urethropexy and fascial sling surgery for urinary incontinence. J Urol. 2012 Apr;187(4):1324-30.

COLLABORATORS •

Charles W. Nager, MD



Emily S. Lukacz, MD



Kaiser Permanente Pelvic Floor Group



Urinary Incontinence Treatment Network



Pelvic Floor Disorders Network

UCSD Department of Reproductive Medicine Division of Urogynecology UCSD Department of Reproductive Medicine Division of Urogynecology Shawn Menefee, MD, Karl Luber, MD, Keisha Dyer, MD, Gouri Diwadkar, MD, Jasmine Tan Kim, MD, Lynn Hall, RNP Michael Albo, MD, , Linda Brubaker, MD, Toby Chai, MD, Elizabeth Gormley, MD, Kimberly Kenton, MD, Ziya Kirkali, MD, Stephen Kraus, MD, John Kusek, MD, Gary Lemack, MD, Wendy Leng, MD, L. Keith Lloyd, MD, Charles Nager, MD, Peggy Norton, MD, Ingrid Nygaard, MD, Holly Richter, PhD, MD, Larry Sirls, MD, Anne Stoddard, ScD, Sharon Tennstedt, PhD, Philippe Zimmern, MD, Halina Zyczynski, MD Michael Albo, MD, Cindy Amundsen, MD, Matthew Barber, MD, Howard Goldman, MD, W. Thomas Gregory, MD, Katherine Hartmann, MD, PhD, Cheryl Iglesia, MD, Alayne Markland, DO, MSc,Shawn Menefee, MD, Pamela Moalli, MD, PhD, Deborah Myers, MD, Charles Nager, MD, Maria Paraiso, MD, Rebecca Rogers, MD, Sandip Vasavada, MD, Anthony Visco, MD

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DIVISION OF UROLOGY JILL C. BUCKLEY, MD, FACS | ASSOCIATE PROFESSOR • • • • •

Urethral Stricture or Obstruction Complications Following Prostate Cancer Treatment Adult Hypospadias and Revision Repair Trauma to the Genitourinary System Urologic Disease in Resource-poor Countries

My clinical research focuses on urethral reconstruction, urinary fistula repair, complications from prostate cancer therapy, genitourinary reconstruction, and trauma. I’m currently the only surgeon in San Diego specializing in complex urinary reconstruction. My goal is to provide not only the highest level of current care, but also be at the forefront of developing new methods to deliver innovative care for both reconstruction and trauma.

RESEARCH ACTIVITIES AND PROJECTS • • • •

Adjunctive Methods to Improve Treatment of Urethral Stricture Disease Incidence, Management, and Outcomes of Lower Urinary Tract Trauma Current Practice Patterns of the treatment of Male Anterior Urethral Stricture Disease Anatomic Investigation of the Lower Urinary Tract

SELECTED PUBLICATIONS 1. Buckley JC. Complications after radical prostatectomy: anastomotic stricture and rectourethral fistula. Curr Opin Urol. 2011;21(6):461-4. 2. Vanni AV, Zinman L, Buckley JC. Radial Urethrotomy and Intralesional Mitomycin C for the Management of Recurrent Bladder Neck Contractures: J Urol. 2011;186(1):156-60. 3. Buckley JC, Wu AK, McAninch JW. Impact of urethral ultrasonography on decision-making in anterior urethroplasty. BJU Int. 2012;109(3):438-42. 4. Hechenbleikner EM, Buckley JC, Wick EC. Acquired rectourethral fistulas in adults: a systematic review of surgical repair techniques and outcomes. Dis Colon Rectum. 2013;56(3):374-83. 5. Buckley JC, Heyns C, Gilling P, Carney J. SIU/ICUD consultation on urethral strictures: dilation, internal urethrotomy, and stenting of male anterior urethral strictures. Urology. 2014;83(3 Suppl):S18-22.

COLLABORATORS • • • • •

Jeff Carney, MD Chris Heyns, MD Jack McAninch, MD John G. Meara, MD Elizabeth Wick, MD

Grady Memorial Hospital Stellenbosch University, South Africa UC San Francisco Harvard Medical School Johns Hopkins University

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DIVISION OF UROLOGY ITHAAR H. DERWEESH, MD |ASSOCIATE PROFESSOR •

Kidney-preserving Treatment for Kidney Cancer



Preclinical and Translational Minimally Invasive Surgeries



Metabolic Impact of Renal Surgery for Kidney Cancer

My research focuses on urologic oncology and renal cell carcinoma. In collaboration with Dr. Kane and our colleagues at UCSD, we reported the first cases in the literature for single incision laparoscopic radical nephrectomy with renal vein thrombectomy and cytoreductive single incision laparoscopic radical nephrectomy – high risk and complex procedures that push the boundaries of minimally invasive surgery. In addition, my team was the second in the world to report single incision laparoscopic partial nephrectomy and nephroureterectomy. I also participated in a multicenter study of robotic partial nephrectomy, which demonstrated the feasibility of a technical modification to further reduce damage to the kidney during kidney-preserving surgery (robotic partial nephrectomy). In the field of experimental surgery, I have pioneered a new approach for nephrectomy (Transrectal NOTES in a preclinical model), which was also the first report of its type. I serve on the AUA Clinical T1 Renal Mass and Follow up of Localized Renal Neoplasm Guideline Panels and the NCCN Guideline Panel for Renal Cell Carcinoma.

RESEARCH ACTIVITIES AND PROJECTS • • •



Randomized Clinical Trial for Radical versus Partial Nephrectomy for Clinical T1b and T2a Renal Mass Characterization of Metabolic Sequelae of Renal Surgery: A Prospective Study Impact of Acute Changes in Renal Function on Markers of Endothelial Health and Erectile Function Feasibility of NOTES Nephrectomy and Partial Nephrectomy in Porcine Kidney

SELECTED PUBLICATIONS 1. Donat SM, Diaz M, Bishoff JT, Coleman JA, Dahm P, Derweesh IH, Herrell SD 3rd, Hilton S, Jonasch E, Lin DW, Reuter VE, Chang SS. Follow-up for Clinically Localized Renal Neoplasms: AUA Guideline. J Urol. 2013; 190:407-416. 2. Bazzi WM, Wagner O, Stroup SP, Silberstein JL, Belkind N, Katagiri T, Paleari J, Duro A, Ramamoorthy S, Talamini MA, Horgan S, Derweesh IH. Transrectal hybrid natural orifice transluminal endoscopic surgery (NOTES) nephrectomy in a porcine model. Urology 2011;77(3):518-523. 3. Woldrich JM, Palazzi K, Stroup SP, Sur RL, Parsons JK, Chang D, Derweesh IH. Trends in the surgical management of localized renal masses: thermal ablation, partial and radical nephrectomy in the USA, 1998-2008. BJU Int. 111:1261-1268, 2013. 4. Silberstein JL, Millard F, Mehrazin R, Kopp R, Bazzi W, DiBlasio CJ, Patterson AL, Downs TM, Yunus F, Kane CJ, Derweesh IH. Feasibility and efficacy of neoadjuvant sunitinib before nephron-sparing surgery. BJU Int. 2010;106(9):1270-1276. 5. Campbell SC, Novick AC, Belldegrun A, Blute ML, Chow GK, Derweesh IH, Faraday MM, Kaouk JH, Leveillee RJ, Matin SF, Russo P, Uzzo RG. Guideline for management of the clinical T1 renal mass. Practice Guidelines Committee of the American Urological Association. J Urol. 2009;182(4):1271-1279.

COLLABORATORS

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Steven Campbell, MD, PhD

Cleveland Clinic



Donna Hansel, MD, PhD

UCSD Dept of Anatomic Pathology



Jihad Kaouk, MD

Cleveland Clinic



Jim Y. Wan, PhD

UT Health Science Center, Memphis

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DIVISION OF UROLOGY T. MIKE HSIEH, MD | ASSISTANT PROFESSOR • • • • •

Germ-cell Maturation and Sperm-function Testing Sexual Dysfunction Associated with Chronic Opiate Exposure Outcomes of Penile Prosthetic Surgery Role of DNA Fragmentation Index on Recurrent Pregnancy Loss and Failed IVF Effect of Fertility on Long-term Health Outcomes

My research focuses on both male infertility and sexual dysfunction. For male infertility, I am actively engaged in both basic science and clinical projects. With the support of a biology grant from California Institute for Regenerative Medicine, we are studying the regulation of spermatogonial stem cells through collaboration with Dr. Miles Wilkinson of Sanford Consortium for Regenerative Medicine. I am also conducting a prospective study on using testicular sperm for the treatment of elevated sperm DNA fragmentation index in cases of failed IVF or recurrent pregnancy loss. For sexual dysfunction, my focuses are on hypogonadism and outcomes of penile prosthetic surgery. With the support of a grant from the Sexual Medicine Society of North America, I am conducting a prospective study on the effect of testosterone therapy on opiate-induced hypogonadism in collation with UCSD Center for Pain Medicine. I am also studying the effect of weight loss on sex hormone abnormality through collaboration with UCSD Bariatric and Metabolic Institute. Utilizing UCSD’s access to the California population database, I am engaged in the first longitudinal big data analysis of outcomes after penile prosthetic surgery in collaboration with with Dr. David Chang, Director of Outcomes Research, UCSD Department of Surgery.

RESEARCH ACTIVITIES AND PROJECTS • • • • • • •

The Effect of Testosterone Replacement Therapy on Opiate-induced Hypogonadism New Regulators of Spermatogonial Stem Cells: Rhox Homeobox Transcription Factors Sonographic and Magnetic Resonance Imaging of Testicular Obstruction Comparison of Medical vs. Surgical Weight Loss on Hormonal Abnormalities Effect of fertility on long term health outcomes Testicular sperm aspiration for the treatment of elevated sperm DNA fragmentation index and failed IVF Reoperation of Penile Prosthetic Surgery: A longitudinal analysis of California population database

SELECTED PUBLICATIONS 1. Hsieh TC, Pastuszak AW, Hwang KH, Lipshultz LI. Concomitant intramuscular human chorionic gonadotropin preserves spermatogenesis in men undergoing testosterone replacement therapy. J Urol. 2013;189(2)647-50. 2. Song HW, Anderson RA, Bayne RA, Gromoll J, Shimasaki S, Chang RJ, Parast MM, Laurent LC, de Rooij DG, Hsieh TC, Wilkinson MF. The RHOX homeobox gene cluster is selectively expressed in humaan oocytes and male germ cells. Hum Reprod. 2013; 28(6):1635-46. 3. McCammack KC, Aganovic L, Hsieh TC, Guo Y, Welch CS, Gamst AC, Cassidy F. MRI of the Epididymis: Can the Outcome of Vasectomy Reversal be Predicted Preoperatively. Am J Roentgenol. In press. 4. Su JJ, Park S, Hsieh TC. The Effect of Testosterone on Cardiovascular Disease: A Critical Review of the Literature. Am J Men’s Health. In press.

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COLLABORATORS • • • • • • •

Lejla Aganovic, MD Eduardo L. Grunvald, MD Lauren Weiss, PhD Christina Chambers, MD H. Irene Su, MD Mark S. Wallace, MD Miles F. Wilkinson, PhD

UCSD Dept of Radiology UCSD Dept of Internal Medicine UCSD Dept of Pediatrics UCSD Dept of Pediatrics UCSD Dept of Reproductive Medicine UCSD Center for Pain Medicine UCSD Dept of Reproductive Medicine

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DIVISION OF UROLOGY CHRISTINA JAMIESON, PhD | ASSISTANT PROFESSOR •

Patient-derived Models of Bone Metastatic Prostate Cancer



Castration-resistant Prostate Cancer and Inflammation



Imaging and Models for Nerve-sparing Prostate Cancer Surgery



Wnt Signaling and Renal Cancer

My research focus is on unmet needs in urologic and bone metastatic cancer. We have established novel patientderived bone metastasis xenograft models for prostate cancer and in vitro long-term 3D-culture models with human mesenchymal stem cells. My group was the first to show that the bone niche supports castration resistant growth of a femoral bone metastatic prostate cancer. We identified gene networks associated with prostate cancer growth in the bone microenvironment. We also established a complementary in vitro co-culture model system in which prostate cancer cells induced osteoblast differentiation of bone marrow stromal cells. These findings support our hypothesis that crosstalk with the bone microenvironment leads to therapy-resistant growth of cancers. Translating these findings into novel therapeutic applications will improve and eventually transform patient care. In 2013 we received a significant three-year grant from The Leo and Anne Albert Charitable Trust.

RESEARCH ACTIVITIES AND PROJECTS • • • • •

Generating Novel Patient-derived Bone Metastasis Xenograft Models for Prostate Cancer Targeted Anti-inflammatory Protein Therapeutic for Castrate-resistant Prostate Cancer Pre-clinical Testing of Novel Splicing Inhibitors for Bone Metastatic Prostate Cancer in the Stem Cell Niche The Role of Aging of the Bone Niche and the Tumor Microenvironment in Promoting the Pathogenesis and Progression of Prostate Cancer Nerve-Specific Fluorescent Peptide Agents for Peripheral Nerve Imaging in Surgery

SELECTED PUBLICATIONS 1. Jamieson C, McCaffrey PG, Rao A, Sen R. Physiologic Activation of T cells via the T cell antigen receptor induces NF-κB. J Immunol. 1991;147: 416-420. 2. Jamieson, CAM and Yamamoto, KR. Crosstalk pathway for inhibition of glucocorticoid-induced apoptosis by T cell receptor signaling. Proc Natl Acad Sci. 2000;97: 7319-7324. 3. Belanto J, Diaz-Perez S, Magyar C, Yilmaz Y, Topp K, Cacalano NA, Jamieson CAM. Dexamethasone treatment of myoblasts induced dysferlin and enhanced myogenic differentiation. Neuromuscul Disord. 2010;20(2):111-21. 4. Raheem O, Kulidjian A, Wu C, Jeong YB, Yamaguchi T, Smith KM, Goff D, Leu H, Morris SH, Cacalano, NA, Masuda K, Jamieson CHM, Kane CJ, Jamieson CAM. A novel patient-derived intra-femoral xenograft model of bone metastatic prostate cancer that recapitulates mixed osteolytic and osteoblastic lesions. J Transl Med. 2011; 9:185-198. 5. Woo JR, Liss MA, Muldong MT, Palazzi K, Strasner A, Ammirante M, Varki N, Shabaik A, Howell S, Kane CJ, Karin M, Jamieson CA. Tumor infiltrating B-cells are increased in prostate cancer tissue. J Transl Med. 2014 Jan 30;12(1):30.

COLLABORATORS

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• • • • •

Michael Burkart, PhD Dennis Carson, MD Michael Karin, PhD Anna Kulidjian, MD Roger Tsien, PhD

UCSD Department of Chemistry and Biochemistry UCSD Department of Medicine UCSD Department of Pharmacology UCSD Department of Orthopedic Surgery UCSD Department of Pharmacology

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DIVISION OF UROLOGY A. KARIM KADER, MD, PhD, FRCSC | ASSOCIATE PROFESSOR • • •

Genetic Markers of Prostate Cancer Risk Markers of Urologic Malignancy Minimally Invasive Surgical Techniques

My research is focused on the identification of populations at high risk for the development of prostate cancer through genetic testing, and to determine the implications of such results on targeted prostate cancer screening and prevention. Together with collaborators at Wake Forest University, this work has received funding from several sources, including a multidisciplinary NIH grant to study the clinical validity and utility of genomictargeted prostate cancer chemoprevention using the 5 alpha reductase class of medications. In addition, I am coordinating further research examining the impact of robotic technology on outcomes for patients undergoing bladder removal for management of bladder cancer and gene therapy for difficult bladder cancer cases.

RESEARCH ACTIVITIES AND PROJECTS • • • •

Genetic Profiling in PCPT: Prostate Cancer Risk, PSA Levels, and Chemoprevention Clinical Validity and Utility of Genomic Targeted Chemoprevention of Prostate Cancer Gene therapy clinical trials for bladder cancer patients Outcomes of Robotic Assisted Radical Cystectomy

SELECTED PUBLICATIONS 1. Zheng SL, Sun J, Wiklund F, Smith S, Stattin P, Li G, Adami HO, Hsu FC, Zhu Y, Bälter K, Kader AK, Turner AR, Liu W, Bleecker ER, Meyers DA, Duggan D, Carpten JD, Chang BL, Isaacs WB, Xu J, Grönberg H. Cumulative association of five genetic variants with prostate cancer. N Eng J Med. 2008;358(9):910-919. 2. Lu Y, Sun J, Kader AK, Kim ST, Kim JW, Liu W, Sun J, Lu D, Feng J, Zhu Y, Jin T, Zhang Z, Dimitrov L, Lowey J, Campbell K, Suh E, Duggan D, Carpten J, Trent JM, Gronberg H, Zheng SL, Isaacs WB, Xu J. Association of prostate cancer risk with SNPs in regions containing androgen receptor binding sites captured by ChIP-On-chip analyses. Prostate 2012 Mar;72(4): 376-385. 3. Kader AK, Sun J, Isaacs SD, Wiley KE, Yan G, Kim ST, Fedor H, DeMarzo AM, Epstein JI, Walsh PC, Partin AW, Trock B, Zheng SL, Xu J, Isaacs W. Individual and cumulative effect of prostate cancer risk-associated variants on clinicopathologic variables in 5,895 prostate cancer patients. Prostate 2009;69(11):1195-205. 4. Xu J, Zheng SL, Isaacs SD, Wiley KE, Wiklund F, Sun J, Kader AK, Li G, Purcell LD, Kim ST, Hsu FC, Stattin P, Hugosson J, Adolfsson J, Walsh PC, Trent JM, Duggan D, Carpten J, Grönberg H, Isaacs WB. Inherited genetic variant predisposes to aggressive but not indolent prostate cancer. Proc Natl Acad Sci USA 2010;107(5):2136-2140. 5. Richards KA, Kader K, Pettus JA, Smith JJ, Hemal AK. Does initial learning curve compromise outcomes for robot-assisted radical cystectomy? A critical evaluation of the first 60 cases while establishing a robotics program. J Endourol. 2011;25(9):1553-1558.

COLLABORATORS • • •

Henrik Grönberg, MD, PhD Ashok K. Hemal, MD William B. Isaacs, PhD

Karolinska Institute Wake Forest University Johns Hopkins University

17



Jianfeng Xu, MD

Wake Forest University

Dr. Kader and Dr. Derweesh were the Co-Directors of the 2013 UCSD Urology Postgraduate Course.

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DIVISION OF UROLOGY CHRISTOPHER J. KANE, MD, FACS | PROFESSOR AND CHIEF INTERIM CHAIR OF SURGERY • • • •

Prostate Cancer Prognosis, Outcomes, and Quality of Life after Treatment Robotic and Laparoscopic Surgical Techniques Utility of CXCR5 Blockade in Castrate-resistant Prostate Cancer Lymphatic Imaging and Urologic Malignancies

My research interests are primarily prostate cancer and kidney cancer risk assessment and outcomes. We established an IRB-approved, HIPPA-compliant relational urologic oncology database. Our prospective entry of data for patients with urologic cancers cared for at UC San Diego allows us to link our biospecimens with detailed information concerning diagnostic and clinical details, medical history, family history, and cancer-specific details such as grade, stage, outcomes, complications, quality of life, and survival. This infrastructure provides a very valuable resource for analyzing factors associated with prognosis and recurrence. I am also co-investigator of the Shared Equal Access Regional Cancer Hospital (SEARCH) database group, a multicenter relational database concerning prostate cancer outcomes among a large cohort of men cared for at the San Diego VA Medical Center. We examined the role of prostate specific antigen (PSA) velocity both before treatment and after biochemical recurrence for men with prostate cancer. Now PSA velocity is incorporated into risk nomograms, largely because of those contributions. We have also examined the influence of obesity in prostate cancer development and the outcomes after treatment. We discovered that obese men have lower PSA values for their particular prostate cancer tumor burden largely because of increased volume of distribution, a hemodilution phenomenon. This was the first time hemodilution was discovered as a mechanism for a lower measurement of a tumor marker in obese patients. I collaborate with the world-renowned lab of Dr. Michael Karin, Dr. Christina Jamieson and Dr. Steve Howell, designing studies to examine the inhibition of B-cell recruitment and CXCL13/CXCR5 signaling in prostate cancer. We are particularly interested in translating the remarkable discoveries of the Karin lab into meaningful therapeutics for men with prostate cancer. We currently have a phase 1 neoadjuvant trial of B cell inhibition prior to radical prostatectomy for men with high risk prostate underway at UC San Diego. I also collaborate with the Department of Radiology to conduct a preclinical evaluation of a receptor-targeted near-infra-red (NIR) optical imaging agent for sentinel lymph node mapping during robot-assisted surgery, with the ultimate objective of having the surgery team prepare a receptor-targeted NIR probe for a “first-in-human” clinical trial.

RESEARCH ACTIVITIES AND PROJECTS • • • • •

Inhibition of B-cell Recruitment and CXCL13/CXCR5 Signaling in Prostate Cancer Testing Fluorescently Labeled Probes for Nerve Imaging during Surgery Robotic Sentinel Lymph Node Mapping via Receptor-Targeted Optical Imaging Kidney Cancer Risk Assessment and Outcomes Prostate Cancer Prognosis and Treatment

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SELECTED PUBLICATIONS 1. Kane CJ, Mallin K, Ritchey J, Cooperberg MR, Carroll PR. Renal cell cancer stage migration: analysis of the National Cancer Data Base. Cancer 2008;113(1):78-83. 2. Bent S, Kane C, Shinohara K, Neuhaus J, Hudes ES, Goldberg H, Avins AL. Saw palmetto for benign prostatic hyperplasia. N Engl J Med. 2006;354(6):557-66. 3. Cooperberg MR, Mallin K, Ritchey J, Villalta JD, Carroll PR, Kane CJ. Decreasing size at diagnosis of stage 1 renal cell carcinoma: analysis from the National Cancer Data Base, 1993 to 2004. J Urol. 2008;179(6):2131-2135. 4. Kane CJ, Im R, Amling CL, Presti JC Jr, Aronson WJ, Terris MK, Freedland SJ. Outcomes after radical prostatectomy among men who are candidates for active surveillance: results from the SEARCH database. Urology 2010;76(3):695-700. 5. Kane CJ, Presti JC Jr, Amling CL, Aronson WJ, Terris MK, Freedland SJ; SEARCH Database Study Group. Changing nature of high-risk patients undergoing radical prostatectomy. J Urol. 2007;177(1):113-117.

COLLABORATORS • • • • •

Michael Burkart, PhD Michael Karin, MD Frederick Millard, MD Roger Tsien, PhD David Vera, PhD

UCSD Department of Chemistry and Biochemistry UCSD Department of Pharmacology UCSD Moores Cancer Center UCSD Department of Pharmacology UCSD Department of Radiology

UC San Diego Health System CEO Paul Viviano and Dr. Kane at the 1st Annual Pedal the Cause in 2013

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DIVISION OF UROLOGY C. LOWELL PARSONS, MD, FACS | PROFESSOR EMERITUS •

Discovery and use of Elmiron to Treat Interstitial Cystitis (IC)



Tamm-Horsfall Protein and its Relationship to the Causes of IC



Developing New Treatments for IC

The work in our laboratory focuses on the causes, diagnosis, and treatment of interstitial cystitis (IC). We have identified a defect in the urinary protein known as Tamm-Horsfall protein (THP), which is present in patients with IC. In the THP of IC patients, there is a direct correlation between reduced sialic acid levels and the high prevalence of nucleotides associated with it. These unique nucleotide isomers identified in our laboratory are very consistent in all IC patients that have them, suggesting biological significance. This study provides additional evidence that THP is abnormal and its binding to nucleotides can adversely affect its protective function in IC patients. Currently we are isolating and indentifying urine metabolites that injure bladder epithelium and cause IC.

RESEARCH ACTIVITIES AND PROJECTS • • •

Development of Bladder Instillation Therapy for IC Patients using Heparin and Alkalinized Lidocaine Tamm-Horsfall Protein–associated Nucleotides in Interstitial Cystitis Patients Identification of Urine Metabolites that Injure Bladder Epithelium and Cause IC

SELECTED PUBLICATIONS 1. Parsons CL, Stauffer C, Schmidt JD. Bladder-surface glycosaminoglycans: an efficient mechanism of environmental adaptation. Science 1980;208(4444):605-7. 2. Parsons CL, Boychuk D, Jones S, Hurst R, Callahan H. Bladder surface glycosaminoglycans: an epithelial permeability barrier. J Urol. 1990 143:139-42. 3. Parsons CL, Greenberger M, Gabal L, Bidair M, Barme G. The role of urinary potassium in the pathogenesis and diagnosis of interstitial cystitis. J Urol 1998 159:1862-6; discussion 1866-7. 4. Parsons CL, Lilly JD, Stein P. Epithelial dysfunction in nonbacterial cystitis(interstitial cystitis). .J Urol. 1991;145 732–5. 5. Parsons CL, Dell J, Stanford EJ, Bullen M, Kahn BS, Willems JJ. The prevalence of interstitial cystitis in gynecologic patients with pelvic pain, as detected by intravesical potassium sensitivity. Am J Obstet Gynecol. 2002; 187: 1395–400

COLLABORATORS • • •

James Koziol, PhD Jeffrey G. Proctor, MD Yongxuan Su

The Scripps Research Institute Georgia Urology, Stockbridge, GA UCSD Department of Chemistry & Biochemistry

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DIVISION OF UROLOGY J. KELLOGG PARSONS, MD, MHS, FACS|ASSOCIATE PROFESSOR • • • • •

Modifiable Risk Factors for Prostate Cancer and Benign Prostatic Hyperplasia Modifiable Risk Factors for Bladder Cancer Translational Epidemiology and Clinical Trials in the Treatment of Urological Neoplasms Active Surveillance for Prostate Cancer Patient Safety and Diffusion of Surgical Innovations

My research focuses on translational epidemiology of urological neoplasms, with an emphasis on modifiable risk factors for and prevention of prostate cancer, benign prostatic hyperplasia, bladder cancer, and adverse patient safety events. I pursue multidisciplinary collaborative research with basic scientists, epidemiologists, and biostatisticians in several hypothesis-driven projects. I am a principal investigator on projects funded by the Department of Defense and the National Institutes of Health (NCI and NIDDK).

RESEARCH ACTIVITIES AND PROJECTS • • • •

PI for CALGB 70807, The Men’s Eating and Living (MEAL) Study, a national, randomized clinical trial of dietary intervention for prostate cancer patients on active surveillance PI for a randomized clinical trial of dietary intervention for bladder cancer Co-PI for an NIDDK-funded observational study of modifiable risk factors for prostate disease in older men Collaborate with Dr. David Chang on outcome studies related to diffusion of surgical innovations and patient safety

SELECTED PUBLICATIONS 1. Parsons JK, Carter HB, Partin AW, Windham G, Metter EJ, and Platz EA. Metabolic factors associated with benign prostatic hyperplasia. J Clin Endocrinol Metab. 2006;91: 2562-2568. 2. Lippman SL, Klein EA, Goodman PJ, Lucia MS, Thompson IA, Ford LJ, Parnes HL, Minasian LM, Gaziano JM, Hartline JA, Parsons JK, Bearden JD, Crawford ED, Goodman GE, Claudio J, Winquist E, Cook ED, Karp DD, Philip Walther P, Lieber MM, Klotz L, Kristal A, Ganz PA, Santella RM, Probstfield JL, Jagpal TJ, Crowley JJ, Meyskens FL, Baker LH, and Coltman CA. The Selenium and Vitamin E Cancer Prevention Trial (SELECT): Southwest Oncology Group Study S0000. JAMA 2009; 301: 39-51. 3. Parsons JK, Schenk JM, Arnold KB, Messer K, Till C, Thompson IM, and Kristal AR. Finasteride reduces the risk of incident clinical benign prostatic hyperplasia. Eur Urol. 2012; 61(6):1263-1270. 4. Parsons JK, Palazzi-Churas KL, Chang DC, and Stroup, SP. Patient safety and the diffusion of surgical innovations: a national analysis of laparoscopic partial nephrectomy. Surg Endo, 27(5):1674-80, 2013. 5. Kopp RP, Marshall LM, Wang PY, Bauer DC, Barrett-Connor E, and Parsons JK. The burden of urinary incontinence and urinary bother among elderly prostate cancer survivors. Eur Urol, 2013 Apr 3. doi:pii: S0302-2838(13)00295-9. 10.1016/j.eururo.2013.03.041. [Epub ahead of print] PMID: 23587870

COLLABORATORS 22

• • • • • • •

John Pierce, PhD Elizabeth Barrett-Connor, MD Karen Messer, PhD Loki Natarajan, PhD James Marshall, PhD James Mohler, MD Lynn Marshall, ScD

UCSD Department of Family and Preventive Medicine UCSD Department of Family and Preventive Medicine UCSD Division of Biostatistics & Bioinformatics UCSD Division of Biostatistics & Bioinformatics Roswell Park Cancer Institute Roswell Park Cancer Institute Oregon Health Sciences University

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DIVISION OF UROLOGY KYOKO SAKAMOTO, MD |ASSOCIATE PROFESSOR • • •

Early Diagnosis of Urological Diseases Minimally Invasive Technologies Progressive Changes in Resident Education

My research at the San Diego VA Medical Center is focused on developing new, minimally invasive technologies for early diagnosis of urological diseases. I am also involved in basic science research studies in physiology and diseases in urology. I enjoy collaborating with other disciplines, and recently worked with the Department of Radiology to publish an article on MR imaging of scrotal tumors and pseudotumors. Another aspect of interest is the progressive changes in resident education, which has been evaluated and presented at national Urology meetings. A manuscript regarding this topic is in progress.

RESEARCH ACTIVITIES AND PROJECTS • • •

Urine TMPRSS2:ERG Fusion Transcript Stratifies Prostate Cancer Risk in Men with Elevated Serum PSA Magnetic Resonance Imaging of Scrotal Tumors and Pseudotumors Prostate Atypia: Clinical and Pathological Variables Associated with Cancer Diagnosis on Repeat Biopsy

SELECTED PUBLICATIONS 1. Sakamoto K, Zupkas P, Wang-Rodriguez J, Chen P. Preliminary report on the analysis of bladder wall vasculature using conjunctival microvascular analysis in patients with and without transitional cell carcinoma. J. Endourol. 2006; 20(5):351-355. 2. Sakamoto K, Uvelius B, Khan T, Damaser MS. Preliminary study of a genetically engineered spinal cord implant on urinary bladder after experimental spinal cord injury in rats. J Rehabil Res Dev. 2002; 39: 347358. 3. Sakamoto K, Suri D, Rajasekaran M. Characterization of muscarinic receptor subtypes in human ureter. J Endourol. 2006;20: 939-942. 4. Sakamoto K, Sharma S, Wheeler JS. Long-term subjective continence status and use of alternative treatments by women with stress urinary incontinence after collagen injection therapy. World J Urol. 2007;25:431. 5. Kopp RP, Parsons JK, Shiau J, Wang-Rodriguez J, Palazzi-Churas K, Silberstein JL, Derweesh IH, Sakamoto K. Prostate atypia: clinical and pathological variables associated with cancer diagnosis on repeat biopsy. Prostate Cancer Prostatic Dis. 2011;14:149-154.

COLLABORATORS •

Japanese Urological Association



Dr. Lejla Aganovic

UCSD Department of Radiology



Dr. Jessica Wang-Rodriguez

UCSD Department of Pathology

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Dr. Kyoko Sakamoto performing robotic surgery at the San Diego VA Medical Center

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DIVISION OF UROLOGY JOSEPH D. SCHMIDT, MD, FACS| PROFESSOR EMERITUS • • • •

Prostate Cancer Cryosurgery Treatment of Metastatic Prostate Cancer Urinary Diversion Treatment of Benign Prostatic Hyperplasia (BPH)

As professor emeritus, my current focus is on clinical activities and patient care. In the past, the vast majority of my research has been in prostate disease, specifically prostate cancer. This includes the evaluation and use of chemotherapy in various stages of prostate and bladder cancer, the use of cryosurgery as an alternative for treatment of localized prostate cancer, and the use of radical perineal prostatectomy as an alternative to standard radical retropubic prostatectomy.

SELECTED PUBLICATIONS 1. Rübben H, Schmidt JD, Eisenberger M, Germa JR, Lluch I, Pienta KJ, Logothetis C (Committee 11): Treatment of hormone resistant disease. In Prostate Cancer, Murphy G, Khoury S, Partin A, Denis L (eds), 2nd International Consultation on Prostate Cancer, June 27-29, 1999, pp. 411-434. 2. Wieder J, Schmidt JD, Casola G, vanSonnenberg E, Stainken BF, Parsons CL: Transrectal ultrasoundguided transperineal cryoablation in the treatment of prostate carcinoma: Preliminary results. J Urol 1995;154: 435-441. 3. Buchsbaum HJ, Schmidt JD, eds: Gynecologic and Obstetric Urology, 3rd ed. Philadelphia: W.B. Saunders Co., 1993. 4. Schmidt JD: Intravesical BCG for superficial bladder cancer: comparison of results on primary tumour to development of progressive disease elsewhere. International Society of Urology Reports, Immunotherapy of Urological Tumours. Society Internationale D'Urologie, JB deKernion (ed), Churchill Livingstone, New York, pp 53-57, 1988. 5. Schmidt J, Buchsbaum H: Transverse colon conduit diversion. Urol Clin North Am 1986;13: 233.

COLLABORATORS •

Gerald R. Murphy, MD, DSc

Roswell Park Memorial Institute



Multiple principal investigators

National Cancer Institute, NIH

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DIVISION OF UROLOGY ROGER L. SUR, MD|ASSOCIATE PROFESSOR • • • •

Role of Tamm Horsfall Protein (THP) in Nephrolithiasis Incidence and Treatment of Nephrolithiasis in the US Military Risk of Radiation Exposure to Health Care Workers Association of nephrolithiasis and cardiovascular disease

My research is focused on four main areas. Collaborating with Dr. Argade, we are evaluating the role of THP in kidney stone patients. Preliminary evidence suggests THP levels are low among kidney stone formers; we seek to confirm these findings and provide more comprehensive detailed role of THP in nephrolithiasis. In collaboration with NMCSD and NHRC, we are investigating the incidence of nephrolithiasis and the rate of undergoing a procedure in US Military service members stratified by occupation and an upcoming deployment. We will also determine the number of medical evacuations for kidney stones from areas of operation, as well as the number of aviation mishaps with symptomatic stones listed as a causative factor. We are also investigating the risk of radiation exposure to health care workers, with a particular focus on kidney stone surgery procedures. Lastly, our most recent collaboration involves a joint NMCSD and UCSF project investigating the association of nephrolithiasis with cardiovascular disease. We demonstrated that statins appear to be associated with reduced risk of nephrolithiasis and are investigating if hyperlipidemia itself therefore increases the risk of nephrolithiasis. Prospective studies are ongoing in this arena with UCSF.

RESEARCH ACTIVITIES AND PROJECTS • • • •

Role of Tamm Horsfall Protein (THP) in Nephrolithiasis Incidence, Treatment, and Threat of Nephrolithiasis among US Military Members from All Services Branches Stratified by Military Specialty Risk of Radiation Exposure to Health Care Workers with a Focus on Kidney Stone Surgery Procedures Association of nephrolithiasis and cardiovascular disease

SELECTED PUBLICATIONS 1. Sur RL, Scales CD, Preminger GM, Dahm P. Evidence-based medicine: a survey of American Urological Association members. J Urol. 2006;176:1127-1134. 2. Kang DE, Sur RL, Haleblian GE, Fitzsimons NJ, Borawski KM, Preminger GM. Long-term lemonade based dietary manipulation in patients with hypocitraturic nephrolithiasis. J Urol. 2007;177:1358-1362. 3. Borawski, KM, Sur RL, Miller, OF, Pak CY, Preminger GM, Kolon TF. Urinary reference values for stone risk factors in children. J Urol. 2008;179:290-294. 4. Cohen SA, Rangarajan SS, Chen T, Palazzi KL, Langford JS, Sur RL. Occupational hazard: radiation exposure for the urologist – developing a reference standard. Int Braz J Urol. 2013; 39(2):209-13. 5. Sur RL, Masterson JH, Palazzi KL, L’Esperance JO, Auge BK, Chang DC, Stoller ML. Impact of statins on nephrolithiasis in hyperlipidemic patients: a ten-year review of an equal access health care system. Clin Nephrol. 2013 May;79(5):351-355.

COLLABORATORS

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James L’Esperance, MD

Naval Medical Center San Diego



Thomas Chi, MD

University of California San Francisco



James Masterson, MD

Naval Medical Center San Diego



Christopher J. Phillips, MD, MPH

Navy Health Research Center



Todd L. Schmitt, PhD

Sea World San Diego



Cynthia R. Smith, PhD

National Marine Mammal Foundation



Stephanie Venn-Watson, PhD

National Marine Mammal Foundation



Marshall Stoller, MD

University of California San Francisco

UC President Janet Napolitano was briefed by Associate Vice Chancellor and UC San Diego Health System CEO Paul Viviano about UCSD’s plans to enhance medical care for San Diegans. Dr. Santiago Horgan, Director of the Center for the Future of Surgery, provided her with an opportunity to experience the surgery simulations provided to UC San Diego medical students. Dr. Roger Sur participated in the October 2013 tour.

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DIVISION OF UROLOGY NICHOLAS M. HOLMES, MD, MBA|PROFESSOR CHIEF OF PEDIATRIC UROLOGY, UC SAN DIEGO SURGEON-IN-CHIEF, RADY CHILDREN'S HOSPITAL-SAN DIEGO • • • •

Recurrent Urinary Tract Infections Vesicoureteral Reflux Prenatal Diagnosis of Urologic Disorders Hypospadias

My research is focused on the identification of pediatric patients who have vesicoureteral reflux, and what are the best outcomes in the treatment of the disease. Presently, we are creating an extensive database of the experience of therapy provided at Rady Children's Hospital San Diego, which for the past 45 years has provided pediatric urology in San Diego. This data will be compared and contrasted with a national database of children’s hospitals to further surgical outcome research in the care of pediatric patients who have vesicoureteral reflux.

RESEARCH ACTIVITIES AND PROJECTS •

Vesicoureteral Reflux: Characterization and Surgical Outcomes of Therapy

SELECTED PUBLICATIONS 1. Holmes NM. Surgical implications of the obesity epidemic. J Urol. 2009;181(5):1985-1986. 2. Christman MS, Chen JT, Holmes NM. Obstructive complications of lichen sclerosis. J Pediatr Urol. 2009;5(3):165-169. 3. Holmes NM, Miller WL, Baskin LS. Lack of defects in androgen production in children with hypospadias. J Clin Endocrinol Metab. 2004;89(6):2811-2816. 4. Holmes NM, Coplen DE, Strand W, Husmann D, Baskin LS. Is bladder dysfunction and incontinence associated with ureteroceles congenital or acquired? J Urol. 2002;168(2):718-719. 5. Holmes NM, Nguyen HT, Harrison MR, Farmer DL, Baskin LS. Fetal intervention for myelomeningocele: effect on postnatal bladder function. J Urol. 2001;166(6):2383-2386.

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DIVISION OF UROLOGY MADHU ALAGIRI, MD|ASSOCIATE PROFESSOR PEDIATRIC UROLOGY • • •

Complex Hypospadias Repair Disorders of Sexual Differentiation and Development Minimally Invasive Treatment of Vesicoureteral Reflux

My research focuses on developing new and less invasive techniques for diagnosing and treating urologic problems in children. My laboratory has developed hypospadias repair techniques that do not require postoperative dressings or catheters, and has also developed a technique for the correction of vesicoureteral reflux using a mini-inguinal incision that does not require tubes or catheters. More recently, my laboratory is seeking a minimally invasive method to identify vesicoureteral reflux in children without the need for bladder catheterization or ionizing radiation.

RESEARCH ACTIVITIES AND PROJECTS • • •

Ten-year Review of my Experience with the Inguinal Approach to Ureteral Reimplantation New Protocol to Identify Vesicoureteral Reflux Without the Use of a Catheter and Minimal Radiation New Surgical Technique to Treat Congenital Buried Penis in the Pediatric Population

SELECTED PUBLICATIONS 1. 2. 3. 4. 5.

Powell CR, McAleer IM, Alagiri M, Kaplan GW. Comparison of flaps versus grafts in proximal hypospadias surgery. J Urol 2000;163:126-89. Bernie JE, Alagiri M. The tubeless Barcat: A patient-friendly hypospadias procedure. Urology 2003;61: 1230-1233. Polepalle SK, Shabaik A, Alagiri M. Leydig cell tumor in a child with spermatocyte maturation and no pseudoprecocious puberty. Urology 2003;62(3):551. Gabal-Shehab L, Alagiri M. Traumatic adrenal injuries. J Urol. 2005;173(4):1330-1331. Arsanjani A, Alagiri M. Identification of filling versus voiding reflux as a predictor of clinical outcome. Urology. 2007;70(2):351-354.

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DIVISION OF UROLOGY GEORGE CHIANG, MD|ASSOCIATE PROFESSOR PEDIATRIC UROLOGY • • • •

Use of the Electronic Health Record for Comparative Effectiveness Research Health Care Outcomes of Children Affected by Spinal Birth Defects Examination and Therapy of the Neurogenic Bladder in Animal Models Laparoendoscopic Single-Site Surgery (LESS) for Pediatric Urology

My research is centered on the care of children with spina bifida, as well as leveraging emerging technology for clinical research and surgical refinement. Clinical research informatics, and multi-institutional prospective or retrospective clinical studies are all part of my current effort. I have been collaborating with the basic science lab of the UCSD Department of Anesthesiology for study and therapy of the neurogenic bladder in animal models. Partnering with UCSD faculty, staff and students at the School of Medicine and at the undergraduate level has expanded our research efforts into projects that vary from determining the quality of life of children with spina bifida in Nicaragua to the use of REDCap for NIH funded summer scholarships for medical students. We are also collaborating with the faculty at USD in determining themes associated with obesity in the adolescent spina bifida population. I have great enthusiasm for our continued efforts in all research arenas involving pediatric urology, and look forward to continued collaborations throughout UCSD and Rady Children’s Hospital-San Diego.

RESEARCH ACTIVITIES AND PROJECTS • •



• •

PCORI Tier 1 Grant: Addressing obesity in Latino adolescents with spina bifida: Parental and patient themes UCSD Academic Senate Grant: We are devising a novel minimally invasive model of micturition in rats in conjunction with the Dept of Anesthesiology to determine the utility of spinal stem cell therapy for treatment of neurogenic bladder in spinal cord injured rats. Multi-center EMR: We are part of a multi-institutional collaboration with Children’s Hospital Colorado and University of Virginia utilizing Epic electronic medical records to create automated patient registries for determining variability in practice patterns in children with prenatal hydronephrosis, VUR and hypospadias RCHSD Surgical Research Grant: Data extraction of the Epic EHR for comparative effectiveness research Investigating outcomes of urological conditions based on inquiry of the Pediatric Health Information System.

SELECTED PUBLICATIONS 1. 2.

3. 4.

Vemulakonda VM, Chiang G, Corbett ST. Variability in Use of Voiding Cystourethrogram During Initial Evaluation of Infants With Congenital Hydronephrosis. Urology. 2014 Jan 4. Woo J, Palazzi K, Dwek J, Kaplan G, Chiang G. Early clean intermittent catheterization may not prevent dimercaptosuccinic acid renal scan abnormalities in children with spinal dysraphism. J Pediatr Urol. 2013 Sep 26 pii: S1477-5131(13)00227-1. doi: 10.1016/j.jpurol.2013.09.001. Marietti, S, Holmes, N., and G. Chiang. Laparoendoscopic Single-Site (LESS) Bilateral Nephrectomy in the Pretransplant Pediatric Population. Pediatric Transplantation 2011 Jun;15(4):396 Marietti S, Decambre M, Fairbanks T, Kling K, Chiang G. Early Experience with Laparoendoscopic

31

Single-Site Surgery (LESS) in the Pediatric Urology Patient Population. J Endourol. 2010;24 (8):13211324.

COLLABORATORS •

Ruth Bush, PhD

USD/Rady Children's Hospital San Diego



Sean Corbett, MD

Pediatric Urology, University of Virginia



Vijaya Vemulakonda, MD, JD

Pediatric Urology, Univ. of Colorado



Tony Yaksh, PhD

UCSD Department of Anesthesiology

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DIVISION OF UROLOGY GEORGE W. KAPLAN, MD, FACS| PROFESSOR PEDIATRIC UROLOGY • • • •

Reconstructive Urology Embryology of the Urinary Tract Outcomes of Pediatric Urologic Reconstruction Hypospadias Repair

My research efforts during my career have involved providing a database in pediatric urology that allowed for evidence-based decisions regarding diagnosis and management. At the time I began my career, there was relatively little information available about the urologic problems of children and their management. I believe my efforts in some small way have provided a great deal more information than was previously available. Because I now have some long-term information about the management of these problems, my efforts are now concentrated largely on collating and evaluating the results of treatment of vesicoureteral reflux and hypospadias. My hobby has been urologic history and I am currently working on a history of pediatric urology in the Western Section of the American Urological Association and an article about Dr. Peter Remondino, an early San Diego physician.

RESEARCH ACTIVITIES AND PROJECTS • • • •

History of Pediatric Urology in the Western Section of the American Urological Association Peter C. Remondino, MD: The Man, His Book, and His Library Management of Spina bifida in Children Long-term Outcomes of Onlay Graft Repair of Proximal Hypospadias

SELECTED PUBLICATIONS 1. Kaplan G, Bulkey G, Grayhack J. Carcinoma of the male urethra. J Urol. 1967; 98:365. 2. Kaplan G, Sammons T, King L. A blind comparison of dilatation, urethrotomy, and medication alone in the treatment of urinary tract infection in girls. J Urol. 1973; 109:917. 3. Kaplan GW, Lamm DL. Embryogenesis of chordee. J Urol. 1975;114:769. 4. Lashley DB, McAleer IM, Kaplan GW. Ipsilateral ureteroureterostomy for the treatment of vesicoureteral reflux or obstruction associated with complete ureteral duplication. J Urol. 2001;165:552-554. 5. McAleer IM, Kaplan GW, Bradley JS, Carroll SF, Griffith DP. Endotoxin content in renal calculi. J Urol. 2003;169:1813-1814.

COLLABORATORS • • • • • • • •

Steven Lerman, MD Irene McAleer, MD John Brock, MD Howard Snyder, MD Margit Fisch, MD Scott Sparks, MD Alan L Kaplan, MD MM Koraitim, MD

UC Los Angeles UC Irvine Vanderbilt University University of Pennsylvania Hamburg University, Germany George Washington University UC Los Angeles University of Alexandria, Egypt

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DIVISION OF UROLOGY SARAH MARIETTI SHEPHERD, MD | ASSISTANT PROFESSOR PEDIATRIC UROLOGY • • •

Pediatric Stone Disease Vesicoureteral Reflux Minimally Invasive Surgery

RESEARCH ACTIVITIES AND PROJECTS • •

Identification of radiation exposure risk to caregivers when diapered age children undergo nuclear renal scans Identification of spina bifida patients at risk for stone disease

SELECTED PUBLICATIONS 1. Marietti SR, N Holmes, G Chiang. Laparoendoscopic single-site (LESS) bilateral nephrectomy in the pretransplant pediatric patient. Pediatric Transplantation. 2011;15(4):396399. 2. Marietti SR, M Decambre, T Fairbanks, K Kling, G Chiang, Early Experience with Laparoendoscopic Singlesite surgery (LESS) in the pediatric urology patient population. J Endourol. 2010;24(8):1321-1324. 3. Chalmers D, Marietti S, Kim C. Xanthogranulomatous Pyelonephritis in an Adolescent. Urology. 2010;76(6):1472. 4. Marietti SR, Driscoll K, Spencer J, Copel J, Kim C, Ferrer F. Cloacal Exstrophy in Two Separate Cases of Monoamniotic-Monochorionic Twins. Dialogues in Pediatric Urology. February 2008. 5. Marietti S, Woldrich J, Durbin J, Sparks S, Kaplan G, Chiang G. Urologic findings on computed tomography of the abdomen and pelvis in a pediatric population. J Pediatr Urol. 2013;9(5):609-12.

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DIVISION OF UROLOGY PUBLICATIONS 2012-2013 1.

Abern, M.R., Aronson, W.J., Terris, M.K., Kane, C.J., Presti, J.C., Jr., Amling, C.L., and Freedland, S.J. 2013. Delayed radical prostatectomy for intermediate-risk prostate cancer is associated with biochemical recurrence: possible implications for active surveillance from the SEARCH database. Prostate 73:409-417.

2.

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