Spring 2018 Newsletter Highlights

Iowa Urology

A full, pdf version of this 2017 Year in Review newsletter is available here:PDF iconUIUrology_Spring2018Newsletter.pdf


Dr. Karl J. KrederAs we celebrate our people and accomplishments of 2017 in this newsletter, I would like to share some of the upcoming events happening in the University of Iowa Department of Urology.

In April, the Department of Urology will host visiting professor of pediatric urology, Dr. Anthony Caldamone. Dr. Caldamone is Professor of Urology and Pediatrics and Director of the Urology Residency Program at Brown University. We also welcome our Rubin H. Flocks Visiting Professor, Dr. Michael O. Koch, in June. Dr. Koch has been the Chairman of the Department of Urology at Indiana University School of Medicine since 1998. He is a previous trustee and past-president of the American Board of Urology, past-Chairman of the Examination Committee for the American Board of Urology, past-President of the Society of Urology Chairpersons, past president of the Society of University Chairpersons, and a member of the GU Surgeons and the Clinical Society.

At our annual Iowa Urologic Society meeting in August, we will host the David A. Culp speaker, Jihad Kaouk, MD, FACS. Dr. Kaouk is the Director of the Center of Advanced Laparoscopic and Robotic Surgery and an American Board certified Urologist in the Cleveland Clinic’s Glickman Urological & Kidney Institute. Also speaking is John L. Gore, MD, MS. Dr. Gore is a clinician, surgeon, researcher, and educator at University of Washington Medical Center and School of Medicine.

I look forward to updating you on our research and philanthropic efforts, as well as our resident and faculty recruitment in the next department newsletter.

Dr. Karl J. Kreder, Professor and Department Executive Officer, Rubin H. Flocks Chair, Department of Urology


Looking Ahead

PSMA imaging
Patient who underwent prostatectomy locally and had biochemical recurrence. PSMA imaging identified a positive lymph node that would not have been detected on standard CT or MRI imaging.

Working with 6 other centers across the United States, the University of Iowa Departments of Urology, Radiology, and Nuclear Medicine are working together to gather data for FDA approval for this new and exciting imaging study. Positron emission tomography (PET) imaging  using a radiotracer (a small amount of radioactive material) that targets prostate-specific membrane antigen (PSMA) may allow doctors to identify smaller areas of disease spread as well as sites of early recurrences. This information is helpful for prostate cancer management and patient counseling.

One of these PSMA-targeting PET agents, Ga-68 PSMA-11, uses small molecules that bind to PSMA to localize a prostate cancer tumor and allows radiologists to image patients after 1 hour to detect small sites of disease. Ga-68 PSMA-11 is not currently approved by FDA for prostate cancer imaging, and its use is considered investigational. Although investigational, multiple studies suggest that this newest agent is superior to currently available FDA-approved agents, particularly at very low PSA levels.

Currently, physicians and scientists at the University of Iowa are investigating the use of this novel agent prospectively in two patient populations: 1) Those with intermediate or high-risk prostate cancer that are planning to have a prostatectomy and 2) those with a PSA recurrence following definitive therapy for prostate cancer (radiation or surgery). In addition to offering a cutting-edge technology to our patients in Iowa, the results of these studies will allow us to better understand the role of this new agent in the management of prostate cancer patients and further expand the individualized approach to prostate cancer treatment.

Pediatric Urology Update

UI Stead Family Children's Hospital LogoWith the assistance of a Stead Family Children’s Hospital research grant, the pediatric urology division has developed working prototype devices to assist in monitoring children and adults with neurologic conditions affecting their bladder. We anticipate testing the accuracy and usability of these devices in people within the next several months. These devices can be thought of as similar to the device a patient with diabetes uses to measure their own blood sugar levels. The information obtained will help patients and physicians adjust a patient’s medications and how often they need to catheterize. Ultimately, it is hoped this will protect the patient’s bladder and kidney function. One device is about the size of a roll of quarters and measures and records the bladder pressure, time, and date and transmits this information wirelessly to a phone or other device. The other device is a larger ‘home unit’ about half the size of a box of Kleenex that makes the same measurements as the smaller device but also pumps the urine out of the bladder and measures and records the volume of urine removed. User-friendly software applications for a variety of phones/computers to be used with the devices are currently under development and patents are pending.


Faculty Focus

Dr. Ken Nepple
Ken Nepple, MD

Dr. Ken Nepple was a recently featured on Faculty Focus, a web-based article highlighting the faculty of the University of Iowa Carver College of Medicine. Originally published December 18, 2017, Dr. Nepple's feature is reprinted below.

What is your hometown?

Templeton, Iowa (pop. 360)

How/when did you become interested in science and/or medicine?

I have always been interested in science, which morphed into an interest in medicine during college. My interest in surgery developed during medical school based on wanting to use my hands, focus on attention to detail, and directly impact patients.

When did you join the University of Iowa faculty?


How or why did you choose to join the faculty at the University of Iowa?

I decided toward the end of urology residency that I wanted to come back to Iowa after urologic oncology fellowship. The department, the hospital, the college, and the people of Iowa are very important to me.

Is there a teacher or mentor who helped shape your career?

Dr. Williams, the former Chair of Urology for 25 years, was a mentor personally and professionally. He taught me to be demanding of myself and to advocate for what you think is right for your patient.

How do you see your faculty role impacting medicine and/or science?

Taking care of one patient at a time, but while also trying to fix problems that impact healthcare delivery for many patients. I also value the role of trying to impact how students and residents approach the way they deliver patient care.

What is the biggest change you've experienced in your field since you were a student? 

Technology. Technology is just starting to catch up to the needs of medicine. I do things on a regular basis that I would have thought were science fiction as a student.

What one piece of advice would you give to today's students?

Don’t settle for one piece of advice.

In what ways are you engaged in professional activities outside the University (i.e. population based research, mentoring high school students, sharing your leadership/ expertise with organizations or causes, speaking engagement off campus, etc.)?

I regularly get the opportunity to interact on the national level with thought leaders in urology, robotic surgery, oncology, informatics, and malnutrition care. I’m appreciative of the support system at Iowa that allows those contributions while still prioritizing the patient.

What are some of your outside (personal) interests?

Spending time with family and watching our three kids grow up, kid’s activities including sports and drama, taking care of the yard including our mini-baseball field, overuse of technology.