Winter 2017 Newsletter

Welcome message from Dr. Kreder

Welcome to the winter 2017 newsletter from the University of Iowa Department of Urology.  We are pleased to bring you this update highlighting just a few of our recent accomplishments. The UI Department of Urology continues to experience a period of tremendous growth.  We now have 11 faculty members and 9 advanced practice providers.  Our teaching programs continue to evolve and our research continues to be recognized with funding and presentation at prominent national and international meetings. It’s an exciting time for urology at Iowa as we celebrated our 100 year anniversary last year and we are well on our way to even greater achievements in the 100 years to come.  We look forward to sharing it with you.

Quick Facts about Urology at Iowa

 


 

 

First in Iowa: Fusion Guided Prostate Biopsy

Chad Tracy

Patients undergoing prostate biopsy at UI Hospitals and Clinics will have a new option beginning in January. Under the direction of Chad Tracy, MD, MRI/ultrasound fusion-guided biopsy has been added to our services to help guide our urologists to more precisely differentiate cancerous tumors from normal prostate tissue during biopsy. The new MRI method shows the prostate gland in much greater detail, so urologists can better visualize areas of tissue that might contain high-grade tumors.

 

 

 


Malnutrition in Hospitalized Patients

Malnutrition is a significant problem for many patients in urology, especially those with urologic cancer. The rate of malnutrition in hospitalized patients is estimated to be 30 to 60 percent, but it is markedly under-recognized in clinical practice. Malnutrition has an impact not only on patient care, but on hospital reimbursement and risk adjustment.

Ken Nepple, MD, FACS, led a multidisciplinary team that redesigned malnutrition assessment and workflow within the electronic health record. This effort focused on helping providers better recognize, diagnose, and address malnutrition in hospitalized  patients. Based on patient and financial benefit, this workflow was subsequently adopted hospital-wide. This work also led to a sponsored role in the Malnutrition Quality Improvement Initiative, a collaboration between the Academy of Nutrition and  Dietetics, Avalere Health, and other stakeholders. Dr. Nepple has also received an American Cancer Society seed grant to develop a comprehensive malnutrition assessment program in radical cystectomy patients. This program has implemented  preoperative malnutrition assessment and intervention with immunonutrition. If you are interested in working on malnutrition quality improvement at your institution, please contact Dr. Nepple.

 


Bringing Urologic Care to Rural Iowans

Brad Erickson, MD, is investigating how to reach patients who experience obstacles to urologic care – while also addressing the near-future shortage of urologists – through outreach clinics, utilization of advanced practice providers, and telemedicine. His current research is supported by an inaugural American Urological Association (AUA) data grant.

 As a largely rural state, Iowa patients often travel long distances to see their urologist. One way Iowa’s urologists are addressing this problem is by performing outreach urologic care and going to patients. These urologists are also performing urologic  procedural care in many of the state’s critical access hospitals.

 However, with current projections revealing that by 2020, the U.S. will have over 5,000 fewer urologists than needed, our approach to providing urologic care will need to change. Dr. Erickson and team are investigating the impact that the addition of  advanced practice providers to urology practices is having on clinical and procedural care as well as in operating rooms. The group’s findings reveal that their addition will have mostly positive benefits, not the least of which is improving access to care.  Telemedicine is another way that access to rural patients will be improved, and the team recently analyzed our experience at UI Hospitals and Clinics providing care to our state’s prisoners using telehealth. The program was found to be safe and effective, and its role will likely need to expand.


Investigative Bladder Cancer Treatments

Michael O'Donnell, MD, will direct a prospective, multi-institutional trial of hyperthermic mitomycin therapy using the Synergo® device. Currently approved for use in Europe,the device combines local radiotherapy and hyperthermia to the bladder walls while infusing a chemotherapy agent into the bladder. This therapy is used after surgical removal of tumors and shows promise in preventing cancer recurrence. The trial, due to start within the next year, will enroll patients with a surface spreading disease known as carcinoma-in-situ (CIS) that has failed conventional topical immune therapy with BCG.

Dr. O’Donnell has been invited by the FDA on multiple occasions for his expertise in treating early bladder cancer, especially cancers that become resistant to topical BCG therapy and has provided guidance on how new trials for FDA approval should be conducted. This past year, Dr O’Donnell published two reports on new therapies he has developed, including a double bladder chemotherapy treatment, gemcitabine-docetaxel, and an advanced 4-drug immunotherapy treatment for patients who fail BCG therapy.

 


Pediatric Voiding Improvement Clinic 

Pediatric urologist Doug Storm, MD, FAAP, and child psychologist Laura Fuller, PhD, have created a partnership to address concomitant medical and psychological issues behind bladder and bowel issues in toilet-trained children. As the only specialized clinic of its kind in the Midwest, this collaborative approach is addressing these issues to provide relief for the emotional toll these issues can have on patients and families.


 

 

Welcome

Sam Brancato, MD has joined the UI Department of Urology as an assistant professor. Dr. Brancato is a urologic oncologist specializing in minimally invasive surgery. He received his medical degree from the University of Missouri-Columbia, his MS from Pennsylvania State University, and he completed his urology residency at Loyola Medical Center. Dr. Brancato then completed a two-year urologic oncology fellowship at the National Institutes of Health in Bethesda, Maryland.

 

 


 

North Central Section Silbar Award, 2016

Sixth-year urology resident Laura Bertrand, MD, received the 2016 American Urological Association North Central Section Silbar Award. The award is given annually to an outstanding urology resident in the North Central Section who reflects outstanding qualities in clinical ability, high ethical and moral standards, compassion for patients, and outstanding bedside manner. 

 

 

 

 

2017 American Urological Association Victor A. Politano Award

Karl Kreder, MD, MBA, has been awarded the 2017 Victor A. Politano Award from the American Urological Association. The award is presented annually to an individual for outstanding research and work in the field of incontinence and for enhancing the treatment of incontinent patients, thereby helping to improve their quality of life. Dr. Kreder is being honored for over two decades of research and clinical excellence in the area of urinary dysfunction and incontinence.

 

 

 

 

CME Events 2017

Mark your calendars for our CME events in 2017!

Flocks Visiting Professor, June 23-24

We are pleased to announce that our 2017 Flocks Visiting Professor is Roger Dmochowski, MD, MMHC, FACS. Dr. Dmochowski is a professor in the Department of Urology at Vanderbilt University in Nashville. He is director of the section of female pelvic medicine and supervisor of the fellowship in pelvic medicine at Vanderbilt. He has published more than 285 articles, 100 book chapters, and 400 abstracts. He is the editor-in-chief of the journal Neurourology and Urodynamics. His current research interests include outcomes of incontinence therapies with a particular emphasis on quality-of-life issues.

Iowa Urologic Society, Aug. 25-26

Mohit Khera, MD, MBA, MPH, will serve as our David A. Culp Speaker at the Iowa Urologic Society annual meeting. Dr. Khera is an associate professor and director of the Laboratory for Andrology Research at McNair Medical Institute, Baylor College of Medicine in Houston. Dr. Khera specializes in male infertility, male and female sexual dysfunction, and declining testosterone levels in aging men. Dr. Khera’s research focuses on the efficacy of botulinum toxin type A in treating Peyronie’s disease as well as genetic and epigenetic studies on post-finasteride syndrome patients and testosterone replacement therapy.

We also welcome Kathleen Hwang, MD, as Special Guest Speaker. Dr. Hwang is an assistant professor of surgery (urology) and pathology and laboratory medicine, and director of the male reproductive medicine and surgery fellowship at Brown University in Providence, Rhode Island. Dr. Hwang also is a member of the urology staff at Rhode Island Hospital, the Miriam Hospital, and the Providence VA Medical Center. Dr. Hwang’s clinical and research interests focus on male infertility and sexual function. She is currently pursuing a particular investigation of ghrelin to minimize postoperative adhesions and aid wound healing, which could ultimately lead to higher fertility rates after vasectomy reversal.

If you would like to become a member of the Iowa Urologic Society, please download a membership application. PDF iconIUS_membership_application.pdf