UAB Insight Urology Volume 5 - Page 2

UAB Urology Researchers at Forefront of Effort to Prevent Kidney Stones F e at u r e d c l i n i c a l TR I A L BOTOX for the Treatment of Urinary Incontinence due to Neurogenic Detrusor Sclerosis. This study sponsored by Allergan is of subjects with urinary specialty and subspecialty clinicians, the expertise of our incontinence caused by overactive research lab provides us with a comprehensive program to bladder as a result of multiple sclerosis attack this rising problem,” he says. (MS). This study will test the safety and effectiveness of a lower dose of BOTOX in the treatment of urinary incontinence, specifically in MS subjects who are not Assimos is a renowned clinician who treats the most complex renal stone disease. He says UAB regularly treats patients with significant comorbidities including morbid counsel to patients toward active surveillance or treatment.” He says that this and other (L-R) Assimos, Holmes, Knight Ross Holmes, PhD, is one of the world’s leading and whose symptoms have not been extra-large stones, and abnormalities of the collecting system demonstrating possible links of this process to oxidative adequately managed with anticholinergic and ureter. stress. His colleague John Knight, PhD, also is the recipient of major federal grant awards. “Our research covers the oxalate consumed in the diet, its this lower dose is effective at reducing and minimally invasive approaches to stone treatment,” says urinary leakage and to evaluate the side Assimos. “We mainly utilize ureteroscopic and percutaneous absorption into the body, its synthesis in the body, and its stone removal, and extracorporeal shock wave lithotripsy. excretion by the kidney,” says Holmes. NCT01600716. PI: Tracey Wilson, MD. Contact: Lisa Harvey, 205.996.2613. In special situations, we perform laparoscopic and robotic Current research topics include the oxalate content of assisted stone removal. We have not employed open surgery diet; the mechanisms of oxalate change as it transits the gut; for stone removal for quite some time.” the digestion of oxalate by the gut bacterium Oxalobacter Assimos and two other major researchers who P U B LI C AT I O N S O F N OT E Assimos DG. “Re: are small residual stone fragments really insignificant in children?” J Urol. 2014 Feb; 191(2):467. Sonpavde G, Willey CD, Sudarshan S. “Fibroblast growth factor receptors as therapeutic targets in clear-cell renal cell carcinoma.” Expert Opin Investig Drugs. 2014 Mar; 23(3):305-15. Truong H…Nix J, et al. “MRI characterization of the dynamic effects of 5α-reductase inhibitors on prostate zonal volumes.” Can J Urol. 2013 Dec;20(6):7002-7. formigenes; how hydroxyproline, glycine, glycolate, and accompanied him from Wake Forest University are glyoxal contribute to oxalate formation; and the accelerated pleased with the research environment provided at UAB synthesis of oxalate in primary hyperoxaluria and what that facilitates complex studies. Much of their research effects that has on liver and kidney mitochondria. employs sophisticated analytical techniques such as ion chromatography coupled to mass detection. Assimos Receives Mentor Award UAB Department of Urology Chair Dean Assimos, developments in prostate cancer management are providing a spark of excitement researchers in endogenous oxalate production and effects associated with this lower dose. male reproductive problems. MD, was the 2013 recipient of the Ralph Clayman among urologists dealing with the disease. When only the PSA, Gleason score, and “Mentor” Award given annually by the American clinical staging were available, patients often could only make crude judgments as Urological Association and presented at the 31st to which treatment to choose. “Now we are in the early days of attempting to utilize World Congress of Endourology in October 2013 commercially available biomarkers of disease in newer blood and urine tests, and the in New Orleans. Assimos also was a member of advent of profiling genetic expression of biopsy tissue is in its early stages as well. the International Scientific Committee and chair Both of these, along with MRI/US imaging, will help us determine if a cancer is of the Fellowship Committee for the event. The inherently, biologically aggressive and needs treatment,” says Nix. event is the world’s foremost meeting for minimally them out of active surveillance. Our goal is to allow physicians to provide better obesity as well as those with associated congenital problems, “We offer a full range of imaging support, a caring faculty, for the Study of Male Reproduction, a national organization devoted to the study of based on image-targeted biopsies showing more aggressive disease and reclassifying using a catheter to empty their bladder therapy. The aim is to test whether microsurgical procedures since joining UAB in 1998. He is president of The Society cancers and allow improvements in staging. Some patients’ information was upgraded to chair the department. “Combined with a full team of correctable with microsurgery, says Kolettis, who has performed more than 600 imaging modality can significantly improve the detection of clinically relevant prostate research laboratory to UAB when he was recruited in 2012 of male infertility is obstruction from vasectomy. Many of these obstructions are who trained in fusion imaging at the NIH and joined UAB in 2013, says, “This Urologist Dean Assimos, MD, moved his world-class can be repaired with microsurgery. The other common surgically correctable cause and the first by a major academic medical center in the Southeast. Jeffrey Nix, MD, intense searches for ways to study and prevent kidney stones. has an abnormal semen analysis, or symptoms such as pain, a varicocele usually UAB recently performed MRI/ultrasound prostate biopsies in clinic, a first in Alabama NIH and foundation grants in one of the nation’s most UAB’s Fusion Imaging of Prostate Biopsy a First for Southeast; Delivers Better Info on Staging, Counseling UAB Urology clinicians and researchers are using multiple Overactivity in Patients with Multiple UAB MEDICINE NEWS Their work also has associated translational repercussions invasive urologic surgery. Assimos has dedicated his career to the medical and surgical Same-Day Evaluations for Couples’ Infertility management of patients with complex renal stone disease and has mentored medical Couples seeking fertility services at UAB can be evaluated separately but students, residents, postgraduate students, and endourology fellows. In addition, he has simultaneously by specialists in the Department of Urology for men and the Division served as a member of the AUA Nephrolithiasis Guidelines Panel since its inception of Reproductive Endocrinology for women. “We can coordinate visits on the same and is on the editorial boards of several urologic journals. He is also committed to day to provide convenience, particularly for people who travel long distances,” says urologic education, participating as a speaker and course director for the AUA and urologist Peter Kolettis, MD. Female evaluation is provided by Wright Bates, MD, other organizations. The 2014 meeting will be held September 3-7 in Taipei, Taiwan. Janet McLaren, MD, and Richard Blackwell, MD. The groups provide management for all forms of infertility. Varicoceles, enlarged veins of the spermatic cord, are the UAB Awarded $1.3 Million From NIDDK most common cause of low sperm production and decreased sperm quality. If a man for Primary Hyperoxaluria Project UAB Urology researchers recently won an award of $1,327,664 over 4 years from under investigation. the National Institute of Diabetes and Digestive and Kidney Diseases for the project “Mitochondrial Metabolism in Primary Hyperoxaluria.” Ross Holmes, PhD, is the principal investigator for the project. Coinvestigators are John Knight, PhD, of UAB continued from cover Renal cancer patients arrive at UAB via referral, usually Urology, Victor Darly-Usmar, PhD, of UAB Pathology, and Todd Lowther, PhD, of aimed at various molecular signaling pathways. Sudarshan’s Wake Forest University, Biochemistry. Holmes says, “We will study the liver and research laboratory studies the metabol ic alterations of from primary care practitioners and community urologists. Sudarshan notes that it is important for referrals to be made kidney metabolism that contributes to the kidney failure and calcium oxalate tissue renal cancer, both in rare hereditary forms of RCC as well as in sporadic kidney cancer. deposition that often occurs in this rare, genetic disease. The grant focuses on the role of mitochondria and peroxisomes.” Primary hyperoxaluria is caused by the shortage in a prompt manner. “Once the malignancy has spread, The UAB Comprehensive Cancer Center provides a patients face an uphill battle, as approved treatments for designated patient advocate-navigator to coordinate initial of an enzyme that normally prevents the buildup of oxalate. People with type 1 advanced disease rarely result in durable responses,” he says. outpatient visits including gathering patient records, primary hyperoxaluria have a shortage of the liver enzyme AGXT. Type 2 primary scheduling laboratory work, further diagnostic studies, hyperoxaluria is due to a shortage of GRHPR, found in the liver and kidneys. Type with advanced disease as well as those who are at risk for and more. “This allows us to see patients very efficiently,” 1 is estimated to occur in 1 to 3 persons per million and is more common in some recurrence. Most of the clinical trials are targeted therapies Sudarshan notes. Mediterranean countries. Although the incidence of type 2 is unknown, it is less The team, however, does offer clinical trials for patients common than type 1. Male and female fertility evaluations are coordinated 2 For Referrals: 800.822.6478 M o r e I n f o r ma t i o n : u a b m e d i c i n e . o r g / p h y s i c i a n 3