UAB Urology Researchers at Forefront of Effort to Prevent
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
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, wil l 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
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 metabolic 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
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
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