Desai Sethi Urologists Flex Research Muscle at AUA 2024
Article Summary
- Desai Sethi Urology Institute researchers played a prominent role at the American Urological Association (AUA) annual meeting.
- DSUI founding director Dr. Dipen Parekh spoke about the results of a clinical trial comparing robotic and open cystectomy.
- Dr. Raveen Syan served as early career editor at the Journal of Urology editorial board meeting and moderated several panels.
The 119th American Urological Association (AUA) annual meeting’s new clinical trial initiative provided an appropriate platform for Desai Sethi Urology Institute (DSUI) faculty to showcase their research and share their extensive expertise.
DSUI faculty, fellows, residents and students participated in presentations, panels, poster sessions and subspecialty meetings at the largest annual global gathering of the urological community.
“Whether we shared practice-changing research, secrets of successful clinical trials or educational updates on topics relevant to everyday urology practice, there’s no question that DSUI faculty are established and respected in our specialty,” said Dipen J. Parekh, M.D., DSUI founding director and chief operating officer of UHealth — University of Miami Health System. “The fact that we were invited to participate in AUA’s new clinical trial initiatives is a testament to the robust clinical and basic research programs we’ve established and AUA put our research and clinical trial expertise on a global stage.”
Dr. Parekh, director of UHealth robotic surgery and professor and chair of the Department of Urology at the University of Miami Miller School of Medicine, presented “Robotic Radical Cystectomy: New Standard?” at the meeting. Dr. Parekh referenced the Randomized Open Versus Robotic Cystectomy (RAZOR) trial, a study published in The Lancet that showed there were no significant differences between robotic and open cystectomy, even after a three-year follow-up.
Clinical Trials Education
AUA leadership invited Sanoj Punnen, M.D., DSUI associate professor and vice chair of research, to serve on a panel of clinical trial experts overseeing the new AUA Clinical Trials Collective. Its mission is to overcome clinical trial resource constraints and reach underrepresented patients.
“Our collaboration on the Clinical Trials Collective started at AUA 2024 with a think tank focus group,” said Dr. Punnen, also co-chair of the Genitourinary Site Disease Group at Sylvester Comprehensive Cancer Center, part of the Miller School. “We have extensive research experience to share with the collective, as our mission at DSUI has been to improve patient care through cutting-edge research.”
AUA invited Dr. Punnen and Emad Ibrahim, M.D., director of the Male Fertility Research Program at The Miami Project to Cure Paralysis and assistant professor of urology at the Miller School, to participate in the Clinical Trials in Progress program.
“This program, which launched at AUA 2024, focuses on investigators’ presenting ongoing, industry-sponsored or investigator-initiated independent studies that are about to open, accruing participants, or in follow-up but have not reported primary findings,” Dr. Ibrahim said.
Dr. Punnen presented “Phase 2 Randomized Trial: Human Amnion Membrane Allograft and Early Return of Erectile Function after Radical Prostatectomy (HAMMER),” while Dr. Ibrahim presented on the ongoing Department of Defense-funded trial on the use of probenecid, “A Novel Therapy to Improve Reproductive Potential in Men with Spinal Cord Injury (SCI).”
Prostate Cancer Research
Thomas Masterson, M.D., assistant professor of clinical urology at DSUI, had a plenary debate on the safely of testosterone replacement therapy for men with prostate cancer on active surveillance.
“This is a controversial topic because the mainstay of prostate cancer treatment begins with blocking testosterone production,” Dr. Masterson said. “Emerging data supports the safety of testosterone use after prostate cancer treatment. However, to date, there are no studies assessing the safety of testosterone in men with prostate cancer.”
Himanshu Arora, Ph.D., assistant professor of urology at DSUI and Sylvester, spoke during “Targeting Lineage Reprogramming in Neuroendocrine Prostate Cancer: The Role of Nitric Oxide-Modulated Molecular Interactions.”
“Increased metastasis, which is independent of androgen receptor, is the key driver behind neuroendocrine prostate cancer. Currently, there are no therapy options which could effectively target this phenotype of cancer,” Dr. Arora said. “Our research has uncovered novel mechanisms in cancer stemness specifically targeted by nitric oxide donors through a protein modification called S-nitrosylation. We believe that our study will pave the way to more effective therapy options in this domain of prostate cancer.”
Dr. Arora’s research team also gave a podium talk on “Highlighting Regions of Interest in Prostate Cancer Aided by Synthetically Generated Tissue Biopsies.”
“Developing translational tools that are assistive in improved diagnostics is the key goal of our research focusing on generative adversarial network models in prostate cancer,” Dr. Arora said. “New advancements we are currently focusing on involve integrating genomics data into the models which are capable of effectively evaluating the morphology of histology sections.”
Urology resident Ruben Blachman Braun, M.D., M.Sc., presented poster and podium sessions on “Functional Outcomes of Combined Single Session Holmium Laser Enucleation of Prostate and High Intensity Focused Ultrasound (HIFU) in Management of Prostate Cancer Patients with Large Prostate: A Comparative Study.”
Male Reproduction Highlights
During AUA 2024’s subspecialty meeting for the Society for the Study of Male Reproduction, Dr. Ibrahim was invited to present “Penile Vibratory Stimulation (PVS) and Electroejaculation (EEJ) Indications and Practical Tips for Sperm Retrieval.”
“I’m considered one of the experts in PVS and EEJ and one of the few people in the country that does these procedures,” Dr. Ibrahim said. “Presenting at AUA is important for DSUI and Miller School because we are a worldwide PVS and EEJ referral center.”
Dr. Masterson was among the Miller School representatives presenting retrospective outcomes on infected penile implant salvage procedures.
“We presented the largest multicenter data assessing device reinfection and survival rates,” said Dr. Masterson, also scientific co-chair of the Urological Society for American Veterans (USAV) meeting.
Dr. Arora also presented “Sexual Function/Dysfunction: Basic Research & Pathophysiology” during the subspecialty meeting.
Men’s Health
Bruce R. Kava, M.D., professor of urology and director of men’s health at DSUI, was inducted as president of the American Society of Men’s Health (ASMH). Dr. Kava served on the ASMH Steering Committee and Workgroup, which developed a men’s health checklist in conjunction with the Sexual Medicine Society of North America (SMSNA) that will guide clinicians and patients to optimize men’s health.
Dr. Kava was joined by Alan J. Wein, M.D., professor and director of business development and mentoring at DSUI. Dr. Wein is currently serving as president of the International Society of Men’s Health and presented a lecture on global men’s health perspectives.
“It is important that we recognize that many of the trends that we see in men’s health are global problems,” he said. “We must keep this in mind as we come up with thoughtful and more effective solutions to men’s health problems here in the United States and internationally.”
Focus on Female Urology
Raveen Syan, M.D., assistant professor of clinical urology at DSUI, had several key roles at AUA 2024, including early career editor at the Journal of Urology editorial board meeting.
“AUA selects from all over the U.S. and Canada for this role and I am the only female pelvic medicine and reconstructive surgery early career editor in the group,” Dr. Syan said. “I feel proud to be working towards the goal of continuing to advance and promote a focus on women’s health and research.”
During the AUA Indian American Urologic Association meeting, Dr. Syan moderated the “Management of Refractory Overactive Bladder (OAB): The New Crop of Implantable Percutaneous Tibial Nerve Stimulation (PTNS) Devices” panel.
“The field of female urology is always evolving with new and innovative technology,” she said. “These advancements allow patients to receive treatment at home, which helps them overcome access to care issues, including transportation, cost of travel, distance to specialized care and more.”
She also was part of a panel addressing “Urodynamic Studies and Female Stress Urinary Incontinence in the Era of the VALUE Trial: Is it Needed? Debate and Panel Discussion of Cases with Audience Response.”
“As we advance in diagnostic capabilities, we should be careful to not overstudy patients, as this can create unnecessary discomfort, risk and costs,” Dr. Syan said. “However, in appropriately screened patients, diagnostic interventions can be crucial to ensure the best therapies are being offered. We need to approach patients as individuals and provide tailored care that is relevant to the individual.”
Dr. Syan led studies on pelvic floor disorders presented during AUA 2024’s poster session. Miller School presenters shared extensive research on minority women, who experience pelvic floor disorders at similar or perhaps even higher rates compared to non-minorities yet are much less likely to receive treatment, according to Dr. Syan.
“We performed a survey of minority women in Miami-Dade County and found, despite extremely bothersome pelvic symptoms, awareness of these disorders and, most importantly, the treatment options are lacking. When patients are made aware of treatment options, they are highly likely to consider treatment,” Dr. Syan said. “We also examined a national database of women with stress urinary incontinence, urge incontinence and both incontinence types and found that, even when controlling for socioeconomic factors, Black women are less likely to receive surgical treatments for these disorders. This emphasizes the need to better understand barriers to care for these women.”
Overactive Bladder
Dr. Wein presented an AUA course on the pathophysiology management of overactive bladder (OAB).
“I presented an objective view of the state-of-the-art oral therapy for OAB, including muscarinic antagonists, beta 3 adrenergic agonists and therapy for nocturia,” Dr. Wein said. “It could just as well be subtitled, ‘The Good, The Bad and The Ugly.’ There is no one best drug for everyone and all results are imperfect, with a large placebo effect. I also presented on the possibilities for future pharmacologic therapy of OAB, the theoretical mechanisms for such an effect and the practicalities of each.”
More from AUA 2024
• Mark Gonzalgo, M.D., Ph.D., M.B.A., professor and vice chair of DSUI and AUA’s education chair-elect, presented the “AUA Education Council Update.” Dr. Gonzalgo also surveyed many of the instructional courses offered, which will help plan for next year’s meeting.
• Francis Petrella, M.D., presented new data on the mental health impact of erectile dysfunction (ED) treatment on men diagnosed with depression. In a study of 678 men diagnosed with depression who received an inflatable penile prosthesis for ED, 15% had no antidepressant prescriptions in the post-IPP follow-up period, representing a complete stop of treatment.
• Chad Ritch, M.D., M.B.A., presented the instructional course “Non-Muscle Invasive Bladder Cancer Treatment Dilemmas: The Cases You Face and How Best to Treat Them,” and gave a talk on “Novel Approaches to Penile Sparing Surgery for Localized Tumors.”
Tags: American Urologic Association, Desai Sethi Urology Institute, Dr. Alan Wein, Dr. Bruce Kava, Dr. Chad Ritch, Dr. Dipen Parekh, Dr. Emad Ibrahim, Dr. Himanshu Arora, Dr. Mark Gonzalgo, Dr. Raveen Syan, Dr. Sanoj Punnen, Dr. Thomas Masterson