Jefferson Urology Year in Review 2020 by Jefferson Urology

Jefferson Urology

Yearin 2020 Review Department of Urology For more information on how philanthropic gifts can help support our research, teaching and patient care missions contact: Leonard G. Gomella, MD, FACS The Bernard W. Godwin Professor of Prostate Cancer Chairman, Department of Urology Senior Director Clinical Affairs, Sidney Kimmel Cancer Center Thomas Jefferson University and Jefferson Health 1025 Walnut Street, Suite 1100, Phila., PA 19107 215-955-1702 Leonard.Gomella@jefferson.edu P. Kenneth Brownstein, MD, FACS Department of Urology Director of Philanthropy Harold A. Honickman Physician Director of Jefferson Signature Services Office of Institutional Advancement Thomas Jefferson University and Jefferson Health 125 S. 9th Street, Suite 600, Philadelphia, PA 19107 215-503-2111 Kenneth.Brownstein@jefferson.edu Emma Laverty Assistant Vice President of Development Office of Institutional Advancement Thomas Jefferson University and Jefferson Health 125 S. 9th Street, Suite 600 Philadelphia, PA 19107 215-503-8679 Emma.Laverty@jefferson.edu “Jefferson Urology 2020 Year in Review” Design and Production Editor: Tricia Shea Editor in Chief: Leonard G. Gomella, MD Contributors: Barbara Devine Shannon Fields Deborah Glassman, MD Andrew Gomella, MD Tricia Gomella, MD Barry Gutman Thomas Hardacker, MD, MBA Karen Kirchoff

Lisette Hilton Costas Lallas, MD Cindy Lefler Ryan Mark, MD Patrick Shenot, MD Abhay Singh, MD Denise Tropea

“Year in Review” can also be found on the issuu.com website (search “Jefferson Urology”) and www.jefferson.edu/university/jmc/departments/ urology.html Published by the Department of Urology Thomas Jefferson University 1025 Walnut Street, Suite 1101, Phila., PA 19107 215 955 6961 | 215 923 1884 (fax) Address correspondence to: Editor, Jefferson Urology Year in Review 2020 at the above address Postmaster: Send address changes to the aforementioned address.

Year in Review

Chairman’s Letter Year in Review 2020 Index FEATURES 4 Safe & Sound Urologic Surgical Training 5 3D Kidney Models Facilitate Robotic Surgery 6 Jefferson’s New Specialty Care Pavilion 8 Jefferson Global Centers 10 Experiences Transgender/ Non-Binary Patients in Doctor’s Office 11 Urology Telehealth 12 Cross Country Flight during COVID 14 Jefferson Urology and AUA 16 Evolution of the Modern Resectoscope MEETINGS 18 SAU January 2020 19 3rd Annual BCAN Symposium 20 International Meeting Presentations 2020 21 Brownstein Visiting Professor Urology Grand Rounds Now on the Web ALUMNI 22 Alumni Achievement Award 23 Alumni Association 24 Alumni Spotlight 26 NOTABLE AND NEWSWORTHY UROLOGY HOUSE STAFF 27 Urology Fellows 28 2020 Urology Graduation 30 House Staff 2020-2021 Welcome New Interns UROLOGY STUDENTS 31 Jefferson Urology Research Scholars SKMC Urology Match 2020 RESEARCH 32 Philadelphia Prostate Cancer Biome Project Update 36 Clinical Trials Update 37 Research Lab Update DEPARTMENT NEWS 38 Provider Spotlight 40 Faculty and Staff Updates Jefferson Urology Enterprise News Faculty Contribute to Classic Medical Textbook 41 Happy or Not? 42 Virtual House Staff Interviews PEDIATRIC UPDATE 43 Nemours/AI DuPont Pediatric Urology Update Welcome New Pediatric Urology Faculty InterStim™ in Children 44 Books 45 Publications 48 Year in Photos 54 Department of Urology Faculty 55 Outpatient Practice Locations 56 Upcoming Events

Dear Friends, I am pleased to present our Jefferson Department of Urology 2020 Year in Review magazine. As I reflected on our last year, I became amazed at the overall research, teaching and patient care performance of our Department that was far above what might have otherwise been expected. Credit is due to Jefferson’s senior leadership who reacted at critical decision points that enabled us to deliver safe care to our patients during the pandemic, while protecting our trainees and staff. Jefferson was one of the handful of universities in our region to sustain a safe and meaningful in-person, on-campus option for our own students through Thanksgiving. Jefferson Health dealt with the most cases of COVID-19 in the region and had no transmission to non-COVID inpatients. When benchmarked to other health systems we had less than 1% employee infection, an amazing number due to the proactive Jefferson Occupational Health Network (JOHN) COVID hotline activation, daily leadership incident command calls and other progressive protocols put in place. Our Department was blessed with a very low COVID-19 infection rate as well among staff, residents and faculty. Essentially all our cases were acquired outside of work and importantly, no one suffered a COVID-19 illness severe enough to require hospitalization. In the early days of the pandemic, Jefferson cancelled elective surgery but maintained surgical care for urgent problems and for cancer care based on an operative “tiering system” adopted by all surgical departments. The goal was to maintain inpatient capacity as ICU admissions swelled and hospital beds were at capacity throughout the spring. We also shifted faculty and residents to alternating teams to limit potential exposure. Where possible, administrative staff were shifted to remote work from home. Jefferson’s long term commitment to telehealth allowed us to rapidly pivot to remote clinical care options (page 11). Our UME and GME programs continued to be a priority while keeping safety in mind. All of our resident recruitment and interviews were conducted online (page 42). As shown on the cover with Dr. Costas Lallas demonstrating one of our Jefferson Health Design Lab 3D kidney tumor models (page 5), virtual Urology rotations also became a routine part of our academic program. The SKMC class of 2020, once again, had a strong showing with 7 graduates matching in Urology (page 31). Our department figured out how to host visiting professorships (page 21) and actually expand our CME approved grand rounds (page 21). Technology has allowed us to participate in international meetings (page 20) and continue our interactions with our Jefferson Global Center international urology partners abroad (page 8) without the need to cancel meetings due to travel restrictions. In spite of the challenges, the past year has been an outstanding one for grants in the Department. Our multiple basic science and clinical awards (pages 26, 37) also includes a new joint five-year NCI RO-1 with Radiology (page 36). A generous alumni gift allowed us to install a new TURP simulator in support of our residents surgical training (page 4). While we are all looking forward to 2021 as the tide turns on the pandemic, the Department of Urology has other reasons to be enthusiastic about the coming year. This spring, our New Jersey JUP practice will relocate to a larger office space in Cherry Hill with expanded staff support. Our well established Jefferson North East/Aria urology colleagues will become full-time members of Jefferson Health. This summer, our Department will establish a full-time academic practice at Abington expanding our Sidney Kimmel Cancer Center presence. It is likely that Einstein Health will become part of Jefferson, adding urology options within Jefferson Health and the Philadelphia region. We are launching a new Jefferson Urology Alumni Directory effort (page 23). The excitement of planning our department’s state of the art clinical space in the new Specialty Care Pavilion on Chestnut Street will continue as the design details take shape (page 6). Please enjoy reading our 2020 year in review. Our Department can boast an impressive year of research, teaching and patient care achievements that could never have been imagined when the pandemic was officially declared on March 11, 2020. I thank my faculty, residents, staff and Jefferson leadership for making this year truly an outstanding one for our Department. Please contact me if you would like any additional details about our Department. My email is leonard.gomella@jefferson.edu. Sincerely,

Leonard G. Gomella, MD, FACS The Bernard W. Godwin Professor of Prostate Cancer Chairman, Department of Urology Senior Director Clinical Affairs, Sidney Kimmel Cancer Center Jefferson Health Enterprise Urology Service Line Clinical Leader

Jefferson Urology

Safe and Sound Urologic Surgical Training

Official ribbon cutting for the new TURP surgical simulator. From left to right: Drs. Kate Berg, Costas Lallas, with Joyce Rivas and Drs. Dale Berg, David Rivas, Leonard Gomella and Pat Shenot. Drs. Kate and Dale Berg are Co-Directors of Jefferson’s Rector Clinical Skills and Simulation Center.

Rivas family gift provides Jefferson Urology with a state-of-the-art surgical simulator. In the “olden days” of medicine—just a few years ago—surgeons learned their craft based on a “see one; do one; teach one” approach to education. The saying articulates the traditional method of teaching surgery: Trainees observe a procedure and are then expected to be able to perform it, after which they teach the operation to the inexperienced. It was an effective way of training physicians, but it came with risks to patients, especially as young surgeons progressed from the “see” stage of training to the “do” stage. Surgical simulation with high-end computers and L 3D Kidney Models Facilitate Robotic Surgery CD displays marks a new era in physician training and patient safety. Thanks to a generous gift from David and Joyce Rivas, Jefferson’s Department of Urology can now teach the hands-on craft of transurethral surgery without laying a hand on a patient. The TURP Mentor Surgical Simulation System allows Jefferson residents to experience and become proficient at an array of endoscopic surgeries, such as prostate and bladder tumor resections, before setting foot in the operating room. The new urology-specific technology, unveiled at a February 2020 ribbon cutting in Jefferson’s Surgical Simulation Center, enables the department to teach future surgeons how to “do” a procedure without exposing patients to previously minimized but unavoidable risks at the hands of inexperienced learners. The TURP

Year in Review

Dr. Pat Shenot demonstrating his TURP (transurethral resection of the prostate) skills on the new simulator while David and Joyce Rivas look on.

simulator joins other high-tech teaching tools including laparoscopic and robotic surgery training simulators. These advanced, 3D systems provide trainees with realistic, hands-on experiences that involve mastering instruments and managing complications without performing procedures on live patients. The system records simulated surgeries and provides real-time feedback and objective reports. Experts predict that surgical simulation training will soon be required as part of medical board exams. Introducing Jefferson Urology residents to this cutting-edge technology will better prepare them for the future while moving our program even further ahead of peer programs. “Surgical simulation is the dawn of a new era in physician training,” notes Dr. Leonard Gomella, Urology Chair and Bernard W. Godwin Professor of Prostate Cancer. “The TURP Mentor Simulator, a first-of-its-kind technology, will be so impactful to the training our department provides residents to become skilled surgeons.” Dr. David Rivas is an alumnus of Sidney Kimmel Medical College (Jefferson Medical College) Class of 1984, completed his residency in Urology (1987-91) and fellowship in NeuroUrology and Incontinence (1992-94) at Thomas Jefferson University Hospital. He served as Assistant Professor of Urology at Jefferson since 1994 and Director of the Division of Neuro-Urology (1996-2000). Currently, he leads pharmaceutical research and development efforts in the Infectious Diseases and Vaccines Therapeutic Area at Janssen, the Pharmaceutical Companies of Johnson & Johnson, as Senior Director, Compound

Development Team Leader. Joyce Rivas is Advisory Chairperson at Doylestown Hospital’s Animal Assisted Therapy Program where she also volunteers with her therapy dog. After touring the Rector Clinical Skills and Simulation Center at Jefferson, one of 85 accredited centers in the country, Dr. Rivas discussed with Drs. Gomella, Lallas, and Brownstein his interest in supporting a simulation device. In the spring of 2019, David and Joyce made a gift to purchase the TURP Mentor Surgical Simulation System that was installed in 2020. “Visionary donors like David and Joyce Rivas know how important it is to train new generations of urologic surgeons,” observes Dr. Gomella. “Their generosity makes it possible for Jefferson to do just that while upholding, more securely than ever, our stringent standards for patient safety and high-quality health care.”

The TURP Mentor Simulator, a first-ofits-kind technology, will be so impactful to the training our department provides residents to become skilled surgeons. Dr. Leonard Gomella

3D Kidney Models Facilitate Robotic Surgery A Department of Urology and the Jefferson Health Design Lab Collaboration By Drs. Costas Lallas, Abhay Singh and Leonard Gomella Kidney cancer often presents as an incidental finding during imaging studies for other conditions. Over time, the standard of care for surgical management of small renal masses (i.e. < 4 cm) has become more focused on renal parenchyma sparing techniques such as using partial nephrectomy. Surgeons in Jefferson’s Department of Urology have been performing partial nephrectomy for decades using standard open surgical techniques. Laparoscopic urologic surgery pioneered at Jefferson and other centers in the 1990’s ushered in the development of new Minimally Invasive Surgery (MIS) techniques. Today, those advances continue with most MIS for renal masses being performed using the latest surgical robotic technology. There have been ongoing efforts into improving outcomes for this procedure. Robotic partial nephrectomy is a technically complex surgery in which the critical steps of removing the tumor and reconstructing the kidney must be done expeditiously as the blood supply of the kidney is temporarily clamped during this time. Therefore, tools to help optimize this surgery can result in meaningful improvements in the patient’s procedure and recovery. Detailed understanding of the three-dimensional anatomy of the kidney and the exact location of the tumor and blood vessels can facilitate the procedure. Recently, the urologic surgeons in the Department of Urology have begun a collaboration with Jefferson’s Health Design Lab to create 3D printed models of patients’ kidneys with their tumor or tumors in preparation for their surgery. These 3D kidney models are proving to be a very useful tool. After a patient decides for surgery, the Health Design Lab team works to create a 3D model from the patient’s cross-sectional

imaging, which is either a CT or MRI. This model includes the kidney, its vasculature, the collecting system and the mass to be resected. While 3D model printing is not new, the Health Design Lab at Thomas Jefferson University has mastered the quality of the prints by employing the necessary skills to interpret the imaging and segment the critical features to facilitate the printing of a high quality 3D model. Distinct coloring is used in the models. In the example shown, the tumor is green while the remainder of the kidney is white, with the arterial blood supply red, and the venous system blue. SKMC class of 2023 medical students Reilly Scott and Samuel Morano work with Jefferson radiologist Dr. Vishal Desai, Assistant Professor of Radiology to accurately segment the model based on the imaging. This also includes the relationship of the tumor to the renal collecting system, which further enhances the utility of the model when the kidney is being reconstructed. Dr. Robert Pugliese is Director of Innovation Design for Jefferson and Jefferson Health, and is co-founder and managing director of the Jefferson Health Design Lab. Dr. Pugliese and his Health Design Lab members Alice Karp and Kaitlyn Boyd format and print the models, taking the extra effort to slice the model in 2 pieces so that the surgical team can appreciate where and how deeply the tumor invades. According to Dr. Pugliese, “Pretty much anything is possible with 3D printing today. While 3D printing technology isn’t new, it has rapidly advanced in recent years making it now accessible and affordable while also increasing in quality and usability. The magic, however, really is putting these tools in the hands of experts and using our design methods to create a model that does not cost much to produce and is designed for optimal value to its users.” With these tangible models, the surgical team is better able to plan pre-operatively. The models provide a clearer understanding of the location of the tumor and the kidney’s blood supply helping the surgeon plan the dissection of the kidney and its blood supply. It also

3D kidney model with an upper pole tumor being printed at Jefferson’s Health Design Lab facility located at 925 Chestnut Street in the old Federal Reserve vault complex.

Dr. Joseph Izes counselling a patient before robotic partial nephrectomy using her generated 3D kidney tumor model. helps with planning how to reconstruct the resulting defect in the kidney. The models are especially helpful in complex procedures when the tumor abuts critical renal structures or when there is a complicated vasculature system to the kidney (for example multiple arteries or veins). They also go a long way toward the education of medical students and urology residents in understanding the cross-sectional imaging of the kidney. It has become standard practice for the Urology team to review the model together before the surgery and to reference it during the operation itself. The model is also a powerful learning tool in helping patients understand their surgery. Patients are shown their 3D printed models before their surgery along with an explanation of the relevant anatomy, by a member of the Urology team. After holding and examining the model, patients often remark that they now Continued on page 6

An example of a completed 3D model demonstrating the kidney tumor in green, normal kidney tissue in white and the blood vessels in red and blue. Jefferson Urology

3D Kidney Models Facilitate Robotic Surgery... Continued from page 5 have a far better understanding of their disease. They also voice a newfound appreciation of the reasoning behind the surgical technique and its potential complications. Knowing the team at Jefferson has taken the extra time and effort to have the model created also instills extra confidence and trust in their care. Dr. Costas Lallas, Professor of Urology and Vice Chair for Academic Affairs in the Department of Urology who leads 3D kidney project explains, “Although cross sectional imaging is helpful in determining the location of a renal mass, being able to hold a copy of the kidney in your hand drives home the mass location and its relationship to critical internal anatomy. Also, when you show these models to the patients, their faces light up with regard to the purpose of the operation, the technique to be used and its inherent risks.” Research is being conducted via an IRB approved investigator-initiated protocol to determine if the 3D models are helping the Urology team and their patients. Members of the surgical team systematically fill out surveys about their operative planning before and after seeing the model, and again after surgery has been completed. Patients also fill out surveys before and after seeing the model to assess if the model helps them understand their disease and the surgery they are about to undergo. Many patients eligible for this process are seen in our Sidney Kimmel Cancer Center Small Renal Mass Clinic. Patients are able to meet in a single setting with both a urologic oncologist who specializes in the management of renal cell carcinoma, the most common kidney tumor, and an interventional radiologist with specific training and expertise in thermal ablation of small renal masses. If appropriate, partial nephrectomy is often the recommended treatment for small renal masses. According to Dr. Lallas, who also serves as Co-Director of our SKCC Small Renal Mass Center, “The incidence of renal cell carcinoma has risen over the past two decades with a disproportionate rise in masses that are less than 4 cm. Our small renal mass clinic is a unique program where our team can evaluate the patients in a multidisciplinary setting and offer many patients who qualify for surgical treatment partial nephrectomy utilizing our 3 D kidney model approach.” Jefferson Urologists have always focused on moving the field forward in a meaningful way, to take advantage of emerging technology and to work in multidisciplinary teams. The current work on 3D printed models follows that philosophy. The use of these models capitalizes on the evolution in 3D printing resulting in higher quality products at very reasonable costs. The accurate production of these models is the result of a strong partnership between the Health Design Labs, Radiology and Urology at Jefferson. The results of the research being conducted on the use of these models could help change the way urologists counsel their patients and impact how surgeons plan these procedures in the future. 6

Year in Review

Urology to Join Jefferson’s New Specialty Care Pavilion 19 Floor State-of-theArt Facility Is Under Construction on 11th and Chestnut Streets. Thomas Jefferson University and Jefferson Health have begun construction on the 19-story medical building in Center City, centralizing an array of clinical services into a Specialty Care Pavilion at 11th and Chestnut Streets for a seamless patient experience. Jefferson is positioning to deliver state-of-the-art, patient focused,outpatient specialty health care in the heart of Center City. Groundbreaking took place this past fall, and the building is planned to open in 2024. “This spectacular new center is our bridge to the future, where we’ll create the nation’s first model of health assurance,” said Stephen K. Klasko, MD, MBA, President of Thomas Jefferson University and CEO of Jefferson Health. “People want to be supported in staying healthy without healthcare getting in the way. At Jefferson’s Specialty Care Pavilion, we will create healthcare with no address.” The Specialty Care Pavilion will include centers and institutes such as the NCIdesignated Sidney Kimmel Cancer Center, the Digestive Health Institute, Jefferson Transplant Institute, and Korman Respiratory Institute, as well as other clinical specialties including cardiovascular, otolaryngology, rheumatology and urology. The building will be capped with a rooftop garden designed to create a space for peace and healing. Jefferson plans to pursue emerging technologies for the building, such as digital wayfinding, virtual surgical theaters, voice assistants, wearable data integration, augmented and virtual reality, and robotics.

This spectacular new center is our bridge to the future, where we’ll create the nation’s first model of health assurance. Dr. Stephen Klasko

Because technology will be so deeply isngrained in the facility, Jefferson will leverage the expertise of John Sculley, the former chief executive officer of Apple Inc., to fuse the building’s design and technology with the patient experience. Mr. Sculley is serving as the Special Assistant to the CEO for the Specialty Care Pavilion. Jefferson’s Specialty Care Pavilion is a cornerstone of Reimagine, the campaign to raise $1 billion for Jefferson by its 200th anniversary in 2024. According to Dr. Edmund Pribitkin, Executive Vice President, Jefferson Health and President, Jefferson Medical Group “We are pleased the Department of Urology will be joining the Specialty Care Pavilion as one of the clinical specialties. Urology patients will not only benefit greatly from the advanced technologies and facilities in the Specialty Care Pavilion but also from the close proximity to other subspecialists in the Sidney Kimmel Cancer Center.” Patients are already excited about what the Speciality Care Pavilion will bring to health care in center city. Examples of philanthropic commitment from longstanding Jefferson patients and benefactors has already begun. Fran and Leon Levy, longtime friends of Jefferson, have already made a gift to designate one of the new Urology exam rooms in honor of Dr. Leonard Gomella, Chair of Urology and Senior Director of Clinical affairs for the Sidney Kimmel Cancer Center. Mr. Stephen Klein has made a substantial gift to endow a portion of the Urology facility in honor of Dr. Ken Brownstein. From the ground up, the Specialty Care Pavilion is being built with our patients and their families in mind. According to Dr. Gomella, “I was deeply moved to learn about Fran and Leon’s gift in my honor. My entire Department is looking forward to working with the design team other potential benefactors to provide the best possible environment to provide individualized urology care. The Specialty Care Pavilion will merge cutting-edge technologies with warm and welcoming design features.” To learn more about the Specialty Care Pavilion visit www.specialtycare. jeffersonhealth.org or contact Emma Laverty (emma.laverty@jefferson.edu) in the Office of Institutional Advancement.

Specialty Care Pavilion on the corner of 11th and Chestnut Streets.

Jefferson Urology

International News Jefferson Global Centers Expand Our Healthcare Programs Beyond Philadelphia

Thomas Jefferson University has been engaged in expanding working relationships that its faculty and students have around the world. Jefferson’s first international center, the Japan Center for Health Professions Education and Research at Jefferson, was created in 2012 by Jefferson, the Japanese Association for the Development of Community Medicine and the Noguchi Medical Research Institute. Dr. Mark L. Tykocinski, Jefferson’s provost and Dean of the Sidney Kimmel Medical College, has led the University’s effort in expanding additional global health centers in India, Israel, and Italy. These centers provide structure to international partnerships that promote the exchange of research ideas as well as personnel. Jefferson Urology has been actively engaged with the Global Centers in Japan, India and Israel.

JAPAN CENTER Our department has participated in educational programs coordinated by the Japan Center since its inception nearly a decade ago. In January of this year the Department of Urology in coordination with the Jefferson Japan Center hosted Dr. Fumihiro Ito. Dr. Ito is a urologist from Kariya Toyota General Hospital in Japan’s Aichi Prefecture. He looks forward to visiting Jefferson again in the future. ISRAEL CENTER Sheba Medical center in Tel HaShomer, Israel is a participant in the Jefferson Israel Center. Sheba is in near Tel Aviv and is the largest hospital in Israel. In 2020, Newsweek magazine ranked it as the 9th-best hospital in the world. Sheba Medical Center has had a relationship with our Department since Dr. 8

Year in Review

Drs. Gomella and Fumihiro Ito from Kariya Toyota General Hospital in Japan.

Nir Kleinman, Sheba’s Chief of Endourology, completed a fellowship at Jefferson in 2013. Both Drs. Gomella and Hubosky serve as guest faculty at the biennial “Friends of Israel Urology” (FOIU) international symposium coordinated by the Chair of Urology at Sheba, Dr. Jacob Ramon and Dr. Laurence Klotz from Toronto who also happens to have been our 2020 Brownstein Visiting Professor (see page 21). Dr. Asaf Shvero, from Sheba, has recently joined our Department for a one-year Endourology Fellowship under the direction of Dr. Scott Hubosky (see page 27). Dr. Zvi Grunwald, Jefferson’s former Chair of Anesthesiology, is the Director of the Jefferson Israel Center and facilitates research activities with our Israeli Center

colleagues. The Department of Urology, and Drs. Pat Shenot and Akhil Das as CoPI’s have applied for a grant with the Israel Innovation Authority International HealthTech Pilot Program. The grant application is a collaborative effort with P. Square Medical, an Israeli startup company that focuses on developing a complete digital health system for the diagnosis of male urinary disorders. The basis of the grant is the development of a portable device and a disposable sensor coupled with mobile application suitable for remote home care self-diagnosis and in clinic use. INDIA CENTER Working with our Jefferson India Center, we have established a joint Urology research

I look forward to expanding Urology’s engagement with these programs and joining us in Italy and other future international sites. Dr. Richard Derman program at KLES Dr. Prabhakar Kore Hospital & Medical Research Centre, Belagavi (Belgaum), India with Drs. Mat Thakur

and Leonard Gomella. The KLE program will expand our work in the VPAC-based urinary cancer detection with a program that is led locally in India by Dr. Rajendra B. Nerli, Director KLES Kidney Foundation, in Belgaum. In January of 2020 just before the international travel restrictions, Dr. Thakur travelled to Belgaum to work with the research team at the newly established Urinary Biomarkers Research Centre. In addition to our urinary detection of prostate cancer projects, Dr. Nerli and associates have begun a related bladder cancer detection project based on VPAC. According to Dr. Richard Derman who serves as Jefferson’s Associate Provost for Global Health “I am appreciative of the Department of Urology

engaging in our Global Centers projects. Japan, India and Israel have been their main focus. I look forward to expanding Urology’s engagement with these programs and joining us in Italy and other future international sites.” A fall 2020 Zoom meeting was held between Jefferson and our India center urology research collaborators. Pictured left, top row: Drs. Nerli, Gomella with Parth Lalakia who coordinates the India Center in Dr. Derman’s office. Second Row: Dr. Shivaprasad Goudar, Professor at Jawaharlal Nehru Medical College in Belgaum who oversees their international research efforts, Dr. Mat Thakur and Dr. Richard Derman, Jefferson’s Associate Provost for Global Health. Bottom row: Dr. Shridhar Ghagane Head Research Scientist at the Urinary Biomarkers Research Centre in Belgaum, India. Jefferson Urology

Amplifying Voices: A collaborative research team works with the transgender community to gather perspectives on barriers to care, unique health needs, and discrimination. “Most providers don’t know the least bit how to treat us. They seem to think that because I’m trans-, a sinus infection is different in me than it is in somebody else. If I wind up talking to them at all about what surgeries I’ve had, most of them just have no clue about any of it.” Going to the doctor is stressful for anyone. It can be hard to find the right words to describe your health concerns, and to find a provider that is both empathetic and efficient in addressing them. Now imagine that in addition to that, you have to navigate questions about your identity, and even confront discrimination and stigma. This is a reality faced by millions of transgender and non-binary patients. Around 1 million people in the United States identify as transgender and non-binary, meaning they have a gender identity which differs from the sex they were assigned at birth. While transgender individuals may identify as masculine or feminine, non-binary individuals may relate to a spectrum of gender identities that are not exclusively masculine or feminine. Transgender and non-binary individuals face significant barriers to healthcare, including high cost of care, inadequate insurance, and lack of culturally-competent care. The quote above comes from a study by Paul H. Chung, MD, Assistant Professor of Urology at Jefferson Health, and Rosie Frasso, PhD, Program Director of Public Health at the Jefferson College of Population Health, who together led a multi-disciplinary research team of medical and public health students, to describe perspectives and experiences of transgender and non-binary patients seeking urology care. As gender affirmation surgeries increase, this community of patients have unique healthcare needs and require general urology care to address conditions like kidney stones, urinary tract infections, sexual dysfunction and urological cancer screenings. In a previous study surveying 67 members of an outpatient urology clinic, including administrative staff, nurses and doctors, Dr. Chung and his colleagues found that more than 80% of respondents felt they didn’t have the necessary training to care for transgender patients. “We hope hearing the experiences of transgender and non-binary patients documented in this study will help address some of those education gaps,” says Dr. Chung, “and ultimately decrease stigma and improve culturally competent care in urological settings.” “Hopefully our findings will translate into other spheres of clinical care,” says Dr. Frasso. “The more spaces transgender and non-binary patients feel safe seeking care, the more we can begin to address the health disparities plaguing this population.” Dr. Paul H. Chung and colleagues recently published “Perspectives and Experiences of Transgender and Non-Binary Individuals on Seeking Urological Care” (Urology. 2020 Oct 28:S0090-4295(20)31297-8; On line ahead of print) addressing the challenges these patients face in healthcare. This aticle is based on an original contribution by Karuna Meda and Carly Williams published December 7, 2020, in thehealthnexus.org, Jefferson’s online health resource.

Year in Review

Jefferson Urology Telehealth Highlighting our Rapid Response to the COVID-19 Crisis By Dr. Deborah Glassman Jefferson Urology has been at the forefront of telemedicine for years, and we were well prepared to rapidly pivot to telehealth visits at the start of the 2020 Covid-19 pandemic. Since 2016, when Jefferson Health led by Dr. Judd Hollander, Associate Dean for Strategic Health Initiatives, initiated the telehealth program, we have been committed to seeing patients virtually for a variety of urologic conditions. Our Department has been a recognized leader in telehealth within the Jefferson Enterprise. Over the last few years, Drs. Glassman, Gomella and Trabulsi have all won institutional awards for our program. Even more noteworthy is that our Department has been nationally recognized as early adopters of this technology. In 2016 we published our initial experience in Urology Practice, a peerreviewed journal of the American Urologic Association and companion to The Journal of Urology1. Our team has also presented at a variety of national meetings, including the American Urologic Association, Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (SUFU) and the American College of Surgeons (ACS). On March 11, 2020, when the pandemic was officially declared, we had to reduce our inperson visits for patient safety and to preserve resources, our Department was well poised to continue our patient care virtually. The Jefferson Enterprise’s vision for telehealth and its encouragement of the faculty to use the platform for so many years prior to the pandemic allowed us to easily transition to an almost exclusively virtual office. As the accompanying table demonstrates, we rapidly and successful increased our telehealth visits ten-fold within a month’s time. Of course, we

were not alone in increasing our virtual visits; across the country the health numbers went up. Improvements in reimbursement for telehealth visits, secondary to the pandemic, have incentivized these remote care opportunities to increase. Our previous experience with the telehealth platform made for a smooth transition. In March, the Centers for Medicare & Medicaid Services (CMS) announced that it would reimburse for telemedicine services at the same rate as regular, in-person visits as part of the federal government response to the pandemic. Later, CMS waived the video requirement for certain telephone evaluation and management services. As we have progressed through the pandemic and were able to re-open our office doors to more face-to-face visits, the quantity of telehealth visits have drifted back down but remain at a much higher level than before the pandemic (see illustration). Patients have begun to embrace the telehealth encounter. Should in person medical office visits be

limited again, we will once again be able to easily increase our virtual telehealth visits to ensure the best, safest and timeliest care for our patients. Through the pandemic our department has been able to collaborate with other institutions to deepen our understanding of telehealth usage, barriers and efficacy. A multicentered working group was formed named the ROUTER Collaborative: Research and Outcomes in Telehealth in uRology. In addition to our work with the ROUTER group, we are about to launch a randomized control trial looking at efficacy and satisfaction of telehealth vs in-person visits in post-operative patients. While the pandemic certainly has presented many challenges, our telehealth success has been a positive experience and will impact how we provide routine patient care in the future. _______________________________________________ 1. Glassman, DT, Puri, AK, Weingarten, S, Hollander, JE, Stepchin, A, Trabulsi, E, and Gomella, LG (2018). Initial Experience with Telemedicine at a Single Institution. Urology Practice, 5(5), 367–371.

Monthly examples of how the pandemic impacted our virtual urology office visits.

Jefferson Urology

John and Laurie Steinberg from Upland, California, travelled to Jefferson for his urology care.

Year in Review

A patient seeks urologic care at Jefferson during the pandemic. An enlarged prostate, also known as benign prostatic hyperplasia (BPH), is quite common in older men. As the prostate grows, it may push against the bladder or close around the urethra. This can cause problems with urination. Urinary problems due to an enlarged prostate should not be considered a normal sign of aging, however. Men should seek treatment; without it, an enlarged prostate may interfere with a normal lifestyle, and sometimes can cause severe bladder or kidney damage. Unfortunately, the availability of holmium laser enucleation of the prostate (HoLEP), a minimally invasive procedure for BPH developed during the 1990s in New Zealand, is quite uncommon in the United States. HoLEP is a transurethral procedure that replicates an open prostatectomy procedure without an incision for treatment of a significantly enlarged prostate. Many clinical trials have shown HoLEP, which uses a laser to remove tissue blocking urine flow through the prostate, to be a very effective and durable procedure with benefits when compared to open prostatectomy or minimally invasive transurethral resection of the prostate (TURP) for many men. HoLEP may result in less catheter time, shorter hospital stays, less risk of blood transfusion and quicker recovery. Fortunately, HoLEP is available at Thomas Jefferson University Hospital in Philadelphia. The procedure is commonly performed by urologist Dr. Akhil K. Das, who learned it from one of its developers as a Fellow at Tauranga Hospital in New Zealand. And that is what led 69-year-old John Steinberg to fly across the country from California, where HoLEP is unavailable, to see Dr. Das in August, despite the pandemic. MANY CATHETERIZATIONS In order to be closer to their daughter and grandson, John and his wife, Laurie, retired to Upland, California, three years ago after he spent 37 years working for the Forestry Division of the Department of Environmental Services in Rochester, NY. For several years, when John underwent annual exams, he was made aware of his enlarged prostate. But because it wasn’t causing him any discomfort, he did nothing about it. He was otherwise in good shape. In July 2018, however, following retirement, John had his gallbladder removed. After his discharge, he ended up in the emergency room. He was catheterized because of severe urinary retention, due to the impact general anesthesia had on his prostate. “Altogether, I had been catheterized five times over two years,” says John. “One especially bad time was when I was unable to urinate during a flight to New York

and had to rush to an ER as soon as I arrived.” NOT MUCH MEDICAL HELP It’s not as though John didn’t try to get help over the past two years. In fact, he saw two different urologists, but neither was much help in shedding light on the problem. One urologist revealed that John’s bladder was infected, and an MRI showed no signs of prostate cancer. Unfortunately, John also found out that his prostate had swelled to 197 cc. For perspective, a healthy prostate is between 25 and 30 cc. “This past July,” he says, “I underwent general anesthesia again—this time, for hand surgery. Following discharge from the hospital, I had to go to the ER yet again, during the pandemic, to be catheterized and then, due to an infection, re-catheterized because I was still retaining a dangerous amount of urine and had a serious bladder infection. That was the final kicker for me. At that point, I at least knew my prostate was seriously enlarged but had been given no decent guidance from any doctor about a suitable treatment option.” A LEAP OF FAITH Frustrated, John finally got some valuable medical advice—but not from a urologist. His nephew, a cardiac thoracic surgeon in Indiana, told John he had successfully undergone the HoLEP procedure, performed by a urologist who had studied under one of its developers in New Zealand. That urologist was unable to see John for a few months, so John and his wife, Laurie, searched the internet for other physicians who did the HoLEP procedure. They struck gold when they found Jefferson’s Dr. Das. They phoned his office and learned that Dr. Das could see them in just three weeks. They immediately booked a flight for August 3, 2020. “We felt that the circumstances warranted that,” says John. “Despite COVID-19, we had to take the risk and a leap of faith because my infection was only getting worse. But we took all possible precautions to fly safely from California to Philadelphia. Fortunately, there were no problems—our entire trip was as smooth as silk.” MAKING A GREAT FIRST IMPRESSION Early the next morning, August 4, John and Laurie met with Dr. Das. “Beginni2020, ng with his receptionist, everyone was so nice,” John enthuses. “Dr. Das was super friendly and put us at ease immediately. He reviewed my history thoroughly, asking many questions, answered all of our questions, and patiently and confidently concluded that he could help me with my BPH. We were especially happy to learn that he had studied the HoLEP procedure from its inventor, Dr. Peter Gilling, while he was in New Zealand, just as my nephew’s urologist in Indiana had. That, along with his vast experience and great bedside manner, greatly comforted Laurie and me.”

Dr. Gilling was the first to describe the HoLEP technique in 1997, during which time Dr. Das was learning the technique from him as a Fellow in Tauranga, New Zealand. In 1998, Dr. Das was one of the first physicians to perform HoLEP in the U.S. and has continued to improve the technique and equipment involved since. The most recent guidelines published by the American Urologic Association note that the HoLEP technique is one of the most thoroughly studied procedures for BPH and can be used for prostates of any size and in patients taking blood thinners. As in the case of Mr. Steinberg it is particularly useful in cases of significantly enlarged prostates. Before John and Laurie left the office on the first day, Dr. Das’ surgical coordinator, Cindy Caruso, walked them through everything, including where they had to go and when, and helped John sign up for Jefferson’s electronic patient record system, MyChart, so he had handy online access to all of this information on his smartphone. “We thought that was fantastic,” says John. Over the next few days, John underwent a number of necessary preoperative procedures. A SUCCESSFUL OUTCOME On August 10, 2020, Dr. Das performed the HoLEP procedure on John. It took three and one-half hours, after which John spent the night resting comfortably in the recovery room at Thomas Jefferson University Hospital. “My night nurse fussed over me like it was nobody’s business,” he enthuses. John was discharged the following morning, but, on the advice of Dr. Das, stayed at the hotel for three more days to recuperate and ensure he experienced no complications from the surgery. Dr. Das conducted one more evaluation and told John all was well. The following Monday—one week after his surgery—John and Laurie took another uneventful flight home, feeling much more comfortable and very relieved. A GREAT PATIENT EXPERIENCE “I’m feeling great!” declares John two months after surgery. “Every day has been an improvement. A side effect of the procedure is temporary incontinence, which is normal. It typically clears up in a number of weeks, and every day has been better and better. I’m almost 100 percent back to normal. I’m back to riding my bike 10 miles a day and living as normal a lifestyle as one can these days. “Jefferson provided me with a great patient experience, and I got my life back. They really took all the worry out of my surgery. Laurie and I knew we were in the hands of people who really care about their patients. We just can’t thank them enough.” Original article by Barry Gutman, reprinted and modified courtesy of Jefferson’s thehealthnexus.org. Jefferson Urology

Jefferson Urology and the AUA Department members have prominent roles in the Urology Care Foundation. In 1987, the American Urologic Association (AUA) established the American Foundation for Urological Disease (AFUD), with the goal to support research professionals through grant programs, clinical trials and publishing. AFUD was renamed The Urology Care Foundation (UFC) in 2012. The Foundation has two functions, to support urological research (Research Council) and be the premier provider and resource for the most current, comprehensive and reliable urologic health information for patients and the public (Public Education Council). The Public Education Council advises the UCF Board on matters requiring medical and scientific judgement, and develops urology specific patient /public educational information, material and videos. There are six committees in this council covering the entire urological landscape (Prostate Health, Pediatric Health, Bladder Health, Kidney and Adrenal Health, Reproductive and Sexual Health, and Technology and Publications Committee). Several members of our Department are actively engaged in these important AUA activities. Dr. Sonny Figueroa, Professor of Urology and Pediatrics and Chief of Pediatric Urology at AI DuPont served as the Chair of the Public Education Council from 2018 to 2020. This position was first held by the current immediate Past President of the AUA, Dr. John Lynch. Dr. Ahmad Bani Hani, also a Jefferson pediatric urology faculty member based at AI Dupont and a member of the Pediatric Health Committee since 2016, is now the new Chair of the Pediatric Health Committee. Anne Calvaresi, DNP, CRNP, RNFA, a member of the Council since 2016, is the new Chair of the Prostate Health Committee, the first advanced practice provider to hold a leadership role in the Urology Care Foundation.

Pictured top to bottom: Dr. Sonny Figueroa, Dr. Ahmad Bani Hani, and Anne Calvaresi, DNP, CRNP, RNFA.

Year in Review

The Patient & Research Advocacy team at the American Urological Association (AUA) leads a coalition, the Bladder Health Alliance (BHA) founded in 2013 with the aim to raise awareness and reduce stigma about conditions impacting bladder health. Since 2013, the BHA has broadened its scope to include research advocacy efforts, managing stigma, access to medical supplies, and more. Additionally, the group

has expanded participants to include more than 30 patient, physician, and research advocacy organizations. These organizations convene annually for a full-day program that comprises networking and discussion topics of interest to the community. As part of this year’s virtual meeting, there was a panel entitled, “A Comprehensive Approach to Informed Decision Making.” As a member of the Urology Care Foundation’s Prostate Health committee, Anne Calvaresi was asked to take part in the panel and provide insight specific to how prostate cancer models for informed decision making can be transferred into the bladder space. This virtual meeting was held on Thursday, October 8, 2020. Anne Calvaresi also recently hosted an AUA Urology health podcast addressing what to know about prostate cancer during the COIVD-19 pandemic. LIVING HEALTHY COOKBOOK WITH INFORMATION ABOUT UROLOGIC CANCERS Last year the Urology Care Foundation published the Living Healthy Cookbook with information about Urologic Cancers as a service to patients, health care professionals and the public. This was cookbook designed to help patients think about what they eat and to help with meal selection when dealing with cancer. It is designed for the common urologic cancers: bladder, kidney, prostate and testis. Dr. Sonny Figueroa served as

Group photo from a 2020 Urology Care Foundation meeting. The Urology Care Foundation is the world’s leading nonprofit urological health foundation and the official foundation of the American Urological Association. Jefferson participants include, Anne Calvaresi, DNP, CRNP, RNFA; Sonny Figueroa, MD; Ahmad Bani Hani, MD; and former Jefferson Endourology Fellow Kelly Healy, MD. Also seen in the photo are past AUA President John Lynch, MD (center between Sonny and Ahmad), Urology Care Foundation Executive Director Mr. Michael Sheppard and Foundation President Harris M. Nagler, MD (extreme right). the editor with other Jeffersonians participating in the project including Ahmad Bani Hani, MD, Anne Calvaresi, DNP, CRNP, RNFA and former Jefferson faculty member Kelly Healy, MD. Celebrity chefs who contributed to the book include Wolfgang Puck, Paul Wahlberg, Spencer Gomez, Frank Pellegrino Jr., Michael Lomonaco, Adam Perry Lang, and Mary Nolan (wife of Jefferson Urology former resident, Dr. Jim Johannes). For additional information, visit www.UrologyHealth.org. AUA VIRTUAL LEARNING SESSIONS Going virtual didn’t hinder attendance for the AUA’s annual Urologic Care for the Advanced Practice Provider (APP) program on May 1617, 2020, which offered interactive, clinically relevant programming for physician assistants, advanced practice nurses, registered nurses and allied health care professionals in a webinar format. The program addressed various topics in urology, including oncology, technology and pharmacology, urolithiasis, infections/ inflammations, men’s health, and voiding dysfunction, and wrapped with a panel on best practices for APP integration in practices. APP podium presentations were also sprinkled

throughout the program, giving providers an opportunity to present their research or clinical pearls. The list of attendees exceeded 500 on both program days. The course was co-directed by Anne Calvaresi, DNP, CRNP, RNFA, and James Kovarik, PA-C of University of Kansas. The Jefferson Urology department was well represented, including presentations from Drs. Leonard Gomella, Alana Murphy, and Edouard Trabulsi. “Chemotherapy and Immunotherapy for Genitourinary Malignancies: A Primer for Urologists and Advanced Practice Providers” was featured on July 21 as part of the AUA Summer School Webinar Series. Dr. Costas Lallas served as Course Director and was joined by course faculty Anne Calvaresi, and Dr. Edouard Trabulsi. The course will be available on-demand at AUA University web site for a year. Dr. Leonard Gomella chaired an “AUA Live” virtual Panel Discussion: Genetic Testing Perspectives in Prostate Cancer and GU Malignancies as part of the AUA’s 2020 Annual Meeting in June. Panelists included Kevin

Loughlin, MD from Brigham and Women’s Hospital, Dr. Veda Giri, Sidney Kimmel Cancer Center and Todd Morgan, MD from the University of Michigan. Dr. Akhil Das participated as a faculty member discussant on the topic of “Expert Discussion: Surgical Management of LUTS in Men with Prostate Size < 40grams - Prostatic Urethral Lift”, during the Indian Urologic Association Sectional Virtual Meeting at the AUA. On Wednesday, October 21, 2020, the AUA and the Society of Urologic Oncology held a day long virtual program titled “The Changing Landscape of Advanced Prostate Cancer Treatment”. Dr. Gomella presented a lecture on “Genetic Testing in Advanced Prostate Cancer” and participated in a series of Case-based roundtable discussions by Zoom with small groups from around the United States. The Department of Urology looks forward to continuing to collaborate and supporting the educational initiatives of the AUA.

Jefferson Urology

Evolution of the Modern Resectoscope

Dedication of the Jefferson Museum of Urology in 2004 during our Centennial Celebration. Shown here with one of the antique ACMI incandescent bulb cystoscopy sets are Dr. Frank D’Elia, Dr. Leonard Gomella, and museum benefactor Dr. Leonard Frank. Also seen are the original museum curators Dr. Dolores Byrne and former Chair of Urology Dr. S. Grant Mulholland.

Historical Artifacts from Our Museum of Urology By Thomas Hardacker, MD, MBA The Leonard Frank Museum of Urology was dedicated during our Departmental Centennial celebration in 2004. Located in the Department of Urology Academic Office in the College building, it houses many historical instruments and artifacts. The museum displays several types of resectoscopes that developed over the last 100 years used primarily in the treatment of prostatitic enlargement. In this article Dr. Tom Hardacker, Chief Resident in the Department of Urology, discusses the evolution of the resectoscope and highlights some the instruments displayed in our museum. Over the last two centuries, the field of Urology had made great strides in the treatment of benign prostatic hypertrophy or BPH. In the 1800’s, as modern surgery was progressing, the options for surgical relief of prostatic obstruction were still 16

Year in Review

limited to an open suprapubic prostatectomy or blind transurethral cutting of prostatic tissue. Significant advances in transurethral surgery began in 1830, when George James Guthrie passed a concealed knife per urethra to incise prostatic tissue, though this was not done under direct visualization and was without a mechanism to control bleeding. This technique was improved upon when Enrico Bottini introduced a mechanism to deliver electrocautery in 1873. It was not until the 20th Century that there were significant advances. In 1909, Hugh Hampton Young, the father of modern urology, developed a “cold punch” in which an inner tube sheared off prostatic tissue in a more controlled manner. Edwin Beer, A.R. Stevens, and H.G. Bugbee all contributed the use of unipolar current in resection, resulting in improved hemostasis and would enable subsequent improvements on the procedure. Maximillian Stern developed the first recognized resectoscope in 1926, and T.M.

Davis made it possible to alternate between unipolar and bipolar current—a huge advancement that enabled both cutting and coagulation via the same mechanism. These advancements set the stage for Joseph McCarthy’s development of a more refined resectoscope, and one that allowed for greatly improved visualization of the procedure. He added a lens system that widened the visual field, a non-conducting outer sheath, and with the help of W.T. Bovie, separate channels for cutting and coagulating current. The SternMcCarthy resectoscope became the initial predecessor to the current resectoscope and made TURP a feasible procedure to a wide number of urologists (Figure 1). The first significant modification to this resectoscope was made by Reed Nesbit, who developed a loop that was pushed against a spring and would return to its initial position once released. This was the first development that enabled delivery of energy current by a one-handed technique, and allowed the surgeon to place a finger in the rectum so

as to draw the prostate toward the loop. In 1945, George Baumrucker reversed the drive mechanism on the working element of the Stern-McCarthy resectoscope, thus enabling the surgeon to pull the loop actively through prostate tissue with the forefinger (Figure 2). He also added a pressure gauge mechanism to prevent overfilling of the bladder—an issue now that energy could be delivered in irrigant solution.

In 1948, Jose Iglesias developed a spring drive mechanism that made transurethral resection an efficient one-handed procedure (Figure 3). In this way, the loop could be advanced and withdrawn with the thumb, much in the way that the modern transurethral resection is performed today. Further collaboration with H. Reuter led to the development of the continuous flow resectoscope that is well known to contemporary urologists.

REFERENCES Baumrucker, G. The new Baumrucker Resectoscope. J Urol. 1985; 133: 997-998. Engel, R. William P. Didusch Center for Urologic History – Resectoscopes. www.urologichistory.museum/histories/ instruments/resectoscopes Herr, H. The enlarged prostate, a brief history. BJU International. 2006; 98: 947-952. Wilde, S. See One, Do One, Modify One: Prostate Surgery in the 1930s. Med Hist. 2004 Jul 1; 48(3): 351–366.

Figure 1. Earlier advancements by Maximillian Stern and T.M. Davis set the stage for Joseph McCarthy’s development of a more refined resectoscope, and one that allowed for greatly improved visualization of the procedure. He added a lens system that widened the visual field, a non-conducting outer sheath, and with the help of W.T. Bovie, separate channels for cutting and coagulating current. The Stern-McCarthy resectoscope became the initial predecessor to the current resectoscope and made TURP a feasible procedure to a wide number of urologists.

Figure 2. The Baumrucker resectoscope, developed by George Baumrucker in 1945, reversed the drive mechanism on the working element of the Stern-McCarthy resectoscope, thus enabling the surgeon to pull the loop actively through prostate tissue with the forefinger. Baumrucker would later add a pressure gauge to prevent overfilling of the bladder during the procedure.

Figure 3. Jose Iglesias developed a spring drive mechanism that made transurethral resection an efficient one-handed procedure in 1948. An iteration of the original Iglesias working element, allowed the loop to be advanced and withdrawn with the thumb, much in the way that transurethral resection is done today. Further collaboration with H. Reuter led to the development of the continuous flow resectoscope that is well-known to contemporary urologists. To the left is a typical Iglesias resectoscope.

The above examples are displayed in the Museum located on the 11th floor of the College building along with other historic urological surgical instruments and artifacts. Jefferson Urology

Meetings Society of Academic Urology (SAU) January 2020 Dr. Leonard Gomella 2020 Program Co-Chair The Society of Academic Urologists (SAU) formed in 2016 when the Society of University Urologists and the Society of Urology Chairpersons and Program Directors voted to merge. SAU provides academic urologists with a forum to discuss, review, and potentially resolve critical issues in all aspects of academic urology. SAU gives academic urology a voice in the AUA Match program, which connects medical students interested in becoming urologists with urology programs.

Dr. Costas Lallas, Professor of Urology and Vice Chair for Academic Affairs presenting our JeffMD Curriculum at the SAU meeting.

The 2020 SAU Program Directors meeting was held in Las Vegas on January 24 and 25. Dr. Leonard Gomella served as Co-Chair for the meeting along with Dr. Joseph Basler from University of Texas San Antonio. Jefferson participants, in addition to Dr. Gomella, included residency program director Dr. Pat Shenot, associate program directors Drs. Alana Murphy and Costas Lallas and PGY5 resident Dr. Tom Hardacker. The two-day meeting consisted of a series of panels and workshops. Some of the sessions that Jefferson representatives participated in included: Developing Medical Student Curriculum: Costas D. Lallas, MD, FACS Sexual Harassment/Bias in Training: Thomas Hardacker, MD, MBA

A session at the 2020 SAU included a discussion on funding residency programs. Our program data was presented by Dr. Pat Shenot, Deputy Chair of the Department of Urology and Residency Program Director.

Resident Involvement in Patient Safety and Quality Initiatives: Scott G. Hubosky, MD Funding for the Residency Programs How Do You Do It?: Patrick J. Shenot, MD, FACS The keynote speaker for the event was Timothy P. Brigham, MDiv, PhD Chief of Staff and Chief Education and Organizational Development Officer for the ACGME. Dr. Brigham was previously at Sidney Kimmel Medical College as the associate dean for graduate medical education and Chief of Staff under Dr. Thomas Nasca. Dr. Brigham is a recognized expert on physician wellness and suicide prevention. His keynote lecture was “Physician Well-Being. With ResidentDirected Effort Back to Bedside.” 18

Year in Review

The SAU 2020 keynote speaker was a former Jeffersonian, Dr. Tim Brigham who is currently Chief of Staff and Chief Education and Organizational Development Officer for the ACGME (center) with program Co-Chairs Dr. Joseph Basler from the University of Texas San Antonio and Dr. Leonard Gomella.

Jefferson Urology 3rd Annual Symposium 2020 Each year the Jefferson Urology Symposium focuses on a specific topic in Urology. This year our Symposium focused on Men’s Health and was held on February 1st, 2020. Our annual CME based Symposium combines the use of didactic lectures and hands on experience with simulated models with experts assisting in the learning process. In our 3rd Annual Jefferson Urology Symposium, nationally recognized experts in their subspecialties discussed topics of interest to men’s health. This conference may have been one of the last in person conference attended by many of the participants since it occurred just prior to the Covid-19 pandemic shutdown. Topics covered included: • The Diagnosis and Management of Patients with Low Testosterone • The Use of Biomarkers in the Diagnosis and Treatment of Prostate Cancer • Peyronie’s Disease – What Do We Know Now and How Do We Treat It? • The Medical and Surgical Treatment of Erectile Dysfunction • BPH: An Update on Minimally Invasive Therapy including Aquablation • Male Urinary Incontinence • HoLEP- Technique, Outcomes, and Current Strategies • Strategies in Developing a Men’s Health Center Visiting faculty included Arthur L. Burnett, II, MD, MBA from Johns Hopkins University School of Medicine, Mohit Khera, MD, MBA, MPH from Baylor College of Medicine Houston, TX and Claus Roehrborn, MD Chair of Urology UT Southwestern Medical Center in Dallas, TX. Jefferson faculty included Course Director Akhil Das, MD, Paul Chung, MD, Leonard Gomella, MD and Perry Weiner, DO Director of Jefferson’s Men’s Health program

Above: Faculty participants at Jefferson Urology 3rd Annual Symposium. From Left to right, Dr. Paul Chung, Dr. Arthur “Bud” Burnett, from Johns Hopkins, Dr. Akhil Das, Dr. Leonard Gomella, Dr. Claus Rhoehrborn, Chair of Urology at UT Southwest in Dallas, Dr. Mohit Khera, from Baylor College of Medicine in Houston and Dr. Perry Weiner. Left: Proceedings of the 3rd Annual Urology Symposium were published in the Canadian Journal of Urology International in August 2020. The entire supplement is available online at: www.canjurol.com/pdfs/ supplements/2020/CJUI_2020_THOMAS_ JEFFERSON_SUPPLEMENT.pdf at the Navy Yard. Proceedings of the Annual Symposium were published in a special supplement of the Canadian Journal of Urology International in August 2020. The Department of Urology expresses our appreciation to our corporate sponsors and exhibitors who made the meeting possible: Boston Scientific, Endo Pharmaceuticals, KARL STORZ Endoscopy-America, Lumenis, Neotract Teleflex, Astellas Pharma US, Coloplast, Macklin Medical, Merck, Pfizer, Photocure, Procept BioRobotics, Retrophin and Uramix.

This year our 4th Jefferson Urology Symposium will be held on April 30, 2021, and will focus on Management of Urinary Incontinence and Innovative Technologies for BPH. In coordination with the CME office at Jefferson, this course will be available via Zoom that includes expert panel discussions with question and answer sessions after each subsection of the didactic lectures. While we are disappointed that this symposium will not be in live in person, our collective experience of “virtual conferences” over the last year will allow us to provide a comprehensive review of these commonly treated urologic conditions to potentially a larger audience.

BCAN Bladder Cancer Symposium Dr. Ryan Mark and other members of the Sidney Kimmel Cancer Center discussed treatment and wellness strategies for patients fighting bladder cancer. The Virtual Symposium was in conjunction with the BCAN Walk to End Bladder Cancer held in Philadelphia on September 10, 2020.

Jefferson Urology

Meetings International Meeting Presentations 2020 The pandemic has impacted many areas of health care. An unusual and perhaps an enduring positive outcome of the pandemic has been the use of video platform technologies in academic medicine. Before 2020, remote video lectures were uncommon and often used in emergency situations such as weather-related travel disruptions. Over the last year, we have all become accustomed to local and remote web-based meetings on video platforms such as Zoom, Adobe Connect, Cisco WebEx, Microsoft Teams and others. Many organizations pivoted major annual meetings to skillfully orchestrated virtual meetings thanks to the advances in these numerous web-based video technologies. Due to social distancing requirements, our department like many others converted our faculty meetings and Grand rounds conferences to virtual meeting platforms. A consequence of this conversion is our ability to share our CME certified grand rounds to a wider local, national and international audience (see page 21).

EXAMPLES OF VIRTUAL INTERNATIONAL CONFERENCES

Our faculty was able to participate virtually without cancelling due to travel restrictions. 1 Dr. Gomella presented the Patrick C. Walsh lecture at the 21st Asia-Pacific Prostate Cancer Conference. The annual international meeting is organized by Dr. Anthony Costello, Executive Director at The Australian Prostate Centre in Melbourne, Head of the Department of Urology at the Royal Melbourne Hospital, University of Melbourne, Australia.

2 Philadelphia International Medicine

(PIM) links patients, leading physicians, and healthcare professionals from around the world to a comprehensive network of medical treatment, medical education and healthcare management services. Jefferson Health is a member of PIM and in addition to bringing patients to receive care in Philadelphia, they coordinate educational activities for international health care providers. On August 10, 2020, Dr. Gomella presented, “Therapeutic Options for NonMuscle Invasive Bladder Cancer” virtually to Urologists across the Central American Urologic Association from countries such as Panama, Honduras, Nicaragua, El Salvador, Guatemala, Costa Rica, and others. The program was coordinated by Arturo Aceves-Serrano from PIM and hosted by Dr. Angel Alvarado from The Panama Clinic, Pacific Center in Panama City.

Seen in the computer photo are Dr. Angel Alvarado, Dr. Leonard Gomella and Philadelphia International Medicine Director of Market Development and Communications Arturo Aceves-Serrano during the August 10, 2020 bladder cancer presentation to urologists in Central America. 20

Year in Review

Dr. Laurence Klotz 9th Annual P. Kenneth Brownstein, MD Visiting Professor On December 9 and 10, the Department of Urology hosted a virtual 2020 P. Kenneth Brownstein, MD Visiting Professorship. This year’s VP was Laurence Klotz, CM, MD, FRCSC, Professor of Surgery, University of Toronto and Sunnybrook Chair of Prostate Cancer Research Sunnybrook Health Sciences Centre, Toronto, Canada (pictured). He completed his urology residency at the University of Toronto and a Urologic Oncology Fellowship at Memorial-Sloan Kettering Cancer Center in New York. Dr. Klotz is one of the leading international figures in Urologic Oncology also serving as Chairman, World Urologic Oncology Federation and Chair, SIU Office of Research and uCARE. He is recipient of the Order of Canada, an honor that recognizes outstanding achievement, dedication to the community, and service to the nation. While he has made numerous contributions to urologic oncology generally and prostate cancer specifically, he is widely known for his pioneering work in the area of active surveillance as a method of managing low risk prostate cancer. The Wednesday evening program was a Zoom based journal club featuring articles selected by Dr. Klotz and presented by our residents. On Thursday, December 10, 2020, Dr. Klotz delivered the Brownstein Lecture titled: “Integrating New Developments in Imaging, Biomarkers, And Therapeutic Interventions Into The Active Surveillance Trajectory.” The Visiting Professorship was established in 2012 to honor the longstanding contributions of Dr. Kenneth Brownstein to Jefferson. Dr. Brownstein is the Harold A. Honickman Physician Director of Jefferson Signature Services and Director of Development for the Department of Urology. Following his Grand Rounds lecture, Dr. Klotz was presented via Zoom with his Brownstein Visiting Professorship commemorative plaque by Dr. Leonard Gomella. Seen here are Dr. Klotz (upper left panel) from his home in Toronto and Dr. Ken Brownstein from his home in Philadelphia.

Urology Grand Rounds Now on the Web The 2020 coronavirus pandemic has made it challenging to clinically manage our patients and restricted our ability to participate in live educational conferences. This has also impacted our student and resident teaching opportunities normally provided through weekly Grand Rounds. These Grand Rounds also offer a platform for practicing urologists to learn about the latest advances in the field and provide a venue to present and discuss complex clinical cases. In response to these challenges, in the summer of 2020 the structure of our Jefferson Urology CME certified Grand Rounds switched completely to the Zoom platform. The Jefferson Office of CME office has provided a pathway for providers to obtain CME credit for participating in our Grand Rounds remotely.

Teaching opportunities and participation in live educational conferences have been significantly impacted by the pandemic.

Sidney Kimmel Medical College at Thomas Jefferson University supports the lifelong professional development of physicians. The goal of Jefferson’s CME/CPD (Continuous Professional Development) Program is to assist physicians in maintaining and continuously improving their core professional competencies as described by the Institute of Medicine and American Board of Medical Specialties as they perform their roles of clinicians, educators, researchers, and administrators for the public good. Jefferson’s CME/CPD activities support improvement in physicians’ and other healthcare providers’ competence, performance and patient outcomes.

Thursday morning Grand Rounds are held weekly from 7:15 to 8:15 a.m. Eastern time. The list of current topics for 2021 Grand Rounds can be found at www.jefferson.edu/university/jmc/departments/urology/ conferences. All Jefferson Health affiliated practices can now obtain CME credit through participating in these web-based conferences after initial registration with the Department of Urology. Providers including nurse practitioners, physician assistants and practice affiliated nursing staff will have full on live access to all presentations with the exception of our monthly M&M conference which is restricted to full time faculty and residents. We have now also extended access to the conferences to our international affiliates at the Jefferson Center in India. Contact Kelley Lilly (kelley.lilly@jefferson.edu) for additional information on our Grand Rounds program participation. To login into the CME Portal, use the following URL: cme.jefferson.edu/, then log in with your campus key and password. If you don’t have an account, you will have to create one, follow the instructions to “Create an Account.” Your attendance at a Jefferson RSS (Regularly Scheduled Series) Meeting such as Grand Rounds will be recorded via text message by texting the session SMS Code to the Jeff LEARN CPD phone number: 215-3235008. Weekly session SMS code is provided several times during the presentation.

Jefferson Urology

Alumni Jefferson Urology Alumni Achievement Award 2020 Col. (Ret.) Martin L. Dresner, MD, FACS The Department of Urology is pleased to announce Dr. Martin Dresner as our 2020 Jefferson Urology Alumni Achievement Award winner. Dr. Dresner attended Jefferson Medical College (now Sidney Kimmel Medical College) and graduated in 1965 following completion of his Bachelor’s degree from Ursinus College in Collegville, PA. Dr. Dresner went on to complete his residency in General Surgery at Martin Army Community Hospital at Fort Benning, Georgia. A second residency in Urology was completed at Letterman Army Medical Center in San Francisco with an additional fellowship in Pediatric Urology at Children’s Memorial Hospital. He was the first person to complete a Pediatric Urology Fellowship in the United States. After receiving his draft notice, he served with the First Cavalry Division as battalion surgeon, brigade surgeon, and commanding officer of a medical clearing station in Vietnam. After leaving the Army 1994 holding the rank of Colonel, he joined the faculty of the University of Arizona in Tucson and the Southern Arizona VA Healthcare System where he served as Program Director of the Department of Urology. In addition he also served as Chief of Surgery at the VA for more than a decade. Dr. Dresner, who is now retired, is well known for his service to the American Urologic Association (AUA), the Western Section of the AUA, the U.S. Army and Veterans Administation and urology residency training.

as well as U.S. Airborne and Special Forces Airborne wings. Ursinus College recogonized him through their Henry M. and M. Paige Laughlin Lifetime Educator Award. One of his biggest recognitions was in 2015 when he was the recipient of the Presidential Citation by the American Urological Association. Dr. Dresner has been a Fellow of the American College of Surgeons and member of the American Urological Association, the American Association of Clinical Urologists, the Society of Government Services Urologists (SGSU) and the American College of Surgeons. He has served as President of the Western Section of the American Urological

A few of Dr. Dresner’s Awards included: • Legion of Merit and Bronze Star (top left) Order of Military Medical Merit (top right) • U.S. Airborne and Special Forces Airborne Wings • Ursinus College’s Henry M. and M. Paige Laughlin Lifetime Educator Award • 2015 recipient of the Presidential Citation by the American Urological Association

Year in Review

In his spare time, Dr. Dresner enjoys spending time with his four grandchildren and listening to Jazz music. As our 2020 Alumni Awardee, Dr. Dresner would have joined us as our guest for the 2020 David M. Davis Visiting Professorship and Graduation Banquet where a formal presentation would have been made.We look forward to this event taking place live in June 2021 where we will once again invite Dr. Dresner and our newest 2021 Alumni awardee (to be announced) to both join us in Philadelphia.

As our Department of Urology 2020 Year In Review was about to be printed, we received the sad news that Marty passed away suddenly in December 2020, in Tucson, Arizona. The entire Jefferson family extends our condolences to his life partner, Ellen, his brother, children, grandchildren, and all of his many other family and friends. To paraphrase a famous TV commercial, “His was a life well-lived.”

Dr. Dresner has been previously honored for his extensive career and expertise in the field of urology. As a Vietnam veteran, Dr. Dresner was the recipient of the Legion of Merit and Bronze Star, the Order of Military Medical Merit,

Association, and Historian and Parliamentarian of the SGSU.

Jefferson Urology Alumni Association Thomas Jefferson University has a long and historic legacy in medical student and residency training. The Sidney Kimmel Medical College is the fifth oldest medical school in the United States and boasts the largest number of living medical school graduates. The Department of Urology, founded in 1904 as the Department of Genitourinary Diseases, is the oldest urology Department in the United States. Jefferson has been training urology residents since 1946 with our first fellows training beginning in the 1980’s. Our medical school continues to have one of the largest numbers of graduates matching into urology each year.

Our goal this year is to create the first directory of Jefferson alumni who specialize in Urology. The importance of alumni to the Department of Urology’s success cannot be overstated. Engaged, connected and supportive alumni are crucial to fostering a legacy of recognizing a superior training environment. Alumni serve as mentors and role models to current students and residents, facilitate job searches, serve as guest speakers at Department conferences, and provide philanthropic support for trainee enrichment. A noteworthy example of how urology alumni support our teaching efforts can be found on page 4 of this “2020 Year in Review” magazine. Alumni engagement is also playing an increasingly vital role in distinguishing the Department’s reputation in hospital ranking metrics and helping to support our research growth. The Jefferson Urology Alumni Award was established in 2019 to recognize a Jeffersonian who has gone on to significant achievement in the field of urology specifically or medicine in general. The awardee can be a previous SKMC student, resident or fellow. Dr. Steve Strup was our inaugural 2019 awardee and Dr. Marty Dresner was our recipient in 2020 (see page 22). Our Awards Committee is currently reviewing nominations to determine who will be our 2021 alumni honoree. Our primary effort for the coming year is to create the first comprehensive directory of former residents, fellows, and SKMC medical students who specialize in urology. This directory will serve as a vehicle to keep alumni connect to the Department and to each other. We are committed to keeping connected with our urology alumni across the United States and internationally. We also encourage our urology alumni to let us know if you have any general news announcement that you would like to share in an upcoming publication. If you have such an item of interest to share with a larger audience, contact Dr. Paul Chung (paul.chung@jefferson.edu).

We are kindly asking for all alumni to update your contact and other information by using the following link https://tinyurl.com/ jeffersonurology or by using the QR code above on your cellphone. Alumni may also directly contact our office by phone (215-955-6961) or email denise.tropea@jefferson.edu to update their information. Specific questions on the Jefferson Urology Alumni Association can be directed to Dr. Paul Chung, Director of the Jefferson Urology Alumni Association (paul.chung@jefferson. edu) or Dr. Leonard Gomella, Chair of the Department of Urology (leonard.gomella@ jefferson.edu).

Jefferson Urology

Alumni Spotlight Jefferson Alum Builds Hope in Home Country By Cindy Lefler Urological Surgeon Brings Healthcare and Education to Zimbabwe. Allen Chiura, MD, returned home to Zimbabwe for the same reason he left: hope. Growing up in an apartheid system, Chiura has vivid memories of his young world being separated into black and white—and then suddenly blended. “I remember being in primary school and not being able to play (sports) matches across the street at the government school because I was black,” he says. “And then I was 16 years old when independence came in 1980 and all of that changed; all of a sudden blacks and whites were just together, and we were growing this new country, and there was a little reconciliation and real great hope that existed.” He left Zimbabwe to attend college, medical school, and residency programs in the United States, staying for another 30 years to practice urological surgery in Delaware, Ohio and Oregon. But in 2011, he knew it was time to come home; it was time to bring more hope to a country that is still struggling to find the reconciliation and equality that independence never delivered. Chiura was born in Zimbabwe to a businessman-turned-educator father and health professional mother. His father Enos Chiura was the first chairman of BCCZ, the first pioneer bank after independence, and the first black CEO of the largest corporation in Zimbabwe. His mother, Faith Chiura, was a prominent nurse and midwife. Chiura attended American University in Washington, D.C., followed by the Medical College of Pennsylvania (MCP). As a youth, he was an athlete who played “every sport known to man.” When he suffered a serious knee injury at 16, the orthopaedic surgeon who repaired the damage made a great impression on him so he decided to set his sights a career as an orthopedic surgeon.

Just being a good doctor really means a lot to me. And I can honestly attribute that to the people that trained me at Jefferson. Dr. Allen Chiura 24

Year in Review

“The doctor was from Zimbabwe, but trained in the United States and came back,” he says. “He was an amazing surgeon and a really charismatic character. That was my first inkling that I wanted to do surgery.” Chiura planned to return to Zimbabwe as an orthopaedic surgeon, and to become the official doctor of the Zimbabwe Olympic team. There was only one problem—when he got to his third year of medical school and did a clinical rotation in orthopaedics, “I absolutely detested it.” Fortunately, there was another influence in his life that led him to urology. “My medical school advisor at MCP was a wonderful man. Dr. Allen Chiura, 1998 Jefferson Urology Residency He always seemed happy, so graduate I asked someone, ‘what does he do?’ They told me he was Brownstein, Irvin Hirsch, and David Rivas. a urologist, and I didn’t know what urology was, but I didn’t care. I said whatever that man After spending three decades in the United does, I want to do because he seems to have States building up his practice and his gotten it right.” After graduating from MCP, reputation, Chiura had an “aha” moment about Chiura applied for a urology residency at the returning to Zimbabwe. Actually, he says, it historically black Howard University Hospital was his wife’s “aha” moment. His wife, J. Nozipo in Washington, D.C. “Ever since I’d gone to Maraire, MD, is a renowned neurosurgeon school, I’d always been a minority,” he explains. and the author of “Zenzele: A Letter for My “In primary school and secondary school… in Daughter,” a New York Times “Notable Book of the U.K (where his family lived briefly when he the Year” and a Boston Globe best-seller. was young)… even in college and grad school in D.C., I was always a minority. And I thought It was one frigid Oregon winter day that to myself: I wonder what it would be like to be Maraire, also a native of Zimbabwe, gave in a majority situation.” Chiura an ultimatum.“It was the dead of winter. She goes out one morning to get into the car to He first had to complete a two-year residency go to work and she can’t open the door because in general surgery at Pennsylvania Hospital, it’s frozen. She comes back into the house to get and by the time he moved on to Howard, he some hot water to throw on the locks and says, found that the situation had changed. “I was ‘All right, that’s it. I’m done. By next winter, you there for a year and the program was shut better have me out of here.’” down,” he says. A mutual friend and colleague suggested he transfer to Jefferson. “And the rest is history.” Chiura, who completed his Jefferson residency in urology in 1998, says what he learned from his time at Jefferson went beyond a good medical education. “I am really passionate about taking care of people and delivering good healthcare, and that’s what I learned from Jefferson,” he says. “Just being a good doctor really means a lot to me. And I can honestly attribute that to the people that trained me at Jefferson.”

Chiura attributes his immense appreciation for “quality health and patient care” to his attending and peers at Jefferson. Specific faculty who impacted his urology training included Drs. Leonard Gomella, Demetrius Bagley, Grant Mulholland, “Sonny” Figueroa, Kenneth

The couple had always been active in helping their home country, collecting medical supplies and raising money to purchase provisions to send home to Zimbabwe.“We finally said, ‘Look, we obviously can have a much bigger impact, and the only way we’re going to be able to do that is go home and be there and do it,’” he says. They visited home in 2011 and had to make an immediate choice based on the availability of placement in a private school for their children. They decided on the spur of the moment: it was a “go.” They were in Zimbabwe a few months later. He admits the move home was not very well planned, and the first year-and-a-half was difficult. “But in hindsight it was the right

thing to do.” He brought with him a wealth of medical knowledge and experience, and a desire to make his portion of the world better. His wife was an enthusiastic partner in this endeavor. Chiura and Maraire knew each other as teenagers—and shared a mutual dislike of each other. When she left to finish high school in Wales, Chiura says it didn’t bother him at all. “Fifteen years later I’m standing at Terminal Four at Heathrow Airport. I turn around and she’s standing in front of me,” he recalls. She was on her way back from Ethiopia to Connecticut to finish her residency; he was on his way back from Zimbabwe to Philadelphia to finish his residency. “She says: ‘Are you Allen?’ I immediately recognized her.” They spent the rest of the time before their flights catching up. “We had a lot in common… and she had changed. So I married her,” he laughs, adding, “Um… that’s my story.” Allen and Nozipo’s wedding was featured in 1999 in Martha Stewart’s Wedding magazine. Together, their story includes providing clinical care to the people of Zimbabwe, medical training to young physicians, and an educational outlet for children. “We’ve been privileged to train in the United States and we wanted to be able to provide that same level of care to the patients that were here,” he says. In addition, Chiura and Maraire are involved in the training of residents in urology and neurosurgery at the University of Zimbabwe’s College of Medicine and Health Sciences and Parirenyatwa Government Hospital in Harare, Zimbabwe. He calls

his involvement with the training program gratifying, as “these young people are so enthusiastic and eager to learn.” Chiura and Maraire have been working to build a small hospital they hope to open the first quarter of 2021. Because securing a loan in the country is difficult, the couple has been selffunding the initiative brick by brick for more than eight years. “The idea behind the hospital is that we will have another location to be able to continue training young surgeons,” he explains. In addition, a more ambitious “hope” is to establish a private medical school. “All the medical schools in Zimbabwe are government medical schools. We are of the belief that we need to have a private medical school just to have a different way of doing things—a more innovative way.” The goal is to eventually harness all the connections and relationships the couple has built in the United States to establish educational ties between the two countries. “I would like to have SKMC students or Jefferson urology residents be able to come and spend some time here. I think it would expose them to a completely different healthcare system, and the interactions that they would have with our training would be beneficial for them.” While the hospital and medical school are works in progress, the couple has succeeded in creating the country’s first— and only—interactive children’s museum, the Discovereum. Chiura explains that they became enamored of children’s museums while

Chiura has vivid memories of his young world being separated. taking their family on vacation throughout the world, making a point to visit a one wherever they traveled. The couple has four children, daughters now 20 and 18, and sons now 16 and 13, the youngest adopted from Zimbabwe. Because they came to appreciate the educational value of children’s museums, they decided to create one in Zimbabwe. “My wife is very creative, and so we started designing and building exhibits, and next thing you knew, we had a big old warehouse that we converted it into a children’s museum,” he says, noting it is an investment in future generations. Today, Chiura is continuing to invest in his country, and to build on the hope he saw as a teenager. Unfortunately, he says, due to ongoing political and social turmoil, complete reconciliation and equality has never been realized in his country. “But I still have great hope in this country, and that is purely because of the people,” he says. “Zimbabweans are amazing people— wonderful, warm, caring, giving people. They get trampled upon, but they get up and they just keep going. And so the hope is not the same kind of hope that I had back then (at 16). It’s a different kind of hope. And I just want to be here and be a part of it.”

Dr. Allen Chiura (far right) and visiting professor Dr. Kurt McCammon, Chairman of the Department of Urology of Eastern Virginia Medical School and his wife with members of urology department of Parirenyatwa Government Hospital in Harare, Zimbabwe. Jefferson Urology

Notable and Newsworthy EDOUARD TRABULSI, MD, MBA, FACS Dr. Ed Trabulsi, Professor of Urology, has completed an Executive MBA at the Temple Fox School of Business. Starting in July 2019, Dr. Trabulsi completed course work in November, followed by a virtual graduation in January, 2021. This 16-month program was a cohort-based program, including a mix of in-person education and online seminars. It included the traditional business courses of finance, accounting, and economics, as well as several courses on leadership and strategy, amongst a broad range of topics. Dr. Trabulsi is grateful for the support provided by Dr. Gomella and all members of the department to allow his successful completion of this program and hopes to contribute back to the department with these new skills he has acquired. DARLENE M. BEWICK, DNP, MSN, CRNP On November 18, 2020, Darlene Bewick, completed the Doctor of Nursing Practice (DNP) Program at Villanova University, M. Louise Fitzpatrick College of Nursing. Darlene presented her DNP Scholarly Project entitled, “The Development and Implementation of a Patient Educational Resource for Female Patients with Overactive Bladder in a Urology Practice.” The project highlights the importance of patient education to empower female patients for engagement in their healthcare decisions and strategies for managing their OAB condition. Darlene’s DNP Scholarly Project was chosen by the Villanova faculty for a school-selected abstract for poster presentation to represent Villanova University College of Nursing at the Eastern Nursing Research Society (ENRS) Conference 2021. Darlene appreciates the guidance with the project from Dr. Patrick Shenot for agreeing to serve as the DNP Practice Mentor; Drs. Alana Murphy, Deborah Glassman, Akhil Das, and Patrick Shenot for identifying participants, Seungeun Oh, MSN, CRNP for providing surveys to the participants, and Dolores E. Shupp-Byrne, PhD for her expertise with the IRB submission. Darlene would like to sincerely thank the entire Department of Urology and Dr. Leonard Gomella for their support and encouragement throughout the DNP Journey. LEONARD G. GOMELLA, MD, FACS Dr. Gomella has been appointed to serve on the Advisory Council of the American College of Surgeons (ACS) for Urology. He was nominated by the American Association of Genitourinary Surgeons (AAGUS) for a 3-year term. The Advisory Council addresses issues that are of concern to the various surgical specialties and works closely with the governing body of the ACS, the Board of Regents. PAUL CHUNG, MD Congratulations to Dr. Paul Chung for his research project, “Contrast Enhanced Ultrasonographic Evaluation of Urethral Stricture Disease,” which was selected for the 2020-2021 Jefferson Emerging Medical Research Supports Program (JEMS) 26

Year in Review

Junior Faculty Award. This JEMS award is an initiative between the Office of the Provost and the Jefferson Clinical Research Institute (JCRI) to support junior faculty in developing their careers in clinical research. In addition to extending appreciation to Drs. Tykocinski and Wheelan, Dr. Gomella would like to acknowledge Dr. Flemming Forsberg, Professor in the Department of Radiology, for his mentorship on this project. ALANA M. MURPHY, MD, FACS Dr. Murphy has been recognized by the 2020 SKMC Educational Honor Roll. The Honor Roll is based on students evaluations and comments indicating exceptional teaching by the faculty member. J. RYAN MARK, MD Dr. Ryan Mark was interviewed for several articles during Prostate Cancer Awareness Month in September. One was for JNJ’s Prostate Cancer Awareness Month Feature: “Understanding Your Prostate Cancer Risk and PSA Level”. (newjersey. jeffersonhealth.org/content/understanding-yourprostate-cancer-risk-and-psa-level). Another was “Types of Prostate Cancer Screening and Why They’re Important” for Jefferson’s Health Nexus. (thehealthnexus. org/types-of-prostate-cancer-screenings-and-whytheyre-important/) VEDA N. GIRI, MD Dr. Giri, Professor of Medical Oncology, Cancer Biology, and Urology at the SKCC, received numerous grant awards in 2020 and is currently Principal Investigator on five national peerreviewed grants, including from the Department of Defense (DOD) and the Prostate Cancer Foundation. Her DOD ADVANTAGE grant focuses on genetic testing in African American Men with Dr. Thenu Chandrasekar as Co-Investigator. Her current grant portfolio covers a wide range of prostate cancer genetic testing topics, including educational opportunities, outcomes of men on PARP inhibitors, impact of workplace genomic testing and others. Several other Urology faculty members serve as co-investigators or consultants on many of these grants. MATHEW L. THAKUR, PhD The Journal of Nuclear Medicine celebrated its 60th anniversary in 2020 with a supplementary publication that included selected landmark papers from the journals 60 year history. An article by Dr. Mat Thakur, Professor of Radiology, Radiation Oncology and Urology, was selected for inclusion in that commemorative issue. The article of interest was “Indium-111-Labeled Autologous Leukocytes in Man. J Nucl Med. 1977;18:1014–1021.” This work is considered an important article as this technology is now being utilized clinically worldwide in the care of millions of patients and has been a key citation in the thesis of 100’s of PhD and MD researchers. The International Society of Radiolabeled Blood Elements in Vienna, Austria is based on this work. Dr. Thakur has served as past president of this Society.

PHILADELPHIA MAGAZINE TOP DOCTORS 2020 Congratulations to the following Thomas Jefferson University affiliated urologists for this recognition: T.E. “Sonny” Fugueroa, MD (AI Dupont) Deborah Glassman, MD (Center City) Leonard Gomella, MD (Center City) Ahmad Bani Hani, MD (AI Dupont) Joseph Izes, MD (Center City) Cadence Kim, MD (Jefferson North East/ Aria) David Kraman, MD (Jefferson North East/ Aria) Costas Lallas, MD (Center City) Patrick Shenot, MD (Center City) Edouard Trabulsi, MD, MBA (Center City) The following private practice urologists who work at a Jefferson Health Enterprise hospital were also acknowledged as Philadelphia Magazine 2020 Top Doctors: Lee Blatstein, MD (Jefferson Abington) Robert Charles, MD (Jefferson Abington) Steven Hirshberg, MD (Jefferson Abington) Marcella Nachmann, DO (Jefferson New Jersey) A. Michael Samaha, MD (Jefferson Abington) Yan Shibutani, MD (Jefferson Abington)

Urology Fellows

ABHAY SINGH, MD FELLOW IN ENDOUROLOGY AND ROBOTIC SURGERY Our Jefferson Urology Fellow in Endourology and Robotic Surgery for the 2020-2021 academic year is Abhay Singh, MD. Dr. Singh participated in the Endourology Society matching program. Born in Maryland he completed his undergraduate education at Duke University. While at Duke, he participated in the Army ROTC and was commissioned as an officer upon graduation. Dr. Singh then went on to receive his medical training at Robert Wood Johnson Medical School at Rutgers University. Dr. Singh became interested in Urology early in his medical training and his interest only grew over the remainder of medical school and he went on to complete his Urology residency at Duke University Hospital. After residency, Dr. Singh served as a general urologist in the Army, first posted to Fort Benning in Georgia and then Fort Belvoir in Virginia. He was promoted to the rank of Major in 2015. As he completed his military commitment in 2020, he wanted to expand his robotic and endourological skills, and was excited to match with the Endourology endorsed fellowship at Thomas Jefferson University. His wife, Bhavana, is a medical oncologist in the Lehigh Valley.

ASAF SHVERO, MD ENDOUROLOGY FELLOW The Department of Urology at Sidney Kimmel Medical School of Thomas Jefferson University is pleased to welcome Dr. Asaf Shvero as a special one-year fellow in Endourology. His fellowship is supported by the Sheba Medical Center in Tel HaShomer, Israel. Dr. Shvero has recently completed his Urology Residency at Sheba Medical Center. He simultaneously completed an associate-degree in bioinformatics and computational biology. During his training, he had extensive exposure to diagnosing and treating patients with upper urinary tract diseases including nephrolithiasis, upper tract urothelial carcinoma and ureteral strictures. While at Sheba Medical Center, he helped facilitate the multi-center OLMYPUS trial, involving patients with upper tract urothelial carcinoma being treated with thermo-sensitive gel enriched with Mitomycin-C recently FDA approved as Jelmyto®. Sheba Medical Center was the leading accrual center. Dr. Shvero will join us for a one-year fellowship with Dr. Scott Hubosky as his primary mentor. After successful completion of the fellowship, he plans on returning to Israel and joining the academic faculty of the Department of Urology at Sheba Medical Center with an appointment at Tel-Aviv University, Sackler School of Medicine. In this new role, he will be joining one of our previously trained fellows, Dr. Nir Kleinmann (class of 2013) who is currently President of the Israeli Endourological Society and has an extremely busy practice. Together, Nir and Asaf will continue to improve and optimize the endourologic care of urology patients in Israel in the Jefferson tradition. Dr. Shvero’s family will remain at home in Israel during his fellowship. His wife, Dana, is a practicing dentist in Israel and they have two sons, Ido and Oren as well as one daughter, Shir. Jefferson Urology

2020 Urology Graduation Ceremony

Graduating Chief Residents Drs. Ali Syed, Tomy Perez, Hong Troung and Endourology Fellow Dr. Kate Smentkowski. While our traditional year-end graduation plans were disrupted, our enthusiasm for giving our graduates a first-class sendoff remained strong. Much like every other academic group, we are pleased to have been able to conduct a virtual Department of Urology 2020 Graduation and Awards ceremony. The ceremony was broadcast live and friends and family were invited to tune in. The event included as many of the usual elements of our annual graduation program such as the awarding of certificates, the opportunity for the graduates to talk about their experience at Jefferson and the presentation of the personalized bobbleheads. What we did miss was the day long David M. Davis Visiting Professorship, seeing many of our former residents who return to Jefferson for the day and the evening Graduation Banquet at a special venue. We look forward to resuming a full program in person next June. The graduation ceremony gave us an opportunity to celebrate the accomplishments of our graduating Chief Residents Drs. Tomy Perez, Ali Syed, and Hong Truong and Endourology Fellow, Dr. Kate Smentkowski. We also acknowledged other trainees who have been a part

of our Urology Team over the last year. Lydia Glick from SKMC and Tim Han from the Chicago Medical School Rosalind Franklin University of Medicine and Science completed an outstanding year as our Jefferson Urology Scholars. The Dolores Byrne Senior Urology Award was given to Dr. JY Leong who joined us this year as an intern in Urology. The Max Koppel, MD Resident Achievement Award is presented to resident(s) who have achieved the highest academic score in the yearly “Inservice Exam” sponsored by the American Urological Association. In 2020 this was a tie with Drs. Victor Kucherov and Andrew Salib sharing the award. We wish our chief residents and fellow well as they depart from their time at Jefferson. Dr. Hong Truong will be starting a two-year Urologic Oncology fellowship at Memorial Sloan Kettering Cancer Center in New York. Dr. Ali Syed will be joining the Advanced Urology Institute New Port Richey, Florida while Dr. Tomy Perez will be heading west to join the Lovelace Medical Group in Albuquerque, New Mexico. Dr. Katherine “Kate” Smentkowski our Fellow in Endourology and Robotic Surgery will be returning home to Maryland to join Chesapeake Urology.

Dr. Costas Lallas presents his Jefferson Urology Scholar plaque to Tim Han virtually at home in Chicago.

Dr. Max Koppel Achievement Award winners Drs. Victor Kucherov and Andrew Salib with residency program director Dr. Patrick Shenot.

Drs. Leonard Gomella and Patrick Shenot with graduating Chief Residents Drs. Hong Truong, Tomy Perez and Ali Syed. 28

Year in Review

All graduating residents and fellows receive a special certificate signed by faculty and residents in the Department of Urology.

SKMC 2020 graduate Dr. J.Y. Leong receiving the Dolores Shupp Byrne Senior Urology Award from Dr. Byrne.

Dr. Lallas with Jefferson Urology Scholar Lydia Glick, SKMC 2021.

Remembering 2020: Even without a DM Davis Visiting Professor our virtual graduation was a success.

Endourology Fellow, Dr. Kate Smentkowski receiving her signed commemorative Jefferson certificate from Endourology Society program Co-Directors Drs. Costas Lallas and Scott Hubosky.

Drs. Lenny and Tricia Gomella with the custom bobble heads, a traditional Jefferson Urology graduation gift. The bobble head process is supervised by Dr. Tricia Gomella and takes six months of adjustments to get them “just right.” Jefferson Urology

Department of Urology House Staff 2020-2021 CHIEF RESIDENTS (PGY 6)

Christopher Caputo, MD Medical School: Temple University – Lewis Katz School of Medicine Undergraduate: Lehigh University

PGY 5

PGY 4

Edward Kloniecke, MD, MHA Medical School: Sidney Kimmel Medical College Undergraduate: University of Scranton

PGY 1

Courtney Capella, MD Medical School: Sidney Kimmel Medical College Undergraduate: Dickinson College

May Jean (MJ) Counsilman, MD Medical School: Sidney Kimmel Medical College Undergraduate: University of Connecticut

Andrew Salib, MD Medical School: Robert Wood Johnson Medical School Undergraduate: Rutgers University

Maria D’Amico, MD Medical School: Boston University School of Medicine Undergraduate: Columbia University

Thomas Hardacker, MD, MBA Indiana University School of Medicine Undergraduate: Kenyon College

Anthony Tokarski, MD Medical School: Sidney Kimmel Medical College Undergraduate: Pennsylvania State University

Joon Yau (JY) Leong, MD Medical School: Sidney Kimmel Medical College Undergraduate: International Medical University Kuala Lumpur, Malaysia

PGY 2 Victor Kucherov, MD Medical School: University of Rochester School of Medicine & Dentistry Undergraduate: University of Rochester

Brian Calio, MD Medical School: Sidney Kimmel Medical College Undergraduate: University of Delaware

Benjamin Rudnick, MD Medical School: Sidney Kimmel Medical College Undergraduate: Vanderbilt Univeristy

Halle Foss, MD Medical School: Medical College of Wisconsin Undergraduate: St. Olaf College

Alex Uhr, MD Medical School: Sidney Kimmel Medical College Undergraduate: University of Pittsburgh

Radhika Ragam, MD Medical School: Rutgers New Jersey Medical School Undergraduate: The College of New Jersey

FELLOWS

Abhay Singh, MD Fellow in Endourology and Robotic Surgery Residency: Duke University Medical School: Robert Wood Johnson Medical School at Rutgers University Undergraduate: Duke University. Asaf Shvero, MD, Endourology Fellow Residency: Sheba Medical Center, Tel HaShomer, Israel Medical School: Technion Institute of Technology Haifa, Israel Undergraduate: Technion Institute of Technology Haifa, Israel

Welcome New Urology Interns The Department of Urology welcomed our new class of incoming residents on June 20, 2020. This outstanding group of three physicians are amongst the best and brightest medical school graduates in 2020, and we are honored to have them as trainees in our Department. Courtney Capella, M.D is a graduate of Dickinson College and joins us from the Sidney Kimmel Medical College of Thomas Jefferson University. Maria D’Amico M.D. completed her undergraduate degree at Columbia University and attended medical school at Boston University. Joon Yau “JY” Leong, M.D. completed his undergraduate training at the International Medical University in Malaysia and graduated from Sidney Kimmel Medical College of Thomas Jefferson University. He was honored wit the SKMC 2020 Dolores Byrne Senior Award in Urology. Because of the COVID-19 pandemic, resident orientation was predominantly held in a virtual format. Despite the challenges, our new interns navigated these unchartered waters with creativity and boundless enthusiasm. Welcome to the Jefferson Urology family. 30

Year in Review

In a brief outdoors unmasked moment, our new Department of Urology Interns: Drs. Courtney Capella, Maria D’Amico and JY Leong.

Department of Urology Students Jefferson Urology Research Scholars The Jefferson Urology research scholar program was initiated in 2017. The program is designed to provide medical students with a mentored year of clinical research in the Department of Urology. Students who apply to the program are typically between their third and fourth year of medical school and usually have an interest in applying for a urology residency. At the present time, the experience is limited to clinical research but may expand to basic science in the future. Participants have the opportunity to present at local and national meetings and are otherwise engaged in all educational activities in the Department such as grand rounds and journal clubs. A small stipend is provided with our goal to identify a benefactor to endow these positions long term. ERICA MANN Erica is a member of the Sidney Kimmel Medical College Class of 2022 and is one of our Jefferson Urology Research Scholars for the 2020-2021 academic year. She earned her Bachelor’s degree from Washington University in 2015 with a double major in Public Health and Women, Gender, & Sexuality Studies.

SKMC Urology Match 2020 Applicants to the specialty of Urology participate in an early match process. This early match allows Urology residency programs to submit the names of these matched applicants into a preliminary general surgery internship during the regular match. Some noteworthy data to share on the 2020 Sidney Kimmel Medical College Match is that 2% of all US seniors who matched into urology were from SKMC (7/337). Overall, 88% (7 of 8) SKMC students matched into this competitive specialty with an 80% national match rate overall.

Prior to starting medical school Erica worked at GeneOne Life Science Inc., a biotechnology startup writing protocols, and managing regulatory documents for clinical trials. According to Erica “Working with the urology department as research scholar has already proven to be incredibly rewarding even with the pandemic challenges. I look forward to a productive year of research.”

According to Dr. Charles Pohl, Vice Provost, Student Affairs and Vice Dean of Student Affairs for Sidney Kimmel Medical College: “The number of urology program interviews granted to our SKMC students was well above national averages.

ANDREA QUINN Andrea Quinn, who is originally from Tucson, Arizona, is a member Sidney Kimmel Medical College Class of 2022. Additionally, she is one of our Urology Research Scholars for the 2020-2021. A 2015 Grinnell College graduate with a degree in Biology, Andrea spent two years as an MCAT instructor and researcher on cytokines and stress in breast cancer survivors.

“On behalf of the Dean’s Office, I thank and applaud the Department of Urology faculty and Program Director Dr. Pat Shenot and Associate Program Directors Drs. Costas Lallas and Alana Murphy that have provided enormous time and meaningful advice to our SKMC students.”

Andrea notes that she “decided to pursue urology because I wanted to be an expert on the urinary tract and to impact both patient survival and quality of life. So far this year. I have enjoyed adding to the body of urologic literature focusing on oncology as a research scholar”. Andrea is working on several projects including a database of small renal masses, explored how genomic analysis affects prostatectomy results, and created videos on operative techniques”. Andrea is our first urology scholar who can play the harp.

“We are pleased that most of the SKMC students got one of their top choices and all of them matched into great programs.

Our 2020 SKMC senior Urology match results: Andre Alabd, MD: Indiana University Courtney Capella, MD: Thomas Jefferson University Michelle Leach, MD: University of California San Diego Joon Yau “JY” Leong, MD: Thomas Jefferson University Spencer Liem, MD: Mt. Sinai Medical Ctr, Florida Seth Teplitsky, MD: University of Kentucky Elaine Yang, MD, PhD: Case Western Reserve

Jefferson Urology

Research

Philadelphia Prostate Cancer Biome Project 2020 Update

The Biome Project is moving our research program ahead. By Shannon Fields, Philadelphia Prostate Cancer Biome Project Coordinator

philanthropic gift from Sydney and Sharon Martin.

In the fight against cancer, research is our most powerful weapon. Jefferson faculty at Sidney Kimmel Cancer Center (SKCC) have literally written the first book on prostate cancer for patients, and they are continuing to rewrite the medical literature with innovative research and new discoveries. The Philadelphia Prostate Cancer Biome Project (PPCBP) is the newest chapter supported through a major

This project is a long-term, multi-disciplinary, multi-institutional collaboration that studies the region’s prostate-cancer biome, the biological-sociological-psychological ecosystem where it flourishes. The project partners with top cancer centers, hospitals, and universities in the Philadelphia region to collect and process biospecimens and patient/ population data. Patients are tracked over years

to understand the many factors that predict outcomes in the prostate cancer biome. The data will be used to develop new strategies to prevent, diagnose, and treat the disease, leading to better outcomes for years to come. The Biome Project is supported by a major philanthropic gift. The overall direction of the program the responsibility of Dr. Kevin Kelly Director, Division of Solid Tumor Oncology and Associate Director of Clinical Research, SKCC and Dr. Leonard Gomella, Chair Department of Urology and Senior Director for Clinical Affairs, SKCC.

Pilot Program Award Success Since launching in 2019, the Biome Project has funded 9 pilot awards in the clinical, basic, and population science arenas. Pilot funds have already been used to develop 3 other successful R0-1 grant applications. See page 36 for details on one specific example of how these pilot grants can lead to major NIH funding. To check out the some of these pilot projects and watch videos from the outstanding investigators behind them visit www.Jefferson. edu/givebiomeproject. The Biome Project is proud to announce that three NIH RO1 grants were awarded to Jefferson researchers with preliminary data gathered through pilot projects funded by the Philadelphia Prostate Cancer Biome Project. Josep Domingo-Domenech, PhD, MD, is identifying the mechanisms that cause and 32

Year in Review

advance prostate cancer, which will help target those mechanisms with potential future therapies. The lab is researching the role of the GATA2 signaling network in lethal prostate cancer. GATA2 has a key role in driving prostate cancer aggressiveness. This work has earned an NIH R01 award. Veronica Rodriguez-Bravo, PhD, is investigating how aggressive tumors adapt and survive with high levels of chromosomal defects in order to find molecular vulnerabilities for therapeutic targeting. The Rodriguez-Bravo lab has been awarded an NIH R01 grant. The five-year R01 grant helps the lab continue to conduct impactful research, potentially developing several other Philadelphia Prostate Cancer Biome Project projects over time.

Thenappan Chandrasekar, MD, and Sushil Kumar Tripathi, PhD, pilot awardees continued work discovered at Jefferson on the VPAC molecule in order to develop a simple and affordable test that uses only voided urine to detect prostate cancer. Dr. Mat Thakur, coinvestigator in this biome project, has recently been awarded an NIH R01 grant based on the foundations of this early research. This five-year NIH grant, with Dr. Edouard Trabulsi as Co-PI with clinical support from the Department of Urology, will substantiate preliminary Biome Project data through this new grant and allow the further refinements of this urinary-based prostate cancer test (see page 36).

Pilot Award Program To further support investigators to make advancements against lethal prostate cancer, we have opened a Rolling Pilot Award Program in which new applications will be reviewed and awarded on a quarterly basis. This provides the best opportunity for researchers to receive much needed funding for promising prostate cancer pilot projects. PILOT AWARD DETAILS: The awards will be one (1) year in duration and will provide funding of $50,000 to $150,000 depending on the innovation of the application. The principle Investigator needs to be a member of Jefferson University, SKCC or a SKCC consortium member. Co-investigators outside of Jefferson University\SKCC are strongly encouraged.

APPLICATION REVIEW SCHEDULE (2021) Reviews at Quarter End (deadline)

Estimated Funding Date

March 31, 2021

April 28, 2021

June 30, 2021

July 28, 2021

September 30, 2021

October 28, 2021

December 31, 2021

January 28, 2022

Funded Pilot Awardees are asked to submit 6-month and final progress reports.

Contact Shannon Fields, Philadelphia Prostate Cancer Biome Project Coordinator, with any questions on the pilot award process at sxf068@jefferson.edu or 215-955-8875 or 407-430-6030.

Applications for the Pilot Awards will be accepted on a rolling basis. Submitted applications will enter a rolling review process to determine funding.

Interested investigators can apply for PPCBP pilot award funding through the Jefferson InfoReady system: https://jefferson.infoready4.com/#competitionDetail/1817617

Prostate Whole Mount Project

Example of a radical prostatectomy whole mount before embedding in wax.

Examples of the whole mount radical prostatectomy specimens preserved in wax. Jefferson Urology

Research

Inset Before: Dr. Peter McCue with the nearly 2,000 whole mounts in bins. Background After: Newly renovated biorepository space to securely store the whole mount prostate specimens. 34

Year in Review

Prostate Cancer Virtual Symposia The PPCBP team sponsored two virtual symposia over the last year, one in the spring (see graphic below) and the latest on November 11, 2020, moderated by Drs. Adam Dicker and Kevin Kelly. The recent program featured some of the recent pilot awardees who gave brief overviews of their research activities supported by the Biome Project. When viewing this program you can also learn about the inspiring story of prostate cancer survivor Erik Marrero, who shared his personal journey, including the benefits of yoga and mindfulness. You can watch the 2020 Advancements in Prostate Cancer symposium anytime or share it with family and friends: https://vimeo.com/480791144

Urology CRNP Fatuma Doka has been overseeing the clinical chart retrieval associated with the nearly 2000 radical prostatectomy specimens.

This truly one-ofa-kind collection will open countless doors for prostate cancer research. As part of the PPCBP, the Sidney Kimmel Cancer Center Biorepository has acquired nearly 2,000 whole mount prostate specimens spanning from 1989 to 2009 under an IRB protocol. A whole mount (see page 33) is a process where by the entire radical prostatectomy specimen is cut into 5-10 individual slices (similar to an egg in an egg slicer). Each wax embedded slice allows the entire specimen to be available for future research efforts including diagnostic testing and drug development. Along with this project, archival medical records are being catalogued, deidentified and will be entered into an IRB compliant database to match the samples with clinical information. This is a powerful combination of carefully annotated pathology samples combined with highly detailed clinical information. The prostate whole mounts currently in bins, are being transferred and organized into specially designed drawer units.

The SKCC Biorepository team along with Dr. Peter McCue in the Department of Pathology and members of the Department of Urology have been working for most of 2020 and into 2021 to organize and annotate this vast collection of prostate specimens and the associated clinical data. This truly one of a kind collection will open countless doors for prostate cancer research.

For general information on the Philadelphia Prostate Cancer Biome Project visit: www.jefferson.edu/givebiomeproject To learn more about how you can help support Philadelphia Prostate Cancer Biome Project please contact Emma Laverty, Assistant Vice President of Development at emma.laverty@ jefferson.edu or 215-503-8679.

In the spring of 2020 members of the Prostate Cancer Biome Project addressed issues relating to the COVID-19 pandemic and answered audience questions on prostate cancer.

Jefferson Urology

Research

Our prostate cancer patients have also continued to benefit from our robust prostate cancer clinical trial portfolio managed in partnership with our Sidney Kimmel Cancer Center medical and radiation oncology colleagues.

Dr. Ryan Mark, Director of Clinical Trials, evaluating a tumor specimen in the operating room as part of a clinical trial enrolment process. The Covid-19 pandemic effects of social distancing and other necessary public health efforts have likewise impacted clinical research activities. Despite the obvious hurdles, the Department of Urology has continued its commitment to conducting clinical research over the last year. During the pandemic, we enrolled 10 patients to SWOG 1602 (NCT03091660). This phase III study explores the effect of standard of care BCG vs. a Tokyo BCG strain previously unavailable in the US. As a result, we have been able to offer full strength BCG and three years of maintenance to our patients with high-risk non-muscle invasive bladder cancer (NMIBC) despite the global BCG shortage. As this trial nears accrual goals, we hope to see FDA approval of the Tokyo strain of BCG further improving patient access to intravesical BCG. For those patients where BCG has failed to control their bladder cancer, we continue to offer intravesical BCG + IL 15 super-agonist through Quilt-3.032 (NCT03022825) as an alternative to radical cystectomy or other salvage therapy.

• Specific to the Department of Urology, we have been examining the role of multiparametric MRI prior to prostatectomy (NCT03697148). • We continue to recruit for the SUO-CTC Priority trial (Society of Urologic OncologyClinical Trials Consortium) testing the ability of current biomarkers to help men avoid unnecessary prostate biopsies. • Molecular-based PSMA PET imaging trial sponsored by the National Cancer Institute (NCI) is bringing this exciting new imaging technology to patients in the Philadelphia region. The trial is: Prostate Specific Membrane Antigen (PSMA)-Based PET Imaging of High Risk Prostate Cancer (NCT03976843). Our department’s clinical research program also participated in two important multiinstitutional trials that were published in highprofile journals in 2020. • Dr. Scott Hubosky was a co-investigator on the OLYMPUS clinical trial that led to the FDA approval of a mitomycin-containing reverse thermal gel (Jelmyto™) for upper tract urothelial carcinoma. “Primary chemoablation of low-grade upper tract urothelial carcinoma using UGN-101, a mitomycin-containing reverse thermal gel (OLYMPUS): an open-label, single-arm, phase 3 trial” was published in Lancet Oncology in June 2020 with our former endourology fellow Dr. Nir Kleinmann as first author.

R01 NCI Grant Award This five-year study will develop a simple urine test for prostate cancer. Mathew Thakur, PhD and Edouard Trabulsi, MD, MBA, were awarded R01 funding as coprimary investigators from the National Cancer Institute on September 1, 2020 (1R01CA24992), for their proposal titled, “NONINVASIVE, UNIPLEX, MOLECULAR, PATHOMIC URINARY ASSAY FOR DETECTION OF PROSTATE CANCER.” This five-year grant, totaling $3.1 million, is the culmination of several years of collaboration between Dr. Thakur’s laboratory in the Department of 36

Year in Review

Radiology and the Department of Urology. The grant is based upon the concept of detecting shed-tumor cells in body fluids. The concept, which was originally developed by Drs. Gomella and Thakur, builds on the previous years of Dr. Thakur’s work evaluating peptide analogs of the ligand for VPAC [vasoactive intestinal peptide (VIP)/pituitary adenylate cyclase activating peptide (PACAP)]. VPAC is a cell surface receptor significantly upregulated in malignant epithelial cells such as prostate cancer. This proposal will examine shed cells in the urine, which are

• A landmark intravesical gene therapy trial was also published in Lancet Oncology in November 2020: “Intravesical nadofaragene firadenovec gene therapy for BCG-unresponsive non-muscleinvasive bladder cancer: a single-arm, open-label, repeat-dose clinical trial.” Dr. Leonard Gomella served as principle investigator at Jefferson for this SUO-CTC trial with our Department registering and tying for the second highest accrual in US for this novel agent, nadofaragene firadenovec (Astiladrin™) in patients with BCG unresponsive NMIBC. This agent is currently under evaluation by the FDA. If approved would represent the first gene therapy product for bladder cancer. A searchable list of our available clinical trials is available for review at Jefferson’s Study Information Portal (SIP, for short) through the site ctmssip.tju.edu/sip/SIPMain). If you have a patient you would like to refer or require more information on a particular trial please contact Dr. J. Ryan Mark (james.mark@jefferson.edu), Director of Clinical Trials for the Department of Urology. We are also pleased to welcome our new clinical trials coordinator, Olivia Dahlgren, BS, Clinical Trials Coordinator (pictured). Olivia joined the department in early 2021 and is available for questions or to assist with any trial eligible patient referrals at olivia.dahlgren@ jefferson.edu. Olivia’s work cell number is 267343-6558. In addition to our extensive portfolio of oncology trials, we look forward to Olivia helping to help expand availability of nononcology studies. labeled with VPAC receptor ligand peptide analogs conjugated to an optical fluorophore, developed by Dr. Thakur, to accurately predict the presence of prostate cancer shed cells using fluorescent microscopy. Jefferson holds multiple patents on this technology. Some of the early pilot work in this area was supported by a Philadelphia Prostate Cancer Biome Project Pilot grant (see page32). The ultimate goal is to evolve this innovative concept into a simple and low cost non-invasive urinary assay for prostate cancer detection.

Urology Research Lab Update Dr. Matthew Schiewer grant successes in 2020 Dr. Matthew Schiewer recently completed his first year as an independent investigator having joined the Department of Urology in November of 2019 as an Assistant Professor in Urology and Cancer Biology. He has a PhD in Genetics and completed his postdoctoral training with Dr. Karen Knudsen in the Department of Cancer Biology. With his strong background in basic and translational research in prostate cancer, Dr. Schiewer was a natural fit to join the Department of Urology. The focus of his lab is developing a better understanding of the molecular mechanisms of DNA repair and regulation of gene expression, and how these pathways impact one another in prostate and bladder cancers, and how they might be capitalized upon for therapeutic benefit. In this “2020 Year in Review” magazine, Dr. Schiewer was asked to provide an update and reflect on his research laboratory activities over the last year. “Writing this reflection on the first year of the laboratory during the holiday season has me feeling very thankful. I am thankful for the opportunity to be part of such a great team in the Department of Urology, where I have been welcomed warmly and supported professionally, with expert academic leadership provided by Dr. Leonard Gomella. I am thankful for the support of the University and of the Sidney Kimmel Cancer Center, and the University leadership “guiding the ship” through these difficult times. It has been an interesting journey this year, with progress in our research plans being made despite the circumstances of the pandemic.

“Since opening the lab, we have acquired the equipment and supplies we need to conduct our research, including the means to: genetically manipulate cancer cells; quantify gene expression changes; monitor changes in protein levels; perform experiments using fixed and fresh human cancer tissues; investigate DNA repair; and interrogate the architecture of DNA and what binds to it, and how this influences gene expression. We have made progress towards a better understanding of hormone signaling in bladder cancer, as well as further identifying the mechanisms by which DNA repair processes influence gene expression in prostate cancer. “Currently, our core basic science team consists of four members: the PI (Matt Schiewer PhD), a research technician, a Master’s student and a PhD student who will be doing a research rotation and we hope she will join our lab for the duration of her thesis. We are also looking forward to recruiting a Postdoctoral Fellow in 2021 as well. “Our lab team was able to hit the ground running thanks to the start-up funds provided by the SKCC and the Department of Urology. Over the last 12 months we have been successful in several grant applications and

Urology lab team ZOOM meeting featuring Jeremy Muhr, research technician (top left), Dr. Matthew Schiewer lab PI (top right), Latese Evans, Master’s student (bottom left) and Moriah Cunningham, PhD student (bottom right).

received funding in the following areas: • Philadelphia Prostate Cancer Biome Project Pilot Award for our work in exploring how DNA repair processes impact gene expression in prostate cancer. • American Cancer Society IRG Grant to support our work dissecting hormone signaling in bladder cancer. • Health Research Formula Fund Grant from the Pennsylvania Department of Health to study the cross-talk between DNA repair and regulation of gene expression in bladder cancer. “In 2021, we will be seeking further funding, including competing for several R01 grants in bladder and prostate cancer. Although the pandemic did slow down bench research the university began a phased return of full lab operations in the fall and when not in the lab we were sequestered at home busy writing papers, preparing grant applications and prioritizing projects for the coming year.”

Jefferson Urology

Department of Urology News: Provider Spotlight

Students participating in the Tender Grassroots program in Uganda founded by Doka. 38

Year in Review

Fatuma Doka, MSN, CRNP By Lisette Hilton

Caring for children back home in Uganda Fatuma Doka, MSN, CRNP, joined the Jefferson Department of Urology nearly 17 years ago as a nurse practitioner. Her journey to Jefferson and the tireless work she does today to help school children in her native Uganda is a story worth telling. “Doka,” as everyone calls her, grew up Uganda and attended the British school system there to pursue nursing. After graduating as a registered nurse, Doka remained in Uganda, working at the Mulago National Referral Hospital, a country-wide referral center located in Uganda’s capital Kampala. Uganda had become so dangerous that Doka decided to move her family to neighboring Kenya in 1984. There was great unrest in the landlocked African country in the early 1980s. Uganda was immersed in a civil war between President Milton Obote’s government and rebel groups including the National Resistance Army. Doka worked at Kenya’s Aga Khan University Hospital until 1989. Her brother, who worked at the World Bank in Washington, DC, encouraged Doka to make a new home for her and her three children in the United States, where there was a nursing shortage. The now grandmother of three would spend the next decade earning her master’s degree in nursing at Johns Hopkins University and working in a variety of health care settings in different states until she heard Jefferson was looking for a nurse practitioner in its Urology Department. She has not looked back since joining Jefferson in 2004. While Doka did not have urology experience initially, she had extensive experience as a nurse practitioner collaborating with many disciplines. “I think that is what I brought to the department. We care for very sick patients. They do not just have urology issues. It is more complex. You have to be able to collaborate, and that is something I enjoy,” she said. Doka’s life would take a turn after she went to Uganda for a month last year. She visited her old primary school at lunchtime and saw it had not been upgraded in decades, the children did not have enough to eat and were hungry, there was little in the way of sanitation and classrooms were overcrowded. “It was sad,” Doka said. “I could not let it go. I had to do something.” Doka returned to life in the United States. but the children in Uganda remained on her mind. She started the nonprofit Tender Grassroots [tendergrassroots.org], recruited her grown children and nieces in the U.S. and Uganda to help. Tender Grassroots provides underserved communities across Uganda with resources, knowledge and skills that will empower them to end the cycle of poverty.

to her home country. “It’s great that through her Tender Roots charity, Doka is getting an opportunity to do just that,” Barron said. Doka and her family have paid for most of the charity’s efforts, colleagues in the Jefferson Urology Department have helped, too. And thanks to those donations, the children where Doka went to school will have hot lunches for the rest of the year. “We started with 300 kids and made sure they had food,” Doka said. During the COVID-19 shutdown in Uganda, Doka’s contacts in Uganda distributed food to those in the community in need through a local church and mosque. The school has reopened for the older students and the nonprofit has since added handwashing stations with soap that were not available to the students before. She is working now on providing health care, including immunizations for the children. Teachers are reporting to Doka that children at the school are attending more and staying in school longer. Before the program, more than half dropped out. “I think the hot lunches may be helping,” Doka said. Doka said the experience brings her family in the U.S., Canada and Africa together. They have Zoom meetings weekly and keep in touch throughout the week with news about what is happening in Uganda, she said. “One thing I have realized is you do not need to have much to make a difference,” she said. “A donation of $100 dollars will feed the entire school for a day.”

Suzanne Barron, MSN, CRNP, Doka’s partner on the inpatient urology service, said that Doka has expressed a desire to give something back

One thing I realized is you do not need to have much to make a difference. Jefferson Urology

Department of Urology News Faculty and Staff Updates Congratulations to the following Urology team members on celebrating these Jefferson Service Milestones: Dr. Irvin Hirsch, Professor: 35 years Marlene Vallett, Practice Operations Manager: 35 years Dr. Perry Weiner, Associate Professor: 30 years Dr. Kenneth Brownstein, Director of Development: 20 years Seungeun Oh, Nurse Practitioner: 15 years Dr. Costas Lallas, Professor: 15 years Scott Bowes, Departmental Administrator: 10 Years Dr. Mark Mann, Assistant Professor: 5 years Kelley Lilly, Administrative Assistant: 5 years Raven Bell, Practice Representative: 5 years

Urology Family Updates Angelica Muniz-Alston – Baby Girl Dr. Chris Caputo & Danielle Squadrito– Baby Girl Christine & Mike Jenkins – Baby Girl Drs. Thenappan Chandrasekar & Ambika Chidambaram– Baby Boy Drs. Tricia and Lenny Gomella’s first grandchild- Baby Boy, courtesy of Dr. Patrick and Samantha Gomella Dr. Alex Uhr engagement to Elizabeth Berry with the wedding in the summer of 2021 Dr. Benjamin Rudnick marriage to Melissa Katz

Year in Review

Jefferson Urology Enterprise News Welcome Adam C. Messer, MPH Enterprise Vice President, Service Line Executive Cardiovascular, Surgical, and Perioperative Services Jefferson Health Adam Messer joined Jefferson Health in late 2019 as the Enterprise Vice President and Service Line Executive for Cardiovascular and Surgical Services. In dyad partnership with Dr. Leonard Gomella, Urology Service Line Clinical Director, Adam is responsible for the Urology Service Line across all of Jefferson’s hospitals and outpatient sites. In addition to Urology, Adam has responsibility for General Surgery, Otolaryngology, Anesthesia, and the ORs throughout Jefferson. This portfolio of responsibilities gives a unique opportunity to align synergies between our outpatient practice, hospitals, and departmental strategies. Adam attended The Ohio State University for undergraduate studies and received a Bachelor of Science in Biology and Molecular Genetics. In 2010, he received a Master in Public Health (MPH) from A.T. Still University of Health Sciences, a private medical school based in Kirksville, Missouri. Prior to joining Jefferson Health, Adam served as the Vice President for Operations and Service Lines at Temple University Health System. During his 5 years at Temple, Adam had responsibility for Surgical Services, Heart and Vascular Services, and Maternal Child Health. With a long list of accomplishments in academic healthcare, we are excited to have Adam as our partner in developing and implementing our strategic vision for urology not only at our center city campus but across the entire Jefferson Health Enterprise. His familiarity with academic health care in the Philadelphia region will serve us well.

Urology Faculty Contribute to a Classic Medical Textbook Drs. Paul Chung and Leonard Gomella were honored to be asked to contribute to one of the classic textbooks in all of medicine, Gray’s Anatomy. The 42nd edition was published in 2020 by Elsevier Clinical Solutions and edited by Professor Susan Standring, Emeritus Professor of Anatomy at King’s College, London. The current edition features a chapter on Bladder, Prostate and Urethra anatomy authored by Drs. Chung and Gomella. Gray’s Anatomy was first published in 1858 and has been continuously updated since that time. The book was originally written with an audience of medical students and physicians in mind, especially surgeons, and is considered a classic and the most authoritative text on the subject. (Note: Grey’s Anatomy was the TV show and not the book!)

Happy or Not? Improving Urology Patient Satisfaction The use of this kiosk system allows me, along with our clinical leadership team, to monitor in real time any issues that may impact the quality of our patients’ experiences.

A sample report generated from our HappyOrNot® kiosk. The significant negative response noted on Thursday was the morning after a major Philadelphia snowstorm. Kiosk provides immediate feedback. Patient satisfaction is important and increasingly used as an indicator for measuring quality in healthcare. Patient satisfaction can influence clinical outcomes, patient retention, and impact medical malpractice claims. These metrics are now being linked to financial reimbursement from Medicare and other insurers, and poor survey results could result in reduced reimbursements. As part of Hospital Value-Based Purchasing Program, the Centers for Medicare and Medicaid Services (CMS) is withholding 1% of Medicare payments, 30% of which are tied to H-Caps survey scores according to the American Medical Association Journal of Ethics (AMA J Ethics. 2015;17(7):616-621). The proportion of the payouts that is withheld from hospitals will undoubtedly increase over time. Since 2008, CMS has used the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. This is a series of 32 questions administered to a random sample of hospital patients about their care experience. HCAPS survey results are posted on the CMS “Hospital Compare” website. Our Jefferson Medical Group (JMG) currently relies on Press-Ganey Surveys to evaluate our outpatient experiences.

Concerns have been expressed about the validity and implementation of patient experience measures and surveys such as HCAPS and PressGaney. Patient experiences are based on patients’ expectations of care as opposed to objective measures of experience, and these perceptions may or may not correlate with technical quality of their care. These voluntary surveys are often long and are often administered weeks after the experience. Selection and recall bias may be present in the responses of those with very positive or very negative experiences.

allows me, along with our clinical leadership team, to monitor in real time any issues that may impact the quality of our patients’ experiences. The healthcare survey instruments are often mailed weeks after the patient office visit. Our kiosk system feedback is immediate allowing us to identify trends in performance and respond to issues impacting patient satisfaction. We look forward to using this feedback tool to positively impact our patients experience and ultimately impact our formal patient survey instruments.”

In our quest to assess patient satisfaction real time, we have placed a proprietary kiosk at the check-out area of our Center City outpatient urology office located at 33 S. 9th Street (833 Chestnut Building). The system is known as HappyOrNot® and consists of a feedback terminal for measuring customer satisfaction. The terminals consist of four smiley-faced buttons that customers are invited to press to indicate whether they are very happy, happy, unhappy or very unhappy with the service they received (www. happy-or-not.com/en/). The option for additional comments is also provided. These terminals are commonly seen in a variety of retail settings and have been used by the TSA in various airport security check points. While at the present time there is no documented prospective independent data these systems influence the perception of patient experience, we have so far found it a valuable tool in our practice. According to Marlene Vallett, Urology Practice Operations Manager, “Our Department is committed to providing our patients with the best experience possible. The use of this kiosk system

Marlene Vallett, Urology Practice Operations Manager, along with the HappyOrNot® kiosk in our Center City office.

Jefferson Urology

Department of Urology News Virtual House Staff Interviews The New Norm in 2020 Like most other programs in 2020, Jefferson Urology conducted its first-ever “virtual” resident’s recruiting and interview season. The first part of the process was announcing and then hosting several online open houses. Since applicants could not travel to site visit programs, the opportunity to experience the program through a video presentation and then interact with the resident’s real time in chat rooms was the next best thing. Dr. Alana Murphy, Associate Urology Residency Program Director, led this initial project. She first scripted and then produced a three-minute video to highlight our training program that featured several faculty and residents. The video is available on-line and can be viewed anytime at: www.jefferson.edu/university/jmc/ departments/urology. Our Department received nearly 400 applications for our residency three spots in the last cycle. Over two days in December 2020, we interviewed 36 candidates from across the US on the Zoom® video conferencing platform with each applicant receiving at least 4-5 interviews. Our Residency Program Director Dr. Patrick Shenot along with Associate Program Directors Dr. Murphy and Dr. Costas Lallas, did an amazing job sorting through the applications to arrive at such a highquality pool of resident candidates. Special thanks to Kelley Lilly who served as the unofficial “Zoom® air traffic controller” on interview day switching all the interviewees in and out of their respective interview sessions. The nationwide interview process was loosely governed by a set of standards distributed by the Society of Academic Urology (SAU) to insure fairness and consistency in this virtual process that was never fully tested before going mainstream. Based on the initial success of these virtual platforms, perhaps in the future some type of “hybrid” interview process where the efficiency and cost savings of the virtual interview can be enhanced by some type of in person experience. The Urology early match results were released on February 1, 2021. We are pleased to report that the following individuals will be starting the Urology residencies at Jefferson this summer: • Mauro Dispagna State University of New York Upstate Medical University • Zachary Prebay Medical College of Wisconsin • Sage Vincent Sidney Kimmel Medical College 42

Year in Review

Dr. Pat Shenot, Deputy Chair and Residency Program Director, presenting our training program on the open house video.

A clip from our Urology residency program open house video. Here our video producer, Dr. Alana Murphy, is shown reviewing a radiology image with PGY2 Resident Dr. Halle Foss and PGY4 Resident Dr. Edward Kloniecke.

Our open house video featured resident testimonials why they choose Jefferson for their Urology training. Here at PGY 2 Dr. Halle Foss and Chief Resident Dr. Thomas Hardacker.

Dr. Pat Shenot in a behind the scenes view of the Department of Urology open house video shoot.

Pediatric Urology Update Nemours/Alfred I DuPont Pediatric Urology Update 2020 Pediatric Urology Visiting Professor John S. Wiener, MD, FAAP, FACS

the senior resident on the Pediatric Service, Dr. Victor Kucherov (PGY-5), who served as master of ceremonies.

On October 14 and 15, 2020, the Division of Urology at the Nemours/Alfred I DuPont Hospital Children hosted the 2020 Pediatric Urology Visiting Professor and William L. Ferris Memorial Lectureship in Pediatric Urology in a virtual format.

On October 15, 2020, Dr. Wiener visited the Department of Urology at Jefferson, virtually, where he presented the lecture on “Men’s Health in Spina Bifida.” Dr. Wiener has extensive experience in the urological issues of spina bifida, having served on numerous committees on spina bifida, including the Coordinating Committee, Centers for Disease Control and Prevention National; the Spina Bifida Patient Registry Advisor; Urologic Protocol for Neurogenic Bladder in Newborns & Young Children with Spina Bifida Centers for Disease Control and Prevention; Congenitalism Task Force, Society for Pediatric Urology, where he served as Vice-Chair. He has been part of the Examination Committee American Board of Urology/American Urological Association.

This year’s visiting professor was Dr. John S. Wiener, Head, Section of Pediatric Urology and Professor of Surgery (Urologic Surgery) and Pediatrics at Duke University School of Medicine in Durham, North Carolina. On October 14, 2020, Dr. Wiener gave Pediatric Grand Rounds at Nemours, and his lecture was titled, “A Pediatric Urologist’s View of Spina Bifida.” The lecture was followed by a series of case presentations and discussions by the urology residents, ably led by

John S. Wiener, MD, FAAP, FACS, 2020 Pediatric Urology Visiting Professor

Welcome New Pediatric Urology Faculty Keara N. De Cotiis, MD Dr. Keara N. De Cotiis joined the Department of Urology as a pediatric urologist at Alfred I. DuPont Hospital for Children/Nemours in July 2020. Keara completed her undergraduate education at Villanova University and followed with her medical training at New Jersey Medical School in Newark, NJ. She then completed urology residency under Dr. Anthony Caldamone at Brown University. Next, she completed

her training with pediatric urology fellowship at the Hospital for Sick Children in Toronto, where she focused on pediatric urologic oncology and renal transplantation. She feels privileged to join such an outstanding group of urologists and is excited to return to the Philadelphia area.

Keara N. De Cotiis, MD is our newest faculty member in the Department of Urology.

AI DuPont Pediatric Urologists Pioneer InterStim™ in Children Sacral neuromodulation was first described in children 15 years ago but has lagged behind the adult population in regard to its widespread acceptance. While InterStim™ lacks formal FDA approval in patients under 16 years of age, it has been found to be an excellent option for children who struggle with chronic bladder and bowel issues. Nemours, as the only institution in the Delaware Valley implanting InterStim™ in the pediatric population, introduced this technology to patients in 2016. Pediatric Urologist, Jennifer Hagerty, DO, and Pediatric General Surgeon, Erin Teeple, MD have implanted more than 30 children as young as 4 years of age. The concept of neuromodulation involves implanting a neurostimulator with a lead that electrically stimulates the sacral nerve. Through this process, it is thought to normalize neural communication between the bladder and brain and between the bowel and brain and potentially treating both overactive and underactive bladders. Although many of the patients who go on to undergo this procedure are otherwise healthy children with overactive bladder, urinary retention, constipation and fecal incontinence, some have complex medical

conditions like cerebral palsy, mitochondrial cytopathy and anorectal malformations. These patients require extensive workups and trials of several other modalities prior to undergoing implantation. There is very limited data in the literature regarding a condition known as mitochondrial cytopathy in pediatrics and this has been an area of focus for Dr. Hagerty and her team. This particular subset of patients, in addition to their other complex debilitating medical conditions, often have the additional burden of severe dysfunctional elimination and bladder discomfort. They tend to wear diapers and do not consistently empty their bladders. Catheterization is typically very difficult in this sensate group of children. InterStim™ has allowed these children to avoid intermittent catherization and be dry giving them one less stressor in their complex lives. Dr. Patrick Shenot, Professor of Urology, has extensive experience in sacral neuromodulation and has collaborated with Dr. Hagerty in this area. “This approach to bladder dysfunction in adults has been a significant step forward in improving their quality of life. It is rewarding to see our pediatric colleagues at AI DuPont apply this technology to improve the lives of children who have benefitted from sacral neuro modulation with the InterStim™.”

Dr. Jennifer Hagerty is applying sacral neuromodulation techniques in pediatric urology.

Jefferson Urology

Books Department of Urology Books 2020 Over the last 10 years, Jefferson faculty have authored or edited more than 25 books in the field of Urology and on other medical topics. Recently the Department has been involved with several new book projects. These recent publications are presented below but first, a brief historical note about books and a famous quote by our University’s namesake:

I cannot live without books.

Thomas Jefferson

This iconic statement was made by Thomas Jefferson to John Adams in June 1815, shortly after the tenth and last wagon carrying his library left Monticello for Washington, D.C. Jefferson had sold his library to Congress to replace the congressional library that was destroyed when the British burned the United States Capitol on August 24, 1814. Congress, he felt, could not function without access to a proper reference library, so he promptly offered his own. His library collection numbered more than 6,500 volumes. It was the result of nearly 50 years of painstaking organization and meticulous selection from all of the principal book marts and publishing centers in Europe and America. (blog.monticelloshop.org/)

CHEMOTHERAPY AND IMMUNOTHERAPY IN UROLOGIC ONCOLOGY

1st edition. Trabulsi, Lallas and Calvaresi, Eds. (Springer International Publishing, New York 2020)

Drs. Ed Trabulsi, Costas Lallas and Anne Calvaresi teamed up to edit Chemotherapy and Immunotherapy In Urologic Oncology, a textbook geared toward Advanced Practice Providers (APP’s), which was released in the fall of 2020. This publication is based on a very successful American Urologic Association Office of Education course titled, “Chemotherapy and Immunotherapy in Urologic Oncology: A Guide for the Advanced Practice Provider.” This course has been given the last few years during the AUA annual meeting. Designed as a practical guide for APPs in the office management of urologic oncology patients, this text was written by authors drawn from Urology programs nationally and internationally. Each chapter paired a urologist with an APP as authors, and includes clinical pearls for the APP at the end of each chapter. The content spans all aspects of urologic oncology. Contributors also included several Sidney Kimmel Medical College faculty with the introduction to multidisciplinary urologic oncology care written by Dr. Gomella.

GOMELLA AND HAIST’S CLINICIAN’S POCKET REFERENCE 12th Edition. Gomella and Haist Eds. (McGraw-Hill, New York 2021)

The Clinician’s Pocket Reference was first published in 1979 with the mission of providing medical students, residents, practicing physicians, and other health care providers with the essential information and basics skills needed to provide excellence in patient care. It has served as a general reference book for generations of medical students and other health care providers starting their clinical rotations. The 12th Edition will be released in the spring of 2021 with contributors from across the United States, including many Sidney Kimmel Medical College faculty. According to Andrew Moyer, Senior Editor with the McGraw-Hill Professional publishing group, “It has been several years since the Clinician’s Pocket Reference was updated. Based on the continuing strong demand for the book, we are pleased that Drs. Gomella and Haist have agreed to prepare the 12th Edition. McGraw Hill has decided to rename the book, Gomella and Haist’s Clinicians Pocket Reference in honor of their long-standing editorial leadership of one of our most enduring medical student publications.” Dr. Steve Haist is Professor of Medicine and Associate Dean of the University of Kentucky College of Medicine-Northern Kentucky Campus.

ADVANCED URETEROSCOPY: TREATING DIFFICULT PROBLEMS

1st Edition. Hubosky, Grasso, Traxer, and Bagley (Springer International Publishing, New York) In Press 2021 The inspiration for this textbook to be published by Springer in the first half of 2021 was drawn from a yearly instructional course, by the same name, presented at the American Urologic Association national meeting. This course was initiated by Dr. Bagley in the mid-1990’s, has been continuously updated and is reliably attended at or close to full capacity on a regular basis. The current course faculty members include Jefferson Urology faculty members, Drs. Demetrius H. Bagley and Scott G. Hubosky, residency program alumnus Drs. Michael Grasso and Olivier Traxer of Hôpital Tenon in Paris, France. This comprehensive textbook will include sections on advanced ureteroscopic treatment of uretero-nephrolithiasis, upper urinary tract neoplasms and ureteral strictures. Updates on ureteroscope design and instrumentation will be included as well as complications and how to best avoid them. Although the intended audience will be attending endourologists, there will be sections on fundamental uretero-scopic maneuvering, how to attain difficult access and patient positioning. Contributing to the various chapters are many current and past Jefferson Urology residents and endourology fellows. This textbook will highlight the contributions to the advanced ureteroscopy in the Jefferson Urology tradition.

Year in Review

Department of Urology Publications 2020 Chandrasekar T, Goldberg H, Klaassen Z, Wallis CJD, Leong JY, Liem S, Teplitsky S, Noorani R, Loeb S. et al. Twitter and Academic Urology in the United States and Canada: A Comprehensive Assessment of the Twitterverse in 2019. BJU Int. 2020 Jan;125(1):173-181. Gomella LG. Comparison of Transrectal Ultrasound Biopsy to Transperineal Template Mapping Biopsies Stratified by Multiparametric Magnetic Resonance Imaging Score in the PROMIS Trial. Practice Update website. Available at: https://www.practiceupdate. com/content/transrectal-ultrasound-biopsy-vstransperineal-template-mapping-biopsies-stratified-bympmri-score/94321/65/3/1. Accessed January 10, 2020 McCann JJ, Vasilevskaya IA, Poudel Neupane N, Shafi AA, McNair C, Dylgjeri E, Mandigo AC, Schiewer MJ, Schrecengost RS, Gallagher P, Stanek TJ, McMahon SB, Berman-Booty LD, Ostrander WF Jr, Knudsen KE. USP22 Functions as an Oncogenic Driver in Prostate Cancer by Regulating Cell Proliferation and DNA Repair. Cancer Res. 2020 Feb 1;80(3):430-443. Hoffman-Censits J, Choi W, Pal S, Trabulsi E, Kelly WK, Hahn NM, McConkey D, Comperat E, Matoso A, Cussenot O, Cancel-Tassin G, Fong MHY, Ross J, Madison R, Ali S. Urothelial Cancers with Small Cell Variant Histology Have Confirmed High Tumor Mutational Burden, Frequent TP53 and RB Mutations, and a Unique Gene Expression Profile. Eur Urol Oncol. 2020 Feb 12. [Epub ahead of print] PMID: 32061548. Meltzer, AC, Burrows PK, Kirkali Z, Hollander JE, Kurz M, Mufarrij P, Wolfson AB, MacPherson C, Hubosky SG, Montano N, Jackman SV. Accuracy of Patient Reported Stone Passage for Patients with Acute Renal Colic Treated in the Emergency Department. Urology 2020 Feb; 136:70-74. Leong JY, Chung PH. A Primer on Extramammary Paget’s Disease for the Urologist. Transl Androl Urol. 2020 Feb;9(1):93-105. Leong JY, Teplitsky S, Han TM, Shah M, Chandrasekar T, Mann M. Parapelvic Dystrophic Calcification as a Result of Mitomycin C Extravasation. Urology. 2020 Feb;136:e34-e36. Chandrasekar T, Han TM, Glick L, Leong JY, Teplitsky S, Noorani R, Goldberg H, Klaassen Z, Wallis CJD, Mark JR, Trabulsi EJ, Lallas CD, Gomella LG. Setting the Standards: Examining Research Productivity Among Academic Urologists in the USA and Canada in 2019. Eur Urol Focus. 2020 Feb 26:S24054569(20)30058-4. Glick L, Xu H, Han TM, HooKim K, Vogel A, Lallas CD. Castleman Disease: An Uncommon Mass in the Retroperitoneum. Urology. 2020 Feb;136:e12-e15. Gomella LG. Boosting Free Testosterone With OTC Natural Supplements: Be Careful What You Wish For. Can J Urol. 2020 Feb;27(1):10067. PMID: 32065859. Mann M, Calio BP, Mark JR, Chelluri R, Hufnagel E, Reese A, Lallas CD, Trabulsi EJ, Chandrasekar T, Shenot PJ, Halpern E, Gomella LG. Hospital-specific Antibiograms and Antibiotic Prophylaxis for Prostate Biopsies: A Reexamination of AUA Recommendations. Can J Urol. 2020 Feb;27(1):10099-10104. Goldberg H, Spratt D, Chandrasekar T, Klaassen Z, Wallis CJD, Santiago-Jimenez M, Fishbane N, Davicioni E, Noorani R, Ahmad AE, Herrera Cáceres JO, Alibhai S, Berlin A, Fleshner NE. Clinical-genomic Characterization Unveils More Aggressive Disease Features in Elderly Prostate Cancer Patients with Low-grade Disease. Eur Urol Focus. 2020 Mar 7:S24054569(20)30065-1. Leong JY, Herrera-Caceres JO, Goldberg H, Tham E, Teplitsky S, Gomella LG, Trabulsi EJ, Lallas CD, Fleshner NE, Tilki D, Chandrasekar T. Questioning the Status Quo: Should Gleason Grade Group 1 Prostate

Cancer be Considered a “Negative Core” in Pre-Radical Prostatectomy Risk Nomograms? An International Multicenter Analysis. Urology. 2020 Mar;137:102-107. Leong JY, Capella C, Teplitsky S, Gomella LG, Trabulsi EJ, Lallas CD, Chandrasekar T. Impact of Tumor Regional Involvement on Active Surveillance Outcomes: Validation of the Cumulative Cancer Location Metric in a United States Population. Eur Urol Focus. 2020 Mar 15;6(2):235-241. Tilki D, Chandrasekar T. Localized Prostate Cancer: Exploring the Boundaries of Current Treatment Paradigms. Eur Urol Focus. 2020 Mar 15;6(2):199-200. Gore JL, du Plessis M, Zhang J, Dai D, Thompson DJS, Karsh L, Lane B, Franks M, Chen DYT, Bianco FJ Jr, Brown G, Clark W, Kibel AS, Kim H, Lowrance W, Manoharan M, Maroni P, Perrapato S, Sieber P, Trabulsi EJ, Waterhouse R, Spratt DE, Davicioni E, Lotan Y, Lin DW. Clinical Utility of a Genomic Classifier in Men Undergoing Radical Prostatectomy: The PRO-IMPACT Trial. Pract Radiat Oncol. 2020 Mar-Apr;10(2):e82-e90. Trabulsi EJ, Rumble RB, Vargas HA. Optimum Imaging Strategies for Advanced Prostate Cancer: ASCO Guideline Summary. JCO Oncol Pract. 2020 Apr;16(4):170-176. PMID: 32048940. Yazdi H, Restrepo C, Foltz C, Hammad M, Chung PH, Gomella LG, Parvizi J. Symptomatic Benign Prostatic Hyperplasia: A Risk Factor for Periprosthetic Joint Infection in Male Patients. J Bone Joint Surg Am. 2020 Apr 1;102(7):543-549. Lin J, Den RB, Greenspan J, Showalter TN, HoffmanCensits JH, Lallas CD, Trabulsi EJ, Gomella LG, Hurwitz MD, Leiby B, Dicker AP, Kelly WK. Phase I Trial of Weekly Cabazitaxel with Concurrent Intensity Modulated Radiation and Androgen Deprivation Therapy for the Treatment of High-Risk Prostate Cancer. Int J Radiat Oncol Biol Phys. 2020 Apr 1;106(5):939-947. Margulis V, Puligandla M, Trabulsi EJ, Plimack ER, Kessler ER, Matin SF, Godoy G, Alva A, Hahn NM, Carducci MA, Hoffman-Censits J; Collaborators. Phase II Trial of Neoadjuvant Systemic Chemotherapy Followed by Extirpative Surgery in Patients with High Grade Upper Tract Urothelial Carcinoma. J Urol. 2020 Apr;203(4):690-698. Margulis V, Puligandla M, Trabulsi EJ, Plimack ER, Kessler ER, Matin SF, Godoy G, Alva A, Hahn NM, Carducci MA, Hoffman-Censits J; Collaborators. Reply by Authors. J Urol. 2020 Apr;203(4):697-698. Teplitsky S, Perez T, Leong JY, Xie K, Murphy A, Shenot PJ. Industry Payments to Female Pelvic Medicine and Reconstructive Surgeons: An Analysis of Sunshine Act Open Payments from 2014-2017. Int Urogynecol J. 2020 Apr;31(4):799-807. Capella CE, Chandrasekar T, Counsilman M, Sebastiano C, Lallas CD, Al-Kouatly HB. Robotic Adrenalectomy for Functional Adenoma in Second Trimester Treats Worsening Hypertension. Urology. 2020 Apr 30:S0090-4295(20)30498-2. Herrera-Caceres JO, Nason GJ, Salgado-Sanmamed N, Goldberg H, Woon DTS, Chandrasekar T, Ajib K, Tan GH, Alhunaidi O, van der Kwast T, Finelli A, Zlotta AR, Hamilton RJ, Berlin A, Perlis N, Fleshner NE. Salvage Radical Prostatectomy following Focal Therapy: Functional and Oncological Outcomes. BJU Int. 2020 Apr;125(4):525-530. Merrill SB, Sohl BS, Thompson RH, Reese AC, Parekh DJ, Lynch JH, Grob BM, Williams DH, Lee RK, Zaslau S, Guzzo TJ, Shenot PJ, Lehman EB, Raman JD. The Balance between Open and Robotic Training among Graduating Urology Residents-Does Surgical Technique Need Monitoring? J Urol. 2020 May;203(5):996-1002.

Capella CE, Godovchik J, Chandrasekar T, Al-Kouatly HB. Nonobstetrical Robotic-Assisted Laparoscopic Surgery in Pregnancy: A Systematic Literature Review. Urology. 2020 May 20:S0090-4295(20)30568-9. Leong JY, Steward JE, Healy KA, Hubosky SG, Bagley DH. Indwelling Ureteric Stents: Patterns of Use and Nomenclature. Arab Journal of Urology 2020 May 19; 18(4): 241-246. PMID: 33312735 Carceles-Cordon M, Kelly WK, Gomella L, Knudsen KE, Rodriguez-Bravo V, Domingo-Domenech J. Cellular rewiring in lethal prostate cancer: the architect of drug resistance. Nat Rev Urol. 2020 May;17(5):292307. Leong JY, Chandrasekar T, Berlin A, Klaassen Z, Wallis CJ, Ahmad AE, Herrera-Caceres JO, Perlis N, Fleshner NE, Goldberg H. Predictors of Prostate-specific Antigen Testing in Men Aged ≥55 years: A Cross-sectional Study Based on Patient-reported Outcomes. Int J Urol. 2020 May 31. doi: 10.1111/iju.14276. Epub ahead of print. Den RB, Greenspan J, Doyle LA, Harrison AS, Peng C, Williams NL, Lallas CD, Trabulsi EJ, Gomella LG, Hurwitz MD, Leiby B, Dicker AP. A Phase IB Clinical Trial of 15 Gy HDR Brachytherapy followed by Hypofractionated/SBRT in the Management of Intermediate-risk Prostate Cancer. Brachytherapy. 2020 May-Jun;19(3):282-289. Teplitsky SL, Leong JY, Shenot PJ. Iatrogenic Bladder Rupture in Individuals with Disability Related to Spinal Cord Injury and Chronic Indwelling Urethral Catheters. Spinal Cord Ser Cases. 2020 Jun 8;6(1):47. Gomella LG. Burnout in Urology and the Hidden Workplace Dangers. Can J Urol. 2020 Jun;27(3):1019910200. Trabulsi EJ, Rumble RB, Jadvar H, Hope T, Pomper M, Turkbey B, Rosenkrantz AB, Verma S, Margolis DJ, Froemming A, Oto A, Purysko A, Milowsky MI, Schlemmer HP, Eiber M, Morris MJ, Choyke PL, Padhani A, Oldan J, Fanti S, Jain S, Pinto PA, Keegan KA, Porter CR, Coleman JA, Bauman GS, Jani AB, Kamradt JM, Sholes W, Vargas HA. Optimum Imaging Strategies for Advanced Prostate Cancer: ASCO Guideline. J Clin Oncol. 2020 Jun 10;38(17):1963-1996. PMID: 31940221. Kleinmann N, Matin SF, Pierorazio PM, Gore JL, Shabsigh A, Hu B, Chamie K, Godoy G, Hubosky SG, Rivera M, O’Donnell M, Quek M, Raman JD, Knoedler JJ, Scherr D, Stern J, Weight C, Weizer A, Woods M, Kaimakliotis H, Smith AB, Linehan J, Coleman J, Humphreys MR, Pak R, Lifshitz D, Verni M, Abidi M, Amin MB, Seltzer E, Klein I, Konorty M, StraussAyali D, Hakim G, Schoenberg M, Lerner SP. Primary Chemoablation of Low-grade Upper Tract Urothelial Carcinoma using UGN-101, a Mitomycin-containing Reverse Thermal Gel (OLYMPUS): An Open-label, Single-arm, Phase 3 Trial. Lancet Oncology 2020 Jun; 21 (6): 776-785. Marascio J, Spratt DE, Zhang J, Trabulsi EJ, Le T, Sedzorme WS, Beeler WH, Davicioni E, Dabbas B, Lin DW, Gore JL, Bloom M, Mann M, Mark JR, Calvaresi A, Godwin JL, McCue P, Hurwitz MD, Kelly WK, Lallas CD, Knudsen KE, Gomella LG, Dicker AP, Den RB. Prospective Study to Define the Clinical Utility and Benefit of Decipher Testing in Men following Prostatectomy. Prostate Cancer Prostatic Dis. 2020 Jun;23(2):295-302. Chandrasekar T, Glick L, Wong D, Han TM, Leong JY, Yi M, Mark JR, Mann MJ, Trabulsi EJ, Lallas CD. Simple Frameshifts in Minimally Invasive Surgery Postoperative Pain Management Significantly Reduce Opiate Prescriptions. Can J Urol. 2020 Jun;27(3):1025010256. Goldberg H, Ajaj R, Cáceres JOH, Berlin A, Chandrasekar T, Klaassen Z, Wallis CJD, Ahmad AE,

Jefferson Urology

Department of Urology Publications 2020 (continued) Leao R, Petrella AR, Kachura JR, Fleshner N, Matthew A, Finelli A, Jewett MAS, Hamilton RJ. Psychological Distress Associated with Active Surveillance in Patients Younger than 70 with a Small Renal Mass. Urol Oncol. 2020 Jun;38(6):603.e17-603.e25. Chandrasekar T, Gross L, Gomella LG, Hegarty SE, Leong JY, Giri VN. Prevalence of Suspected Hereditary Cancer Syndromes and Germline Mutations Among a Diverse Cohort of Probands Reporting a Family History of Prostate Cancer: Toward Informing Cascade Testing for Men. Eur Urol Oncol. 2020 Jun;3(3):291-297. Goldberg H, Ahmad AE, Chandrasekar T, Klotz L, Emberton M, Haider MA, Taneja SS, Arora K, Fleshner N, Finelli A, Perlis N, Tyson MD, Klaassen Z, Wallis CJD. Comparison of Magnetic Resonance Imaging and Transrectal Ultrasound Informed Prostate Biopsy for Prostate Cancer Diagnosis in Biopsy Naïve Men: A Systematic Review and Meta-Analysis. J Urol. 2020 Jun; 203(6):1085-1093. Goldberg H, Ahmad AE, Chandrasekar T, Klotz L, Emberton M, Haider MA, Taneja SS, Arora K, Fleshner N, Finelli A, Perlis N, Tyson MD, Klaassen Z, Wallis CJD. Reply by Authors. J Urol. 2020 Jun;203(6):1093. Capella C, Schlegel L, Shenot P, Murphy A. Female Representation at High-profile Urology Conferences, 2014-2019: A Leadership Metric. Urology. 2020 Jun 5:S0090-4295(20)30644-0. Goldberg H, Mohsin FK, Saskin R, Kulkarni GS, Berlin A, Kenk M, Wallis CJD, Klaassen Z, Chandrasekar T, Ahmad AE, Sayyid RK, Saarela O, Penn L, Alibhai SMH, Fleshner N. The Suggested Unique Association Between the Various Statin Subgroups and Prostate Cancer. Eur Urol Focus. 2020 Jun 30:S24054569(20)30163-2. Eisenbrey JR, Kamaya A, Gummadi S, Bird K, Burrowes D, Arias D, Lallas CD, Trabulsi EJ, Lyshchik A. Effects of Contrast-Enhanced Ultrasound of Indeterminate Renal Masses on Patient Clinical Management: Retrospective Analysis from Two Institutions. J Ultrasound Med. 2020 Jul 13. doi: 10.1002/jum.15383. Epub ahead of print. PMID: 32657452. Lee DJ, Talwar R, Ding J, Chandrasekar T, Syed K, Fonshell C, Danella J, Ginzburg S, Lanchoney T, Tomaszewski J, Trabulsi E, Reese A, Smaldone M, Uzzo R, Raman JD, Guzzo TJ. Stakeholder Perspective on Opioid Stewardship After Prostatectomy: Evaluating Barriers and Facilitators From the Pennsylvania Urology Regional Collaborative. Urology. 2020 Jul 22:S0090-4295(20)30857-8. Epub ahead of print.

after Radical Prostatectomy is Associated with Poorer Outcomes: A Validation Study Using Prospectively Collected Biobank Specimens. J Urol. 2020 Aug;204(2):289-295. Giri VN, Knudsen KE, Kelly WK, Cheng HH, Cooney KA, Cookson MS, Dahut W, Weissman S, Soule HR, Petrylak DP, Dicker AP, AlDubayan SH, Toland AE, Pritchard CC, Pettaway CA, Daly MB, Mohler JL, Parsons JK, Carroll PR, Pilarski R, Blanco A, Woodson A, Rahm A, Taplin ME, Polascik TJ, Helfand BT, Hyatt C, Morgans AK, Feng F, Mullane M, Powers J, Concepcion R, Lin DW, Wender R, Mark JR, Costello A, Burnett AL, Sartor O, Isaacs WB, Xu J, Weitzel J, Andriole GL, Beltran H, Briganti A, Byrne L, Calvaresi A, Chandrasekar T, Chen DYT, Den RB, Dobi A, Crawford ED, Eastham J, Eggener S, Freedman ML, Garnick M, Gomella PT, Handley N, Hurwitz MD, Izes J, Karnes RJ, Lallas C, Languino L, Loeb S, Lopez AM, Loughlin KR, Lu-Yao G, Malkowicz SB, Mann M, Mille P, Miner MM, Morgan T, Moreno J, Mucci L, Myers RE, Nielsen SM, O’Neil B, Pinover W, Pinto P, Poage W, Raj GV, Rebbeck TR, Ryan C, Sandler H, Schiewer M, Scott EMD, Szymaniak B, Tester W, Trabulsi EJ, Vapiwala N, Yu EY, Zeigler-Johnson C, Gomella LG. Implementation of Germline Testing for Prostate Cancer: Philadelphia Prostate Cancer Consensus Conference 2019. J Clin Oncol. 2020 Aug 20;38(24):2798-2811. Leong JY, Clark CB, Syed A, Hubosky SG. Palliative Endoscopic Treatment of Metastatic Uveal Melanoma to the Upper and Lower Urinary Tract. Urology. 2020 Aug;142:e49-e51. Smentkowski KE, Bagley DH, Hubosky SG. Ureteroscopic Biopsy of Upper Tract Urothelial Carcinoma and Role of Urinary Biomarkers. Transl Androl Urol. 2020 Aug;9(4):1809-1814. Murphy AM, Shenot PJ, Lallas CD. Faculty Development: How Do We Encourage Faculty to Become Better Teachers and Mentors? Curr Urol Rep. 2020 Aug 18;21(10):40. Das AK, Han TM, Uhr A, Roehrborn CG. Benign Prostatic Hyperplasia: An Update on Minimally Invasive Therapy including Aquablation. Can J Urol. 2020 Aug;27(S3):2-10. Weiner PR, Salib A. Developing a Men’s Health Program. Can J Urol. 2020 Aug;27(S3):51-53. Chung PH, Han TM, Rudnik B, Das AK. Peyronie’s Disease: What Do We Know and How Do We Treat It? Can J Urol. 2020 Aug;27(S3):11-19.

Talwar R, Friel B, Mittal S, Xia L, Fonshell C, Danella J, Jacobs B, Lanchoney T, Raman J, Tomaszewski J, Trabulsi E, Reese A, Singer EA, Ginzburg S, Smaldone M, Uzzo R, Mucksavage P, Guzzo TJ, Lee DJ. Concordance of Confirmatory Prostate Biopsy in Active Surveillance with National Guidelines: An Analysis from the Multi-institutional PURC Cohort. Urol Oncol. 2020 Jul 29:S1078-1439(20)30330-6. Online ahead of print. PMID: 32739228

Das AK, Kucherov V, Glick L, Chung P. Male Urinary Incontinence after Prostate Disease Treatment. Can J Urol. 2020 Aug;27(S3):36-43

Das AK, Teplitsky S, Chandrasekar T, Perez T, Guo J, Leong JY, Shenot PJ. Stress Urinary Incontinence post-Holmium Laser Enucleation of the Prostate: A Single-Surgeon Experience. Int Braz J Urol. 2020 JulAug;46(4):624-631.

Gomella LG. Utility of Multiparametric Magnetic Resonance Imaging in the Risk Stratification of Men with Grade Group 1 Prostate Cancer on Active Surveillance. PracticeUpdate website. Available at: https://www.practiceupdate.com/ content/multiparametric-mri-for-risk-stratificationof-men-with-prostate-cancer-on-activesurveillance/101954/65/3/1. Accessed August 18, 2020

Salib A, Rudnick B, Murphy A. Vesicoureteral Reflux in Adults with Urinary Tract Infections: Is There a Role for Treatment? Curr Urol Rep. 2020 Aug 12;21(10):35. Chandrasekar T. Editorial Comment. J Urol. 2020 Aug;204(2):301-302. Woon DTS, Herrera-Cáceres JO, Goldberg H, Shiakh H, Whelan E, Nason G, Ajib K, Tan GH, Chandrasekar T, Alhunaidi O, Finelli A, Zlotta A, Berlin A, Diamantis E, Fleshner N. A High Percent Free Prostate Specific Antigen in the Setting of Biochemical Recurrence

Year in Review

Das AK, Han TM, Hardacker TJ. Holmium Laser Enucleation of the Prostate (HoLEP): Sizeindependent Gold Standard for Surgical Management of Benign Prostatic Hyperplasia. Can J Urol. 2020 Aug;27(S3):44-50.

Uhr A, Glick L, Gomella LG. An Overview of Biomarkers in the Diagnosis and Management of Prostate Cancer. Can J Urol. 2020 Aug;27(S3):24-27. Gomella, LG Treatment alternatives to radical cystectomy for bladder cancer continue to evolve Urology Times August, 2020

Miron B, Hoffman-Censits JH, Anari F, O’Neill J, Geynisman DM, Zibelman MR, Kutikov A, Viterbo R, Greenberg RE, Chen D, Lallas CD, Trabulsi EJ, Alpaugh RK, Dulaimi E, Golemis EA, Uzzo R, Ross EA, Plimack ER. Defects in DNA Repair Genes Confer Improved Long-term Survival after Cisplatin-based Neoadjuvant Chemotherapy for Muscle-invasive Bladder Cancer. Eur Urol Oncol. 2020. Aug; 3(4): 544547. PMID: 32165095 Isguven S, Chung PH, Machado P, Delaney LJ, Chen AF, Forsberg F, Hickok NJ. Minimizing Penile Prosthesis Implant Infection: What Can We Learn from Orthopaedic Surgery? Urology. 2020 Sep 26:S00904295(20)31174-2. Epub ahead of print. Goldberg H, Glicksman R, Woon D, Hoffman A, Shaikh H, Chandrasekar T, Klaassen Z, Wallis CJD, Ahmad AE, Sanmamed-Salgado N, Qu X, Moraes FY, Diamandis EP, Berlin A, Fleshner NE. Can Posttreatment Free PSA Ratio be Used to Predict Adverse Outcomes in Recurrent Prostate Cancer? BJU Int. 2020 Sep 14. doi: 10.1111/bju.15236. Epub ahead of print. Thederan I, Chandrasekar T, Tennstedt P, Kuehl L, Sorbe C, Tilki D, Augustin M, Heinzer H, Zyriax BC. Poor Adherence to International Cancer Prevention Recommendations Among Patients With Prostate Cancer: First Results From the MARTINI-Lifestyle Cohort. Eur Urol Focus. 2020 Sep 15;6(5):935-940. Goldberg H, Mohsin FK, Berlin A, Chandrasekar T, Wallis CJD, Klaassen Z, Ahmad AE, Saskin R, Kenk M, Saarela O, Kulkarni GS, Alibhai SMH, Fleshner N.The Suggested Chemopreventive Association of Metformin with Prostate Cancer in Diabetic Patients. Urol Oncol. 2020 Sep 17:S1078-1439(20)30401-4. . Herrera-Caceres JO, Wettstein MS, Goldberg H, Toi A, Chandrasekar T, Woon DTS, Ahmad AE, Sanmamed-Salgado N, Alhunaidi O, Ajib K, Nason G, Tan GH, Fleshner N, Klotz L. Utility of Digital Rectal Examination in a Population with Prostate Cancer Treated with Active Surveillance. Can Urol Assoc J. 2020 Sep;14(9):E453-E457. Teplitsky S, Leong JY, Calio BP, Hubosky SG, Bagley D. Ergonomics in Endourology: Measurement of Force for Deflection in Contemporary Ureteroscopes. J Endourol. 2020 Sep 30. doi: 10.1089/end.2020.0369. Epub ahead of print. PMID: 32993396. Scotland K, Wong VKF, Chan JYH, Tawfiek E, Chiura A, Chew BH, Bagley D. Evaluation of a Single-Use Flexible Cystoscope: A Multi-Institutional International Study. J Endourol. 2020 Sep;34(9):981-986. PMID: 32578453. Ajaj R, Cáceres JOH, Berlin A, Wallis CJD, Chandrasekar T, Klaassen Z, Ahmad AE, Leao R, Finelli A, Fleshner N, Goldberg H. Gender-based Psychological and Physical Distress Differences in Patients Diagnosed with Non-metastatic Renal Cell Carcinoma. World J Urol. 2020 Oct; 38(10):2547-2554. Hird AE, Magee DE, Bhindi B, Ye XY, Chandrasekar T, Goldberg H, Klotz L, Fleshner N, Satkunasivam R, Klaassen Z, Wallis CJD. A Systematic Review and Network Meta-analysis of Novel Androgen Receptor Inhibitors in Non-metastatic Castration-resistant Prostate Cancer. Clin Genitourin Cancer 2020 Oct;18(5):343-350. Chung PH, Leong JY, Teplitsky S, Shenot PJ, Das AK, Gomella LG. Next-generation DNA Sequencing for Infected Genitourinary Implants: How I Do It. Can J Urol. 2020 Oct;27(5):10418-10423. Chung PH, Spigner S, Swaminathan V, Teplitsky S, Frasso R. Perspectives and Experiences of Transgender and Non-binary Individuals on Seeking Urological Care. Urology. 2020 Oct 28:S0090-4295(20)31297-8. doi: 10.1016/j.urology.2020.10.026. Epub ahead of print. PMID: 33129873.

Woo J, Santasusagna S, Banks J, Pastor-Lopez S, Yadav K, Carceles-Cordon M, Dominguez-Andres A, Den RB, Languino LR, Pippa R, Lallas CD, Lu-Yao G, Kelly WK, Knudsen KE, Rodriguez-Bravo V, Tewari AK, Prats JM, Leiby BE, Gomella LG, Domingo-Domenech J. Urine Extracellular Vesicle GATA2 mRNA Discriminates Biopsy Result in Men with Suspicion of Prostate Cancer. J Urol. 2020 Oct;204(4):691-700.

Hoffman-Censits J, Choi W, Bivalacqua TJ, Pierorazio P, Kates M, Lombardo K, Parini V, McConkey D, Trabulsi EJ, Hahn N, Matoso A. Small Cell Bladder Cancer Response to Second-line and Beyond Checkpoint Inhibitor Therapy: Retrospective Experience. Clin Genitourin Cancer. 2020 Nov 12:S1558-7673(20)302512. doi: 10.1016/j.clgc.2020.10.009. Epub ahead of print. PMID: 33358150.

Leong JY, Wessner CE, Kramer MR, Forsberg F, Halpern EJ, Lyshchik A, Torkzaban M, Morris A, Byrne K, VanMeter M, Trabulsi EJ, Lallas CD, Eisenbrey JR. Superb Microvascular Imaging Improves Detection of Vascularity in Indeterminate Renal Masses. J Ultrasound Med. 2020 Oct;39(10):1947-1955.

Gomella LG. Pain in Men Undergoing Transperineal Free-Hand Multiparametric Magnetic Resonance Imaging Fusion-Targeted Biopsies Under Local Anesthesia: Outcomes and Predictors From a Multicenter Study of 1,008 Patients. PracticeUpdate website. Available at: www.practiceupdate.com/content/ pain-in-men-undergoing-transperineal-free-handmultiparametric-mri-fusion-targeted-biopsies-underlocal-anesthesia/109599/65/3/1. Accessed December 02, 2020.

Antonarakis ES, Gomella LG, Petrylak DP. When and How to Use PARP Inhibitors in Prostate Cancer: A Systematic Review of the Literature with an Update on On-Going Trials. Eur Urol Oncol. 2020 Oct;3(5):594611. Crawford ED, Andriole G, Freedland SJ, Garnick M, Gomella LG, Henderson J, Higano CT, Kader AK, Kane C, Keane TE, Koo PJ, Petrylak DP, Reiter RE, Slovin SF, Yu EY. Evolving Understanding and Categorization of Prostate Cancer: Preventing Progression to Metastatic Castration-resistant Prostate Cancer: RADAR IV. Can J Urol. 2020 Oct; 27(5):10352-10362. Gomella LG. Editorial. COVID-19 and The Prostate Cancer Connection. Can J Urol. 2020 Oct; 27(5): 10346. Shenot PJ, Teplitsky S, Margules A, Miller A, Das AK. Urinary Undiversion by Conversion of the Incontinent Ileovesicostomy to Augmentation Ileocystoplasty in Spinal Cord Injured Patients. J Spinal Cord Med. 2020 Oct 15:1-8. doi: 10.1080/10790268.2020.1829420. Epub ahead of print. PMID: 33054669. Goldberg H, Noorani R, Benton JZ, Lodh A, Berlin A, Chandrasekar T, Wallis CJD, Ahmad AE, Klaassen Z, Fleshner NE. Is There an Association between a History of Military Service and Cancer Diagnosis? Results from a US National-level Study of Self-reported Outcomes. Cancer Causes Control. 2020 Oct 16. doi: 10.1007/ s10552-020-01355-4. Epub ahead of print. PMID: 33064242. Scotland KB, Hubbard L, Cason D, Banks J, Leong JY, Healy K, Leiby B, Hubosky SG, Bagley DH. Long Term Outcomes of Ureteroscopic Management of Upper Tract Urothelial Carcinoma. Urol Oncol. 2020 Nov; 38(11): 850.e17-850.e26. PMID: 32773230 Chung PH, Gross JA, Robinson JD, Hagedorn JC. CT Volumetric Measurements Correlate with Split Renal Function in Renal Trauma. Int Urol Nephrol. 2020 Nov; 52(11): 2107-2111. PMID: 32519239. Gómez Rivas J, Carrion DM, Chandrasekar T, ÁlvarezMaestro M, Enikeev D, Martínez-Piñeiro L, Barret E. The role of multiparametric magnetic resonance imaging in the selection and follow-up of patients undergoing active surveillance for prostate cancer. An European Section of Uro-Technology (ESUT) review. Actas Urol Esp. 2020 Nov 11:S0210-4806(20)30235-7. English, Spanish. doi: 10.1016/j.acuro.2020.04.011. Epub ahead of print. PMID: 33189417. Boorjian SA, Alemozaffar M, Konety BR, Shore ND, Gomella LG, Kamat AM, Bivalacqua TJ, Montgomery JS, Lerner SP, Busby JE, Poch M, Crispen PI, Steinberg GD, Schuckman AK, Downs TM, Svatek RS, Mashni J, Lane BR, Guzzo TJ, Bratslavsky G, Karsh LI, Woods ME, Brown G, Canter D, Luchey A, Lotan Y, Krupski T, Inman BA, Williams MB, Cookson MS, Keegan KA, Andriole GL, Sankin AI, Boyd A, O’Donnell MA, Sawutz D, Philipson R, Coll R, Narayan VM, Treasure FP, Yla-Herttuala S, Parker NR, Dinney CPN. Intravesical Nadofaragene Firadenovec Gene Therapy for BCG-unresponsive Non-muscle-invasive Bladder Cancer: A Single-arm, Open-label, Repeat-dose Clinical Trial. Lancet Oncology. Nov 27, 2020 doi.org/10.1016/ S1470-2045(20)30540-4. Online ahead of print. PMID: 33253641

Gomella LG: Editorial. “Send Me a Picture of your Urine”: Telemedicine in Urology. Can J Urol 2020, December; 27(6): 10424-10425. Glick L, Chandrasekar T, Hubosky SG, Teplitsky S, Shah M, Leong JY, Ouma G, Mark JR. How I Do It: Anticoagulation Management for Common Urologic Procedures. Can J Urol 2020 Dec; 27(6): 10480-10487. Goldberg H, Mohsin FK, Saskin R, Kulkarni GS, Berlin A, Kenk M, Wallis CJD, Chandrasekar T, Klaassen Z, Saarela O, Penn L, Alibhai SMH, Fleshner N. The deleterious association between proton pump inhibitors and prostate cancer-specific mortality - a populationbased cohort study. Prostate Cancer Prostatic Dis. 2020 Dec;23(4):622-629. PMID: 32641738. Isguven S, Chung PH, Machado P, Delaney LJ, Chen AF, Forsberg F, Hickok NJ. Minimizing Penile Prosthesis Implant Infection: What Can We Learn From Orthopedic Surgery? Urology. 2020 Dec;146:6-14. PMID: 32991908 Handley NR, Feng FY, Guise TA, D’Andrea D, Kelly WK, Gomella LG. Preserving Well-being in Patients With Advanced and Late Prostate Cancer. Urology. 2020 Dec 26:S0090-4295(20)31513-2. doi: 10.1016/j. urology.2020.12.018. Online ahead of print BOOK CHAPTERS Counsilman MJ, Das AK, Chapter Author: Urinary Tract Infections in Females. In: Williams and Wilkins The 5 Minute Clinical Consult, 2020 Edition, Domino FJ, Editor, Lippincott Williams and Wilkins, Baltimore, MD 2020. Trabulsi EJ, Halpern EJ, Gomella LG. Prostate Biopsy: Techniques and Imaging. In: Campbell-Walsh Urology. 12th Edition, AJ Wein et al. (Editors) Elsevier: Philadelphia, PA, 2020.

Gomella LG. Introduction: Integration of APP into Urologic Oncology Practice. In Chemotherapy and Immunotherapy in Urologic Oncology: A Guide for the Advanced Practice Provider, Trabulsi EJ, Lallas CD, Calvaresi,AE, (Eds) Springer Nature. Oct.2020. Pg 1-3. Izes JK, McBride, TP. Overview and Active Surveillance of Prostate Cancer. In Chemotherapy and Immunotherapy in Urologic Oncology: A Guide for the Advanced Practice Provider, Trabulsi EJ, Lallas CD, Calvaresi, AE, (Eds) Springer Nature. October 2020. Pgs. 7-19. Barron S, Mann MJ: Immunotherapy and Novel Agents on the Horizon for the Treatment of Prostate Cancer. In Chemotherapy and Immunotherapy in Urologic Oncology: A Guide for the Advanced Practice Provider, Trabulsi EJ, Lallas CD, Calvaresi, AE, (Eds) Springer Nature. October 2020. Pgs. 133-138. Izes, JK, Oh S. Novel and Experimental Strategies in the Treatment of Metastatic Urothelial Carcinoma. In Chemotherapy and Immunotherapy in Urologic Oncology: A Guide for the Advanced Practice Provider, Trabulsi EJ, Lallas CD, Calvaresi, AE, (Eds) Springer Nature. October 2020. Pgs. 215-220.. Lizardi-Calvaresi AE, Bagley DH, Smentkowski KE. Upper Tract Urothelial Carcinoma. In Chemotherapy and Immunotherapy in Urologic Oncology: A Guide for the Advanced Practice Provider, Trabulsi EJ, Lallas CD, Calvaresi, AE, (Eds) Springer Nature. October 2020. Pgs. 221-228. Truong H and Kogon, A; Acute Kidney Injury in Gomella’s Neonatology Management, Procedures, OnCall Problems, Diseases and Drugs, 8th Edition (2020) McGraw Hill Education Mark JR, Squadrito D. Penile Cancer. In Chemotherapy and Immunotherapy in Urologic Oncology: A Guide for the Advanced Practice Provider, Trabulsi EJ, Lallas CD, Calvaresi, AE, (Eds) Springer Nature. October 2020 Pgs. 295-302. Mark JR: Professional chapters for Merck Manual: Prostate Cancer, Bladder cancer, Kidney Cancer, Penile Cancer, Renal Pelvic and Ureteral Cancer, Testicular Cancer, Urethral Cancer (2020) Mark JR: Consumer chapters Merck Manual: Prostate Cancer, Bladder Cancer, Kidney Cancer, Penile Cancer, Renal Pelvic and Ureteral Cancer, Testicular Cancer, Urethral Cancer (2020) Chung P, Gomella LG. Bladder, Prostate and Urethra in Gray’s Anatomy, 42nd Edition Elsevier Clinical Solutions (2020) (see page 40)

Smentkowski KE, Das AK, and Trabulsi EJ. Transrectal Ultrasound. In: Practical Urological Ultrasound (3rd Edition). PF Fulgham and B Gilbert (editors) Humana Press: Springer: New York, NY October 2020. Pgs. 185-198. Hirsch I, “Male Sexual Dysfunction,” in The Merck Manual, edited by Porter RS, Merck & Co., Inc, Kenilworth, NJ, 2018, pp. 2134-2137; also published online (updated June 2019 and July 2020) at https:// www.merckmanuals.com/professional/genitourinarydisorders/male-sexual-dysfunction/overview-of-malesexual-function. Hirsch I, “Sexual Dysfunction in Men,” in Merck Manual Consumer Version, Merck & Co.; updated and published online June 2019 and July 2020 at https:// www.merckmanuals.com/home/men-s-health-issues/ sexual-dysfunction-in-men/overview-of-sexualdysfunction-in-men

Jefferson Urology

The Year in Photos 1

Our namesake, Thomas Jefferson, showing perfect face mask technique.

Year in Review

1 Residents and Fellows participated in a slightly modified “Movember” activity. Movember is an annual, month-long event involving the growing of moustaches during the month of November to raise awareness of prostate cancer and other male health related issues. We are not sure but a couple of real moustaches might be hiding behind some of those masks. 2 SKMC 2020 graduate and former Jefferson Urology Scholar Dr. Seth Teplisky celebrates his new medical school degree with “Turtle” before heading to start his urology training at the University of Kentucky in Lexington, KY.

3 The 2020 Urology inservice exam was held in November that prepares residents for their board certification exams. While many other programs cancelled their annual test due to safety concerns, our residents were able to take the computer test using safe social distancing at one of our Jefferson computer labs. 4 The 2020 Jefferson Health Foundation gala was held at the Borgata in Atlantic City on February 29, 2020. The Department of Urology was well represented at the event. Drs. Paul Chung, Jeanne Llenado and Ryan Mark were part of the Jefferson Urology team supporting the event that raised funds for a planned Jefferson Pride Primary and Specialty Care Practice.

5 The Philadelphia Father’s Day Run presented $5,000 to the Department of Urology Sidney Kimmel Cancer Center Prostate Cancer Programs. The “Virtual Philadelphia Father’s Day Run,” which took place this past June, was produced by Sharon Phillips Waxman of SPW Productions, LLC and Tim Krueger of Run the Day Race Management. The donation was made in honor of Stephen T. Phillips, Sharon Phillips Waxman’s brother, who lost his fight to Prostate Cancer in 2018. The run supports the mission of the Sidney Kimmel Cancer Center Prostate Cancer Programs to reduce prostate cancer incidence and mortality by cutting-edge research and development of new diagnostic and treatment techniques. This year’s Philadelphia Father’s Day Run will take place on Father’s Day, Sunday, June 20, 2021. 6 The Department of Urology was well represented at the February 2020 ASCO GU meeting in San Francisco. Robotic and Endourology Fellow, Dr. Kate Smentkowski is shown here presenting a poster on our GU multidisciplinary clinic management of muscle invasive bladder cancer.

Jefferson Urology

Year in Review

7 The traditional Department of Urology year end celebration with prizes and fun games such as “Deal or No Deal” could not take place because as we all know the COVID stole our Holidays! The entire “HOW THE COVID STOLE OUR HOLIDAYS” video can be seen on a private YouTube Channel: youtu.be/KaU4U0JSuB0

8 Instead a virtual video raffle was held with the Grinch and Cindy Lou Who drawing the prizes for the Department of Urology staff.

9 Bird’s eye view of Jefferson’s emergency COVID drive through testing site set up at the start of the pandemic in March, 2020.

10 Dr. Scott Hubosky (center) participated in a panel on “Resident Involvement in Patient Safety and Quality Initiatives: Culture, Curriculum and Coordination” at the 2020 Society of Academic Urology meeting (SAU) held in Las Vegas, January 2020. Seen here with Dr. Steven Riggs (l) Levine Cancer Institute in Charlotte, N.C. and Dr. Erica Traxel (r), Washington University in St. Louis (see also page 18).

11 The residents’ photo gallery in the Department of Urology College offices was recently updated. Pictured is Barbara Devine, the most senior staff member in the Department of Urology, seen here with more than 40 years of Urology residency graduates.

12 Our thanks to the Department of Urology’s dedicated front desk staff at our Center City office and to all our staff, faculty and residents for their work during the pandemic. While many urology visits were converted to telehealth our wonderful staff continued to support our essential in-person patient care using precautions such as the early installation of plexiglass barriers, now a common site everywhere.

13 A behind-the-scenes look at our 2020 Virtual Urology Graduation ceremony. Current Chief Resident Dr. Tom Hardacker agreed to serve as our video engineer while Karen Kirchoff from Medical Media was our official photographer (also see page 28).

Jefferson Urology

16 52

Year in Review

14 Our graduting residents and fellow and their custom bobble head graduation gifts.

15 At the start of every academic year Sonia Hurtado, RN Urology Nurse Specialist and her surgical team provide an overview of equipment used in the endourology suite. Participating in the summer 2020 demonstration are students and residents.

16 While we were required to curtail elective surgery early in the pandemic our team continued to provide surgical care to patients requiring surgical interventions. All appropriate precautions were always taken on the operating room.

17 Dr. Matt Schiewer Director of our Urology research lab, participated in this fall 2020 virtual seminar series sponsored by Jefferson’s Graduate Student Association. The program was designed for individuals who are interested in learning about the various pathways available to basic science researchers in academic medicine.

18 A positive aspect of the pandemic was getting caught up on some housekeeping tasks. The Department used some of the pandemic patient care downtime to work with our staff to clean out files that were no longer needed.

19 As 2020 came to an end, we were all relieved that the vaccine had arrived at Jefferson.

19 Jefferson Urology

Faculty Listing Department of Urology Faculty Sidney Kimmel Medical College Thomas Jefferson University Leonard G. Gomella, MD, FACS Chairman, Department of Urology The Bernard W. Godwin Professor of Prostate Cancer Senior Director Clinical Affairs, Sidney Kimmel Cancer Center Clinical Director, Jefferson Health Urology Service Line Fellowship: Surgical Oncology, National Cancer Institute

Joseph K. Izes, MD, FACS Clinical Assistant Professor Fellowship : Urologic Oncology Lahey Clinic, Burlington

Demetrius H. Bagley, MD The Nathan Lewis Hatfield Professor of Urology, Professor of Radiology Fellowship: Surgical Oncology, National Cancer Institute

Jeanne V. Llenado, DO, FACOS Clinical Assistant Professor Director, South Philadelphia Campus

P. Kenneth Brownstein, MD Clinical Assistant Professor The Harold A. Honickman Physician Director of Jefferson Signature Services Director of Development Dolores E. Byrne, PhD Assistant Professor Director of Medical Student Education Director Jefferson’s Postbaccalaureate PreProfessional Program (P4) Post-Doctoral Fellowship: University of Pittsburgh Thenappan Chandrasekar, MD Assistant Professor Director of Abington-Jefferson Urology Fellowship: Urologic Oncology, University of Toronto Fellowship: Robotic Surgery and Endourology, Thomas Jefferson University Paul H. Chung, MD, FACS Assistant Professor Co-Director Men’s Health Program Director Reconstructive Urology and Jefferson Urology Alumni Association Fellowship: Male Genitourinary Reconstructive Surgery and Trauma, University of Washington Akhil K. Das, MD, FACS Associate Professor Director Postgraduate Continuing Medical Education Fellowship: Endourology Tauranga Hospital, New Zealand Deborah T. Glassman, MD, FACS Clinical Associate Professor Director Telehealth Program Irvin H. Hirsch, MD Clinical Professor Co-Director Men’s Health Program Fellowship: Andrology and Mens Health, Baylor Scott G. Hubosky, MD Demetrius H. Bagley Jr. MD Associate Professor Vice Chair Quality Improvement & Safety Director Division of Endourology Fellowship: Robotic Surgery and Endourology, Eastern Virginia Medical School, Norfolk

Year in Review

Costas D. Lallas, MD, FACS Professor Vice Chair, Academic Affairs Associate Director Urology Residency Program Fellowship: Robotic Surgery, Mayo Clinic

Mark J. Mann, MD Assistant Professor Director Urologic Diagnostic Center Fellowship: Robotic Surgery and Endourology, Jefferson James Ryan Mark, MD Assistant Professor Director of Clinical Trials Fellowship: Urologic Oncology, Carolinas Medical Center, Charlotte Alana M. Murphy, MD, FACS Associate Professor Associate Director Urology Residency Program Director Female Urology Fellowship: Female Pelvic Medicine and Reconstructive Surgery, Cleveland Clinic Matthew Schiewer, PhD Assistant Professor, Urology & Cancer Biology Director Urology Research Laboratory Postdoctoral Fellowship: Sidney Kimmel Cancer Center Patrick J. Shenot, MD, FACS Professor, Deputy Chair & Residency Program Director Fellowship: Neurourology, Thomas Jefferson University Edouard J. Trabulsi, MD, MBA, FACS Professor & Vice Chair for Research Director of Urologic Oncology Fellowship: Urologic Oncology, Memorial Sloan Kettering Cancer Center Perry R. Weiner, DO, MSc, FACOS Clinical Associate Professor Director Men’s Health Program

JOINT SIDNEY KIMMEL MEDICAL COLLEGE FACULTY Karolynn Echols, MD Associate Professor Director, Female Pelvic Medicine & Reconstructive Medicine Department of Obstetrics and Gynecology Ethan J. Halpern, MD Professor of Radiology and Urology Vice Chair for Research, Department of Radiology

Veda Giri, MD Professor Medical Oncology, Cancer Biology, and Urology Director, Cancer Risk Assessment and Clinical Cancer Genetics Sidney Kimmel Cancer Center William Kevin Kelly, DO Professor, Medical Oncology and Urology Director, Division of Solid Tumor Oncology Associate Director of Clinical Research, Sidney Kimmel Cancer Center Karen E. Knudsen, PhD, MBA Chair & Hilary Koprowski Endowed Professor Dept. of Cancer Biology Professor of Cancer Biology and Urology Executive Vice President, Oncology Services, Jefferson Health Enterprise Director- NCI-Designated Sidney Kimmel Cancer Center President- Association of American Cancer Institutes (AACI) Mathew L. Thakur, PhD, FSNMMI, FNAI, FACNM, FICNM, FARR Professor of Radiology, Radiation Oncology and Urology Director, Laboratories of Radiopharmaceutical Research and Molecular Imaging

DUPONT NEMOURS PEDIATRIC UROLOGY FACULTY

T.E. (Sonny) Figueroa, MD, FAAP, FACS Professor of Urology and Pediatrics Chief, Division of Urology at Nemours/Alfred I. duPont Hospital for Children Fellowship: Children’s Hospital of Michigan, Detroit Ahmad Bani-Hani, MD, FAAP, FACS Clinical Associate Professor of Urology and Pediatrics Fellowship: Riley Children’s Hospital of Indiana University, Indianapolis Keara N. DeCotiis, MD Clinical Assistant Professor of Urology Fellowship: The Hospital for Sick Children, Toronto Jennifer Hagerty, DO, FAAP Clinical Assistant Professor of Urology and Pediatrics Fellowship: Northwestern University, Ann & Robert H. Lurie Children’s Hospital Puneeta Ramachandra, MD Clinical Assistant Professor of Urology and Pediatrics Fellowship: Rady Children’s Hospital of San Diego

Outpatient Practice Locations Jefferson Department of Urology Associates Outpatient Practice Locations

Jefferson’s expanded Navy Yard location at 3 Crescent Drive, the location of the Department of Urology and Men’s Health Program offices.

The Asplundh Cancer Pavilion (3941 Commerce Avenue, Willow Grove) is conveniently located minutes from the Willow Grove Turnpike exchange and currently houses the Department of Urology Outpatient offices in addition to the Sidney Kimmel Cancer Center operations.

Abington/Asplundh Cancer Pavilion Sidney Kimmel Cancer Center Site Contact: Noreen Wielgus, MSN, RN 3941 Commerce Avenue Willow Grove, PA 19090 215-481-4668 Fax: 215-481-3200

Jefferson Urology Cherry Hill (New location effective April 1, 2021) Site Contact: Linda Teschko 511 Kings Highway North Cherry Hill, NJ 08002 844-542-2273 Fax: 856-406-4570

Abington Hospital Jefferson Health (Summer 2021) Price Medical Office Building, 1245 Highland Avenue, Suite 302 Abington, PA 19001

Jefferson Health Navy Yard Site Contact: Tammy Aversa 3 Crescent Drive 2nd Floor Philadelphia, PA 19112 215-503-7124 Fax: 215-503-3321

GU Multidisciplinary Clinic Sidney Kimmel Cancer Center Site Contact: Crystal Shypherd, CPhT 215-503-0581 111 S. 11th Street Street Level Philadelphia, PA 19107 215-955-6700 Fax: 215-955-0412 Center City Office Site Contact: Marlene Vallett, Practice Manager 33 S. 9th Street, #703 (Formerly 833 Chestnut) Philadelphia, PA 19107 215-955-1000 Fax: 215-503-2066

Men’s Health Program at the Navy Yard Site Contact: Alana Flowers 3 Crescent Drive 2nd Floor Philadelphia, PA 19112 215-503-7240 Fax: 215-503-3191 Pediatric Urology Care Nemours Physicians: 302-651-4200 Locations in Delaware, Philadelphia, Main Line

Jefferson Urology

UROLOGY GIFT

Each year, the Leonard and Barbara Frank Fund supports a special project for our urology residency program. In 2020, the annual contribution was used to purchase new lead aprons for use by the residents in the operating room.

Upcoming Events MARCH 3-4

JUNE 18

2021 Zimskind Virtual Visiting Professor

2021 DM Davis Visiting Professor and Graduation Banquet (virtual or live TBD)

Stephanie Kielb, MD Professor of Urology, Medical Education, and Obstetrics and Gynecology Northwestern University Feinberg School of Medicine, Chicago Journal Club and Case Presentations Wednesday, March 3, 2021 6:00-8:00 PM Grand Rounds Thursday, March 4, 2021

Chairman, Department of Urology, W.A. “Tex” & D. Moncrief, Jr. Distinguished Chair in Urology, University of Texas MD Anderson Cancer Center, Houston, TX

FALL 2021

7:15-8:15 AM

2021 Philadelphia Prostate Cancer Consensus Conference

APRIL 30

Prostate Cancer and Genetics in the African American Population (working title)

4th Annual Jefferson Virtual Urology Symposium Topics: Management of Urinary Incontinence and Innovative Technologies for BPH. This course will be available via Zoom. Details will be posted on: cme.jefferson.edu 56

Colin P.N. Dinney, MD

Year in Review

The Third Philadelphia Prostate Cancer Consensus meeting to be scheduled in the fall of 2021. Details will be posted on phillyprostate.com later this year.

Jefferson Urology Year in Review 2020

Articles inside

Outpatient Practice Locations

SKMC Urology Match

Department of Urology Faculty

Publications

Books

Nemours/AI DuPont Pediatric Urology Update Welcome New Pediatric Urology Faculty InterStim™ in Children

Virtual House Staff Interviews

Faculty Contribute to Classic Medical Textbook Happy or Not?

Provider Spotlight

Clinical Trials Update

Research Lab Update

Philadelphia Prostate Cancer Biome Project Update

Jefferson Urology Research Scholars

House Staff 2020-2021

2020 Urology Graduation

Urology Fellows

Alumni Spotlight

Brownstein Visiting Professor

Alumni Association

International Meeting

SAU January 2020

3rd Annual BCAN Symposium

Alumni Achievement Award

Evolution of the Modern Resectoscope

Jefferson Urology and AUA

Jefferson Global Centers

Experiences Transgender/ Non-Binary Patients in Doctor’s Office

3D Kidney Models Facilitate Robotic Surgery

Jefferson’s New Specialty Care Pavilion

Urology Telehealth

Cross Country Flight during COVID

Safe & Sound Urologic Surgical Training