CLEVELAND CLINIC Glickman Urological Glickman Urological & Kidney Institute & Kidney Institute A Physician Journal Urology & Kidney of Developments in Urology and Nephrology Vol. 24 | Winter 2015 Disease News | Urology & Kidney Disease News | Vol. 24 2015 2 Urology & Kidney Disease News Department Chairs Urology & Kidney Edmund Sabanegh Jr., MD Chairman, Department Disease News of Urology Glickman Urological & Kidney Institute Chairman’s Report ....................................................................4 News from the Glickman Urological & Kidney Institute New Staff... ...............................................................................5 CME Upcoming Events — Save These Dates ...............................5 2014 Glickman Urological & Kidney Institute Achievements..........6 Robert J. Heyka, MD Chairman, Department of Nephrology and Best Practices Hypertension We’re No. 1 ... by Putting Patients First .......................................7 Glickman Urological Cleveland Clinic Urology, Las Vegas Expands Staff, & Kidney Institute Adds Services............................................................................8 From Inspiration to Commercialization: How a Prostate Cancer Test Gets to Market .........................................................9 Urology Residency Training at Cleveland Clinic: Striving for Excellence ..............................................................10 Medical Editors Center for Robotics and Laparoscopic Surgery Intracorporeal Hypothermia During Robotic Partial Sankar Navaneethan, MD Nephrectomy Using Renal Ice Slush ..........................................11 Glickman Urological New Robotic System Designed for Single-Port Surgery: & Kidney Institute First Clinical Experience ...........................................................13 Medical Editor, Nephrology Robotic Radical Perineal Prostatectomy: Urology & Kidney Disease News Potential Advantages of a New Approach ...................................15 Partial Nephrectomy: Saving as Many Nephrons as Possible........18 Robotic Radical Cystectomy with Intracorporeal Urinary Diversion: A New Horizon .............................................20 Center for Urologic Oncology Daniel Shoskes, MD Emerging Technologies in Radiation Therapy May Improve Glickman Urological Tumor Control in Prostate Cancer ..............................................22 & Kidney Institute Medical Editor, Urology Use of Salvage Therapies in the Treatment of Radioresistant Prostate Cancer ....................................................................................23 Urology & Kidney Disease News Determining Biochemical Success Following Primary Whole-Gland Prostate Cryoablation ...........................................24 Debunking the Myths of Chemotherapy in Prostate Cancer ..........25 A Progress Report on the Genomic Prostate Score and its Impact on Risk Stratification and Active Surveillance Decisions ...28 Multiparametric Magnetic Resonance Imaging Ultrasound (MP-MRI-US) Fusion Targeted Prostate Biopsy ...........................30 Brachytherapy Versus Other Radiotherapeutic Modalities for Prostate Cancer: Why the Bias? ............................32 On the Cover Advances in multiparametric magnetic resonance imaging and the fusion of that information with real-time transrectal Center for Blood Pressure Disorders ultrasound imaging (termed MP-MRI-US fusion biopsy; see ar- ticle on p. 30) have improved diagnostic accuracy for prostate Department of Nephrology and Hypertension Designated cancer. This image shows a prostate cancer lesion identified as a Comprehensive Hypertension Center ..................................34 using diffusion-weighted imaging. Reprinted from Natarajan S, Marks LS, Margolis DJA, et al. Clinical application of a 3D ultrasound-guided prostate biopsy system. Urol Oncol 2011; 29(3):334-342. © 2011, used with permission from Elsevier. More articles online at ConsultQD.clevelandclinic.org/urology-nephrology 3 Center for Chronic Kidney Disease Pulmonary Hypertension and Kidney Disease: A Deadly Duo .......35 More News Articles Center for Genitourinary Reconstruction Available Online Erectile Dysfunction Is a Major Cause of Peyronie Disease: A Personal View .........................................................................37 Staged Buccal Graft Urethroplasty for Difficult Strictures .............39 Consult QD — Urology and Nephrology Center for Reproductive Medicine Proteomics and the Future of Sperm Testing ...............................41 A blog featuring insights and perspectives from Cleveland Clinic Center for Endourology and Stone Disease experts. Visit today and join the Renal Access for Percutaneous Nephrolithotomy: Where Are We Today? ..............................................................44 conversation. Center for Female Pelvic Medicine and Reconstructive Surgery ConsultQD.clevelandclinic.org/ Predictors of Pelvic Organ Prolapse Progression ..........................46 urology-nephrology Distribution and Homing of Bone Marrow-Derived Mesenchymal Stem Cells Following Postpartum Intraperitoneal Injection into LOXL1 Knockout Mice ....................47 Center for Renal and Pancreas Transplantation Kidney Transplantation at Cleveland Clinic: A Global Resource.....49 Impact of Low Testosterone in Renal Disease and Kidney Transplantation .............................................................51 A Surgical Approach to Patients with Intractable Nephrolithiasis ........................................................53 Center for Dialysis Dialysis Therapies and Cleveland Clinic: Bringing Patients Back Home .............................................................................55 Urgent-Start Peritoneal Dialysis at Cleveland Clinic: A Multidisciplinary Approach ....................................................56 Center for Pediatric Urology The Changing Paradigm of Management of Children with Vesicoureteral Reflux ........................................................58 Transitional Urology Prepares Patients with Congenital Genitourinary Problems for Adult Care .......................60 Physician Resource Guide.......................................................62 4 Urology & Kidney Disease News Chairman’s Report • Surgical innovation, including intracorporeal hypo- thermia during robotic partial nephrectomy to pre- Eric A. Klein, MD serve long-term renal parenchymal function; renal autotransplantation and pyelovesicostomy to resolve Chairman, Cleveland Clinic Glickman chronic pain in patients with intractable nephroli- Urological & Kidney Institute thiasis; and robotic radical perineal prostatectomy for localized prostate cancer. • High-impact research that may lead to new treatment options, including tracking mesenchymal stem cells’ preferential homing to pelvic organs in a mouse model Dear Colleagues, of pelvic organ prolapse; using proteomic studies to Welcome to the Winter 2015 issue of Glickman Urological & identify novel biomarkers for sperm dysfunction; and Kidney Institute’s Urology & Kidney Disease News. As these examining the effect of low testosterone in renal dis- pages demonstrate, 2014 was a banner year for our institute ease and kidney transplantation, as a disease severity and its talented clinicians and researchers. indicator and a therapeutic target. I am proud to report that our urology program was named • Clinical best practices, such as our efforts to educate the nation’s best and our nephrology program was No. 2 in patients about peritoneal dialysis and home hemo- U.S. News & World Report’s annual rankings of America’s top dialysis, and advice on how to transition adolescent hospitals. Our Urology Residency Program also was judged patients with congenital genitourinary problems to to be the country’s finest in an assessment by the online adult care. physician network Doximity in collaboration with U.S. News • Strategies to improve outcomes prediction in pelvic & World Report. And the American Society of Hypertension organ prolapse, after primary whole gland prostate accredited our Department of Nephrology and Hyperten- cryoablation, and in salvage therapies for radioresis- sion as the first Comprehensive Hypertension Center in tant prostate cancer. News from the Glickman Urological & Kidney Institute & Kidney Urological Glickman the from News Northeast Ohio, and one of only 12 nationally. This issue also brings you two thought-provoking prostate These achievements are the result of a relentless drive for cancer articles — on our increasing use of brachytherapy excellence by the programs’ directors and the Urological & (while other institutions are turning away), and on research Kidney Institute’s staff. I am pleased that their efforts have that’s overcoming the negative perceptions of systemic brought us recognition. Please be assured that we don’t take chemotherapy for castration-resistant cases. And we offer the honors for granted, and we don’t intend to rest on past progress reports on our kidney transplant program and our accomplishments. Continuously improving our patients’ medical and surgical care, conducting research that alters expansion of urology services in Las Vegas. disease outcomes, and providing superlative training for the I hope you find UKD News informative and helpful in your next generation of urologists and nephrologists will remain practice. If we can assist in any way, please let us know. our top priorities. Urology & Kidney Disease News offers a rich digest of what we’ve done and learned in the past year, and where we’re