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Urology

Division Photo

Urology

Left to Right:  P. Noh, E. Jackson, C. Sheldon, P. Reddy, E. Minevich, S. Alam, W. DeFoor, Jr.

Division Data Summary
Research and Training Details
Number of Faculty6
Number of Joint Appointment Faculty1
Number of Research Fellows3
Number of Support Personnel1
Direct Annual Grant Support $197,801
Peer Reviewed Publications2
Clinical Activities and Training
Number of Clinical Staff15
Number of Clinical Fellows2
Inpatient Encounters373
Outpatient Encounters15,640

Faculty Members

Curtis A. Sheldon, MD,  Professor ; Division Director
William Robert DeFoor, Jr, MD,  Assistant Professor ; Director of Clinical Research
Research Interests: Clnical trials and bladder detrusor activity
Eugene A. Minevich, MD,  Associate Professor
Pramod P. Reddy, MD,  Associate Professor ; Director of the Pediatric Urology Fellowship Program
Research Interests: Bladder organogenesis; Clinical trials and bladder detrusor activity
Shumyle Alam, MD,  Assistant Professor
Paul H. Noh, MD,  Assistant Professor

Joint Appointment Faculty Members

Elizabeth Jackson, MD,  Associate Professor
Division of Nephrology
Clinical Trials and bladder detrusor activity

Trainees

  • Samy Heshmat, MD,  PL-7,  Mount Sinai Hospital, University of Toronto, Canada
  • Erica  Traxel, MD,  PL-6,  Washington University School of Medicine

Significant Accomplishments in FY08

 The Urogenital Center  

The Urogenital Center provides expert, comprehensive care management to patients locally, nationally and internationally and is a major teaching resource for the education of physicians, residents, fellows, nurses, and patients/families. Dr. Sheldon is a nationally recognized authority in performing complex genitourinary reconstructive surgery and kidney transplantation. Dr. Sheldon oversees the Urogenital Center Clinics managing the comprehensive medical, nursing and surgical care management of patients with complex genitourinary conditions and patients requiring renal transplantation after bladder reconstruction or the creation of a neobladder. Debbie Reeves, RN, and Lisa Creelman, RN, case manage all Urogenital Center patients and work closely with the CCHMC’s Global Health Center. The Urogenital Center partners with Cincinnati Children’s pediatric surgeons, Alberto Peña, MD, and Marc Levitt, MD, of the Colorectal Center for Children and gynecologist, Leslie Breech, MD, of Adolescent Medicine during weekly care conferences to develop a plan of care for our complex patients. Drs. Peña and Levitt manage a high volume of patients with anorectal malformations who will also require urological, surgical and/or gynecological interventions. Additionally, the division has developed a collaborative taskforce entitled Disorders of Sexual Development for patients diagnosed with ambiguous genitalia or intersex issues The Center is composed of physicians and clinical staff from Endocrinology, Human Genetics, Gynecology, Psychology and Social Services.

Affiliation with Arkansas Children's Hospital

The Division of Pediatric Urology has been the catalyst to an affiliation agreement between Cincinnati Children’s and Arkansas Children’s Hospital to collaborate on clinical, educational, quality and research opportunities that result in better access to care for children and their families. Under the agreement, the Division will send urologic surgeons to Arkansas Children’s on a monthly basis to perform complex surgical cases. The surgeons involved in this endeavor are Curtis Sheldon, MD, Pramod Reddy, MD, and Eugene Minevich, MD.  The first surgical cases are targeted for October 2008. Longer term, CCHMC will assist Arkansas Children’s in developing a free-standing urology program of its own. This arrangement is in line with CCHMC's strategic plan to develop collaborative relationships with other health care providers, giving children and families seamless access to subspecialty services close to home. Prior to this arrangement, families would have traveled to Cincinnati Children’s or other pediatric providers to receive these complex services. To this end, CCHMC pediatric urologists will train their counterparts at Arkansas Children’s in these complex procedures.  

Laparoscopic Pediatric Urology

Paul Noh, MD, joined the Division of Pediatric Urology in Sept. of 2007 for his expertise in the field of laparocopic pediatric urologic surgery. Dr. Noh presented at the International Pediatric Endosurgery Group's annual meeting in France in May of 2007 and was a key instructor at an international course on laparaocopic surgery held at the Hospital for Sick Children in Toronto. Dr. Noh is assisting all the urologic surgeons in the division to further develop skills of less invasive surgical techniques. Additionally, Dr. Noh is developing the ground work to build a robotic surgery program that will link the Division of Pediatric Urology and the Division of Pediatric General and Thoracic Surgery. Dr. Noh's work is in line with CCHMC's strategic plan to be a leader in child health by delivering state-of-the-art surgical care that will inhance clinical outcomes and provide provide value to our children and families.

Significant Publications in FY08

DeFoor W, Minevich E, Jackson E, Reddy P, Clark C, Sheldon C, Asplin J. Urinary metabolic evaluations in solitary and recurrent stone forming children. J Urol. 2008 Jun;179(6):2369-72.  

CCHMC Pediatric Urology previously reported a high rate of urinary metabolic abnormalitites in stone-forming children compared to normal controls.  A 24-hour urine evaluation is initiated after the first stone episode in children to measure stone risk indices.  Findings indicate there are significant differences in 24-hour urinary calcium levels between solitary and recurrent calcium stone-forming children.  A patient with increased urinary calcium indices on a 24-hour specimen may benefit from more aggressive initial dietary and pharmacological treatment to prevent stone recurrence. 

Reddy PP. Recent advances in pediatric uroradiology. Indian J Urol. 2007 Oct-Dec;4(23):390-402.

Pediatric imaging continues to evolve as technological innovations are incorporated into clinical imaging modalities.  A thorough understanding of the contemporary imaging techniques, their indications and limitations will enable the surgeon to tailor the appropriate combination of diagnostic tests for any given patient, bearing in mind the potential problems and costs associated with these imaging modalities.  When treating pediatric patients, it is the responsibility of all healthcare professionals to ensure that the "ALARA" principle is followed whenever radiographic studies are obtained.  Evidence based ressearch will enhance the managemenet and improve the outcomes of children with vesicoureteral reflux, urinary calculus disease and complex genitourinary anomalies. 

Division Highlights

Pramod Reddy, MD

Dr. Reddy is on his second year of funding by the prestigious American Urological Association Surgeon-Scientist award. Dr. Reddy is the primary investigator for the division’s basic science research which focuses on the basis of urinary bladder development. His laboratory collaborates with the Division of Developmental Biology. Dr. Reddy is funded with an NIH K08 grant and his laboratory is investigating the molecular basis of organogenesis of the urinary bladder using the Xenopus as an experimental system. Our basic science research is essential to the training of our fellows. The division’s ACGME accredited Pediatric Urology fellowship program, under the leadership of Dr. Reddy, Director of the Pediatric Urology Fellowship Program, is highly recognized nationally and internationally. The division attracts outstanding candidates to train in the fellowship program. Samy Heshmat, MD from the University of Toronto, Canada, began his fellowship in September of 2006 and graduated in May of 2008. Erica Traxel, MD from Washington University School of Medicine, St. Louis began her two year fellowship training as of July of 2007.

W. Robert DeFoor Jr., MD

Dr. DeFoor is the principal investigator (PI) for the recruitment, implementation and supervision the division’s clinical trials. Dr. DeFoor and Dr. Elizabeth Jackson are co-investigators on the Alfachin Sanofi-Aventis clinical trial addressing the treatment of detrusor overactivity associated with a neurological condition in the pediatric patient. Dr. DeFoor was awarded an NIH subcontract on a national NIH grant entitled “Randomized Intervention for Children with Vesico Ureteral Reflux" held by the Research Foundation of State University of New York. Additionally, Dr. DeFoor is conducting his own research trial entitled, “Efficacy of Gentamicin Bladder Irrigations in Complex Urologic patients” funded by the division. Drs. Reddy and DeFoor have proposed and received an acceptance from Astra-Tech on two investigator-initiated studies trialing low friction catheters. Dr. Reddy is the PI for a clinical trial agreement with Novartis Pharmaceuticals for the efficacy and treatment of neurogenic detrusor overactivity.  Dr. DeFoor's interests include clinical outcomes research, urologic oncology, robitic/laparoscopy and visico-ureteral reflux (RIVUR study).

Division Collaboration

Collaboration with Division of Pediatric General and Thoracic Surgery-Colorectal Center for Children; Division of Adolescent Medicine - Gynecologic Surgery; Division of Nephrology; Social Service

Collaborating Faculty: Marc Levitt, MD and Alberto Pena, MD; Leslie Breech, MD; Elizabeth Jackson, MD;

The Urogenital Center, the Colorectal Center for Children and Gynecology Surgery jointly evaluate local, national and international children with complex genitourinary conditions and anorectal malformations. A complete evaluation of the child' is performed, a plan of care is developed and a plan for surgery and after care is implemented. Support services such as social service, nutrition and psychology will assist in care of the patient/family as needed. The Division of Pediatric Urology actively presents at the bi-annual Colorectal Conference to meet educational needs of surgeons and other clinical staff.  (Dr. Curtis Sheldon and Dr. Shumyle Alam)

Collaboration with Division of Endocrinology; Division of Human Genetics; Division of Adolescent Medicine - Gynecologic Surgery; Social Service; Psychology

Collaborating Faculty: David Repaske, MD; Howard Saal, MD; Leslie Breech, MD

Taskforce entitled Disorders of Sexual Development is a team established to assess and present a cohesive evaluation of the condition, prognosis and recommendations for patients/families who are dealing with diagnoses such as ambiguous genitalia, intersex etc.  (Dr. Curtis Sheldon and Dr. Shumyle Alam)

Collaboration with Division of Nephrology; Division of Pediatric General and Thoracic Surgery; UC Donor Advocate; Psychology

Collaborating Faculty: Entire Divisional Faculty; Maria Alonzo, MD and Greg Tiao, MD; Linda Page; Roehrig Helmut

Endstage Renal Disease Team collaborates on the evaluation and management of children with end-stage renal disease and includes, but is not limited to children awaiting or have undergone surgical transplantion.  (Dr. Curtis Sheldon)

Collaboration with Division of Pediatric General and Thoracic Surgery - Fetal Care Center

Collaborating Faculty: Timothy M Crombleholme, MD

Collaboration between Pediatric Urology and the Fetal Care Center focuses on the assessment, evaluation and treatment of prenatal patients with diagnosed urological conditions.  The collaboration includes participation in a multi-disciplinary conference.  Each family is present for discussion of test findings and treatment options. (Dr. Pramod Reddy)

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Division Publications

  1. DeFoor W, Minevich E, Jackson E, Reddy P, Clark C, Sheldon C, Asplin J. Urinary metabolic evaluations in solitary and recurrent stone forming children. J Urol. 2008; 179: 2369-72.
  2. Reddy PP. Recent advances in pediatric uroradiology. Indian J Urol. 2007; 4: 390-402.
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Grants, Contracts, and Industry Agreements

Grant and Contract Awards Annual Direct / Project Period Direct

Defoor, W

Randomized Intervention for Children with VesicoUreteral Reflux
U01 DK 07406306/01/08 - 05/31/09 $54,051 / $54,051

Reddy, P

Molecular Basis of Bladder Organogenesis
K08 DK 06960802/01/05 - 01/31/10 $115,750 / $578,750
Molecular Basis of Bladder Organogenesis
03/01/07 - 02/28/10 $28,000 / $84,000
Current Year Direct$197,801
Service Collaborations

DeFoor, W

$ 1,274
Current Year Direct$1,274
Total$199,075
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