Urology Research

Urology research at Beaumont Hospitals is on the cutting edge of clinical practice, aimed at bringing innovative research protocols to patient care, advancing the treatment of disease, improving patient outcomes and enhancing their quality of life. Known as a leader in the field, the department is involved in several innovative studies including interstitial cystitis, urinary incontinence and the prostate gland.

Research projects concentrate on developing novel treatments for urinary incontinence, overactive bladder, pelvic pain, prostate cancer, female reconstructive surgery and neurogenic bladder. These translational and clinical studies along with sponsored pharmaceutical and equipment/device trials offer the opportunity to treat disease states that traditional therapies fail to address. Funded through grants from the National Institutes of Health (NIH), philanthropy including the Ministrelli Program for Urology Research and Education (MPURE), and industry contracts, Beaumont physicians serve as the principal investigators in these national and international trials.

Studies on neuro-urology and incontinence identify and utilize novel therapies such as neuromodulation and nerve re-routing to treat men, women and children who have voiding problems demonstrated to be refractory to standard therapies.

Nerve Re-routing

Beaumont Hospitals launched a research study to "rewire" nerves in the spinal cord in the hope of giving bladder control to people with spinal cord injury or spina bifida who otherwise depend on self-catheterization to urinate. The first procedure garnered national attention and appeared in more than 160 news outlets including U.S.News and World Report, The Washington Post and Forbes. Beaumont is the only institution in the United States to perform this procedure and also provide funding for all the associated costs.

The research at Beaumont uses nerve rerouting to redirect nerves in the spinal cord to gain better control of urination. After the procedure, patients signal the bladder to urinate by scratching or pinching their leg or buttocks. The Chinese doctor who developed the surgery, Chuan-Guo Xiao, M.D., reports an almost 90-percent success rate. The average time it took to see results was 12 to 24 months after surgery, with patients in China reporting better urinary control and improvements in their bowel function.

Adult Stem Cell Study for Stress Urinary Incontinence

Beaumont Hospital urologists are first in the United States to research stress urinary incontinence treatment using a person's own stem cells. The stem cells are used to strengthen weak muscles that control urination. "If successful, (autologous) muscle-derived stem cell therapy could offer new hope to people and offer them a life free of urinary leakage," says Dr. Peters, who is leading the research at Beaumont. Stress urinary incontinence - the cause of wetness with coughing or physical activity - affects about 13 million Americans, most of them women, but also men who have had a prostatectomy (surgery for prostate cancer). Current treatments, including medicine, exercises and surgery, are not always effective and may have undesirable side effects. The stem cells from 48 female research participants age 18 or older will be collected at Beaumont Hospital, Royal Oak, and duplicated. The cells will then be injected into the muscles that control urination to strengthen them and prevent leakage.

Participation will last 12-14 months, and will include physical exams, procedures to assess the bladder, completing voiding diaries and questionnaires and a variety of diagnostic tests. A small sample of the participant's thigh muscle will be collected, which is the source of the stem cells. Pregnant or nursing women may not participate.

InterStim

The InterStim® - a pacemaker-like device used for urinary frequency, urgency and incontinence, is showing promise for treatment of interstitial cystitis symptoms. With the InterStim® Therapy, manufactured by Medtronic, Inc., a small electrode is placed adjacent to the sacral nerve. The electrode is externalized and patients monitor their urinary urgency, frequency and pain for two weeks. If the symptoms are at least 50 percent improved, the stopwatch-size power generator is implanted in the upper part of the buttock. The generator is then connected to the previously-placed lead. When the generator produces a small electrical pulse, it stimulates the sacral nerve, helping to control the bladder, sphincter and pelvic floor.

In addition to stimulating the sacral nerve, Urology chairman Kenneth Peters, M.D., is conducting a research study looking at pudendal nerve stimulation using the InterStim device. Thirty subjects were implanted with both sacral and pudendal nerve electrodes. Patients tested each electrode in a blinded fashion. Seventy nine percent of subjects chose the pudendal lead as superior for treating their voiding dysfunction.

Beaumont is also the only hospital in the country routinely performing pudendal nerve stimulation and is the No. 1 implanting hospital in the country of InterStim sacral nerve stimulator for overactive bladder.

Prostate Cancer treatment investigating outcomes of three separate surgical approaches to prostate removal and cryotherapy (freezing) of the prostate to improve patient outcomes. Additional databases to support data mining and outcomes research are under development.

Women's Initiative for Pelvic Pain and Sexual Health (Approximately one in six women are reportedly affected by pelvic pain, but it's something that most women don't want to talk about—even to their best friends or their doctors.

That's why Beaumont Hospitals has created a new Women's Urology Center offering leading-edge treatments, innovative research and the most advanced minimally invasive procedures for women's urological conditions such as incontinence, pelvic pain and sexual dysfunction.
"This is an important place for women because they often have to go doctor to doctor to doctor to figure out what's wrong with them and get a solution," said Urology Chairman Kenneth Peters, M.D. "We bring in specialists from many areas that treat urological conditions women suffer. A one-stop doctor shop will improve their quality of life."

The 4,200-square-foot, $1.6 million eco-friendly center, which opened in March, is the first in the Midwest dedicated and designed exclusively for women's urological care and sexual health. It was made possible through a generous $5 million gift from Susan E. Cooper of Birmingham, a long-time member of the Boards of Directors of Beaumont Hospitals and the Beaumont Foundation. A portion of her gift funded construction, equipment and furnishings for the center; the remainder will fund ongoing research to advance women's urology.

"The intent of my gift is to create another important women's health destination at Beaumont, by expanding the range of Beaumont's special health services for women that include a Women's Heart Center and a Comprehensive Breast Care Center," said Cooper. "I am gratified to support the work of Dr. Peters and his associates in providing cutting-edge urology treatment and research options for women."

"We've had a lot of success with our clinical research," Peters added. "One thing we do is a lot of neural modulation, which is like a pacemaker for the bladder that improves overactive bladder symptoms. We do a lot of novel things here, so we're involved in a lot of projects that are really leading edge."

The new center is located on 2 South, right next to the entrance to the skywalk. Staffed by board-certified, fellowship-trained physicians and a nurse practitioner who specialize in women's urologic conditions, the center offers:

  • Beaumont's nationally renowned pelvic floor physical therapy program
  • Comprehensive integrative medicine services, including medical massage, guided imagery and Reiki therapy
  • Psychological support to help women understand and manage emotional stress resulting from urologic conditions
  • Access to clinical research trials evaluating new treatment options

Conditions evaluated and treated at the center include urinary frequency or urgency, urinary incontinence, interstitial cystitis or painful bladder syndrome, unexplained pelvic pain, vulvar pain, sexual problems or pain associated with sex and post-cancer treatment for vaginal discomfort or dryness

Notable Accomplishments of Urology Research

  • Ananias Diokno, M.D., urologist, executive vice president and chief medical officer of Beaumont Hospitals, received the 2010 Victor A. Politano Award from the American Urological Association (AUA). The award recognizes Dr. Diokno for three decades of outstanding contributions in the field of incontinence and the understanding and management of lower urinary tract disorders.
  • Donna Carrico, NP, MS, Women's Urology Center, was selected as the winner of the 2009-2010 Urologic Nursing Novice Literary Excellence Award for her article entitled "The Relationship of Interstitial Cystitis/Painful Bladder Syndrome to Vulvodynia." She was presented with the award during The Society of Urologic Nurses and Associates' (SUNA) 41st Annual Conference in Boston, Mass., on Oc. 10.
  • Michael Chancellor, M.D., director, Neurourology, was awarded a grant by the NIH-NIDDK in the amount of $207,834 in support of the first year of the project "Intravesical Liposome Drug Delivery to Treat Interstitial Cystitis." The three-year grant award (June 2010-May 2013) totals more than $600,000 to Beaumont, Royal Oak.
  • Pradeep Tyagi, PhD, Urology Lab, was named the Grand Prize winner of the 2010 Annual Jack Lapides Essay Contest on Urodynamics and Neurourology Research. He was honored for his essay on establishing a molecular link between obesity and overactive bladder at the annual AUA meeting in San Francisco, where he also presented his essay. Dr. Tyagi also presented his essay at the annual Society for Urodynamics and Female Urology (SUFU) in St. Petersburg, Fla., in February 2010.
  • Kenneth Peters, M.D., Chairman, Urology, is on the Research Council for the AUA.

Investigators

Ananias Diokno, M.D.

adiokno@beaumont.edu

Incontinence, Interstitial Cystitis, Neurogenic Bladder,

Kenneth Peters, M.D.

kmpeters@beaumont.edu

Female Urology (Interstitial Cystitis, Pelvic Floor Dysfunction, Sexual Function), Incontinence, Neuromodulation

Larry Sirls, M.D.

lsirls@beaumont.edu

Incontinence, Prolapse, Voiding Dysfunction

Pradeep Nagaraju, M.D.

pnagaraju@beaumont.edu

Incontinence, Prolapse, Voiding Dysfunction

Melissa Fischer, M.D.

melissa.fischer@beaumont.edu

Incontinence, Prolapse, Robotic Reconstructive Surgery, Voiding Dysfunction

Jay Hollander, M.D.

jhollander@beaumont.edu

Prostate Cancer, Robotics

Donna Carrico, NP, MS

dcarrico@beaumont.edu

Female Urology (Interstitial Cystitis, Pelvic Floor Dysfunction, Sexual Function)

Robotics Committee

248-551-9238

Includes: Jay Hollander, M.D., Kenneth Kernen, M.D., James Relle, M.D., Brian Seifman, M.D., Sugandh Shetty, M.D., William Spencer, M.D., Bradley Rosenberg, M.D., Jason Hafron, M.D., Melissa Fischer, M.D., Ronald Rubenstein, M.D., Richard Sarle, M.D., David Steinberger, PA-C, Kaylyn Petzel, RN, Amanda Nash, RN