Improving Patient Care through Research
Conducting research, in addition to a full surgery and clinic schedule, is challenging, and historically there has been a separation between clinical practice and research. Frequently, research findings had little impact on the day-to-day work of clinicians. Times have changed however, and the demand has shifted toward clinical research that is driven by the clinical needs of patients.
In addition, clinical research must demonstrate effectiveness of clinical and surgical practices and improve the overall quality and costeffectiveness of patient care. The involvement in clinical research of “front-line” urologists and other urology providers is critical.
At the forefront of this new paradigm are Department of Urology faculty and staff who actively collaborate with basic science and other researchers and who initiate their own clinical investigations. Some UW Health urologists conduct basic science research. Findings from these studies are crucial to understanding mechanisms of disease. Thanks to motivated faculty, staff and trainees, there is a growing body of dynamic clinical research projects in female urology, urologic cancers, kidney stones, male infertility and sexual health and in the development and use of minimally invasive surgical tools and techniques.
The number of clinical research studies in the Department is higher than ever and includes epidemiologic and population studies using UW Health patient data or larger patient databases, meta-analyses of specific research literature, systematic surveys of both providers and patients regarding surgical and clinical practices and their outcomes, retrospective audits and reviews of internal clinical and surgical practices, reports of outcomes of various surgical and medical interventions, comparisons of surgical techniques or instruments, controlled and/or randomized interventions and clinical trials involving drug or device development.
Clinical investigators in the Department partner with collaborators on the UW-Madison campus and at other institutions and receive funds from the National Institutes of Health (NIH), disease-specific research foundations, professional associations, sources within UW-Madison, UW Health and industry. Urology residents, fellows, medical school students and undergraduate students looking for research opportunities are integrally involved in much of this work. Examples of recently reported or ongoing clinical research:
Urinary Continence and Infection
- Meta-analysis of literature on complication rates of slings used in urinary incontinence treatments
- Effect of dried cranberries on urinary tract infection recurrence in women and on gastrointestinal bacterial profile
- Evaluation of trends and knowledge in primary care treatment of overactive bladder
- Determination of the role of operative time length as an independent predictor of risk for venous thromboembolism in patients undergoing robot-assisted radical prostatectomy; review of hospitals’ selfreporting of risks from robot-assisted laparoscopic prostatectomies
- Effect of medical management on urinary continence and quality of life after robot-assisted prostatectomy
- Effect of vitamin D and genistein (a soy-derived isoflavone) on early stage prostate cancer
- Effect of chemotherapy alone or chemotherapy plus hormone therapy on hormone-resistant prostate cancer
Renal and Bladder Cancers
- Practice patterns of urologists in the U.S. with respect to ablation of small renal masses
- Identification of a novel critical risk factor, the neutrophil-lymphocyte ratio, that predicts upstaging for bladder cancer
- Effect of polyphenon E (a green tea-derived antioxidant) on risk for bladder cancer
- Audit of surgical outcomes for microsurgical denervation of the spermatic cord in the treatment of chronic testicular pain
- Development of an automated technique to better estimate renal stone burden by assessing calculi volume
- Determination of normal reference ranges for urinary risk factors for kidney stones in children
- Assessment of patient attitudes toward management of kidney stones and of health-related quality of life and development of the first disease-specific instrument to assess stone patients’ quality of life
- Effect of a behavioral intervention in patients with recurrent kidney stones on clinical outcomes