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1 N O R T H W E S T E R N U N I V E R S I T Y S D E P A R T M E N T O F U R O L O G Y N E W S L E T T E R T H E U R O L O G Y F L O W F A L L M E S S A G E F R O M T H E C H A I R M A N I N S I D E T H I S I S S U E : D R. J O H N H A I R S T O N O N CBS N O R T H W E S T E R N U R O L O G Y S W E D I S H E X C H A N G E R O T A T I O N I N I N D I A 2 3 G R A D U A T I O N 6 V I T A M I N D D E F I C I E N C Y I N C H I C A G O S A W P A L M E T T O N O B E T T E R T H A N P L A C E B O Northwestern Medicine is a joint effort by the Feinberg School of Medicine, Northwestern University and Northwestern Memorial Hospital to integrate care, education and research to better serve our patients. Over the last several years, a significant amount of effort has been directed at integrating these divergent entities around common goals. The goals of Northwestern Medicine are to integrate care not only at Northwestern Memorial Hospital but also at outlying institutions. Lake Forest Hospital is the first new institution to be added to Northwestern Medicine. We are fortunate to have two of our graduates, Merrill Matschke and Ron Kim, provide excellent care to patients in the northwest suburbs. Over the next few years, other institutions will join the Northwestern Medicine fold and challenge us to continue to provide outstanding care to an everincreasing population. On September 1 st, 2011 our new Dean, Eric Neilson, MD, began his Northwestern tenure. I had a chance to meet with Dr. Neilson on a number of occasions and find him to be a very smart, engaging, and approachable individual. His success at Vanderbilt as the Thomas Fearn Frist Senior Professor of Medicine was outstanding and I believe he will help accelerate our activities here. At the Chairmen s retreat in mid-september, each department presented its clinical, research and educational achievements and goals. We continue to enjoy substantial market share, both locally and nationally. We are very well represented in all the disciplines of Urology with a well-balanced and talented faculty. Most recently, Ed Gong, a pediatric urologist, joined the Urology division at Children s Memorial Hospital. Ed trained at Harvard under Alan Retik who provided him with an outstanding clinical background, and his research interest in regenerative medicine of failed bladder smooth muscle is a very creative and noteworthy program. We continue to attract outstanding fellows to our pediatric, minimally invasive, male health (erectile dysfunction and infertility), reconstructive and oncology programs. Our research programs continue to thrive in a very difficult environment. We are currently ranked 4 th in NIH funding and have a diverse portfolio, including oncology, infections, inflammation, pain, nanotechnology, erectile dysfunction and regenerative medicine. The research program is also highly regarded because of its high degree of interactivity with other basic and clinical departments in the university and beyond. Our residency continues to be among the best in the country. Eric G. Neilson, MD, Approximately 80% of our Dean, Feinberg graduates are from top tier School of Medicine (top 25) medical schools in the country. We are appropriately diversified with 55% women and minorities. About 66% have pursued academic careers. All of our graduates appear to be well established in their practices across the country. - Anthony J. Schaeffer, MD Herman L. Kretschmer Professor and Chair

2 Page 2 DR. JOHN HAIRSTON FEATURED ON CBS SEGMENT Faced with a severe bladder condition preventing him from realizing his dream as a pilot, Chicagoland native Andrew Banieki, turned to Dr. John Hairston for a solution. Dr. Hairston had pioneered a robotic procedure which enabled the patient to eliminate the medication he needed to treat the condition which would allow Banieki to take his place in the cockpit. He was at the upper limit of the medications required to control his bladder that the FAA would allow. Really, the options had become very limited, Dr. Hairston said. Banieki suffered from myelomeningocele, commonly known as spina bifida. Daily medication helped keep the congenital disease at bay, but after two surgeries Banieki still struggled with bladder problems which were hindering his ability to become a pilot. Banieki's doctor at Children's Memorial Hospital referred him to Dr. Hairston who is just one of only several doctors in the country who perform a special type of surgery called robotic bladder augmentation. When Andrew and his family came to see me, they were anxious to help him get to a point where he could live more comfortably and pursue his dreams, said Dr. Hairston, who is a pilot himself. Bladder augmentation has been performed since the 1980's, although typically done with an open abdominal incision. Dr. Hairston and his colleagues have developed a safer, more effective method of bladder augmentation surgery using the DaVinci TM robot. Successful surgery was completed on Banieki in 2010 and he no longer needs medication. Just months later, Banieki took to the sky on his 18 th birthday, flying a training plane for the first time. Now 19, Banieki is on his way to becoming a pilot at Lewis University's flight school and is optimistic for the future. Now here I am, free to do what I want, and now you focus on your career, and you go right at it head on, says Banieki, who never gave up hope on his dream. Dr. Hairston is just glad he could contribute. That s the great part of his story, Hairston says. He s going to be able to achieve his lifelong dream, and I was able to at least help him a little bit along the way. Now here I am, free to do what I want, and now you focus on your career, and you go right at it head on. - Andrew Banieki

3 Page 3 N O R T H W E S T E R N C O M P L E T E S E X C H A N G E W I T H S W E D I S H U N I V E R S I T I E S During the 2009 AUA Annual Meeting in Chicago, members from two universities in Sweden jumped the pond looking to learn from the meeting. Taking advantage of being in a fantastic city like Chicago with an abundance of highly regarded hospitals, they contacted Northwestern for a meeting to discuss American healthcare and visit the hospital. They enjoyed their time with faculty members Kevin McVary, MD, and Christopher Gonzalez, MD, MBA, so much that they offered to host the Northwestern Urology Department in Sweden at a future date. This past March, Drs. McVary and Gonzalez took four other members of the Department to Sweden to exchange ideas and cultural understanding. The two universities who were gracious enough to host the members from Northwestern were Umea and Uppsala Universities. Arriving in Stockholm, Sweden on a clear but chilly day in late March the team made their way up to Uppsala. Far from the bustling city of Chicago, Uppsala is a quiet town with centuries old churches marking the skyline above cobblestone streets. There they observed several surgeries highlighting the application of hexaminolevulinate (HEXVIX), used for detecting Urothelial Carcinoma. This is a new technology, currently only approved in Europe, but being evaluated in the US for detecting CIS as an adjunct with white light cystoscopy. After surgery, a symposium was held for each side to present talks from their lecture series. Topics included ductal adenocarcinoma, urethral stricture disease, T1a and T1b prostate cancer and more. From left to right: Joshua Meeks, Geoff Nuss, Jessica Casey, Dae Kim, Kevin McVary, Christopher Gonzalez Leaving Uppsala behind, the team boarded a plane to jump the Gulf of Bothnia and flew two hours north to Umea. Again, it was back to the operating room where they observed a bulbar urethroplasty, radical prostatectomy, and a nephrectomy. Another symposium was held to keep the exchange of ideas flowing. Sweden, which has a socialized system of healthcare ensuring everyone in the country has insurance, seemed to have a very successful approach according to PGY 5 Dae Kim. Doctors stick to a 40 hour work week but patient time seemed longer according to the group from Northwestern. The trip ended up being a great success as both sides learned a great deal and Sweden was able to show off their fundamentally different healthcare system. The team even managed to squeeze in some sightseeing around Vasa and Stockholm. Dr. Gonzalez performing surgery

4 Page 4 R E S I D E N T E L E C T I V E R O T A T I O N P R O F I L E : I N D I A India is a country where less than 2% of its population has access to medical specialists. This is part of the reason PGY 5, Brian Le, spent 5 weeks there on an international medical trip through Northwestern s Department of Urology. Looking for a vastly different medical perspective than the one found in the United States, Le travelled to the capital city of Delhi, India looking to learn from the experience as well as share his knowledge with the locals there. Le, who began his journey in late January of this year, split his time between two major hospitals in Delhi, home to 22 million people. He was based at a private hospital which was part of the Max Healthcare Hospital System (pictured on page 5), but also spent time at the public hospital, where the line for services stretches out the door. Jumping right into the fray, Le was in the operating room with local Indian urologists everyday. He quickly became immersed in a scene much different from life in a Chicago operating room. While technologically modern, the operating rooms were run very cost-efficiently. All equipment is milked for maximum usage. Nothing is thrown away unless absolutely necessary. While India itself is a very affluent country, its people are quite poor. Because of this, costs are kept at a minimum to ensure patients are able to take advantage of the modern technology. In an area of the world populated with poverty, India is also a mecca of those seeking treatment from neighboring countries. Time and again Le saw patients come in seeking treatment from modern technology and techniques only to later return to their home countries outside of India.

5 Page 5 Le, who grew up in Virginia, is a 1st generation American, coming from a middle class background that is half Vietnamese and half Mauritian. Le rates his trip to India as one of the highlights of his residency so far. It was a wonderful opportunity to learn and experience medicine and the world beyond Northwestern s walls, says Le. It was a great clinical experience and I came away with some new surgical techniques and a different thought process where you have to prioritize based on needs and costs. Le is keeping close ties to those he worked with in India, including PB Singh, the president of the Urological Society of India, whom Le reunited with at the 2011 AUA conference in Washington DC. D R. D A V I D K L U M P P A N D T E A M R E C E I V E G R A N T T O S T U D Y I N T E R S T I T I A L C Y S T I T I S David Klumpp was recently awarded a pilot R24 team science grant from NIDDK for leading an interdisciplinary team to explore a novel question about interstitial cystitis (IC). This new award, Microbiomes of IC, is a Multi-PI grant including Dr. Anthony Schaeffer and Dr. Bryan White of the University of Illinois at Urbana-Champaign. Dr. Schaeffer is an expert on IC pathogenesis and treats many IC patients. Dr. White is an expert at using next-generation DNA sequencing strategies to determine the extent of bacterial diversity (the microbiome ) in clinical samples. The impetus for examining the microbiome comes from recent studies demonstrating that altered microbiomes play a causal role in various diseases, including obesity and colitis. The potential role of the microbiome in IC comes from Dr. Klumpp s data demonstrating that bacteria influence pelvic pain. Together, the team will determine if the fecal and/or vaginal microbiomes of IC patients differ from healthy individuals and whether the associated bacteria alter pain behavior in mice. If successful, this pilot R24 award will generate preliminary data for future grant applications examining the microbiomes in urologic disease.

6 Page 6 C L A S S O F G R A D U A T I O N The Department of Urology said farewell to its chief residents on June 16th, 2011 with a celebration dinner at Gibson s Bar and Steakhouse. Over 75 members from the Department were in attendance to honor Brian Helfand, MD, PhD, Ronald Kim, MD, and Joshua Meeks, MD, PhD. Several doctors spoke glowingly about the residents as well as poked fun at certain events during their time as a resident. Department Chair, Anthony Schaeffer, MD, also addressed the graduates, recognizing the great achievements they ve made with the Department. Dr. Kim has taken a position at Lake Forest Hospital. Dr. Meeks took an oncology fellowship at Memorial Sloan Kettering in NY. And Dr. Helfand enjoyed his time at Northwestern so much that he s staying on for an oncology fellowship. As is tradition, the chief residents had to first endure a roast put on by future Northwestern chiefs, which was one of the best in recent memory thanks to now PGY 6 Vishal Bhalani and PGY 5 Dae Kim. The residents were not the only ones graduating. Northwestern Urology had three fellows this past year who were on hand to receive their certificate. Geoffrey Nuss, MD, completed his Genitourinary Reconstruction Fellowship working with Chris Gonzalez, MD. Jason Hedges, MD, PhD, finished his year as an Andrology Fellow under Robert Brannigan, MD, and Kevin McVary, MD. And David Rebuck, MD was presented his certificate by Robert Nadler, MD, and Kent Perry, MD, for his Endourology Fellowship. Before receiving their certificates, the chief residents took to the podium to reflect on the six years they ve spent at Northwestern and present an award of their own. Som Kundu, MD, was chosen by the chief residents as the Educator of the Year, a highly regarded annual award given out by the graduates. Dr. Meeks received the prestigious RIBA House Staff Award, presented to a senior resident for outstanding performance and whose empathy and skill in patient care best exemplify the standards set by Dr. Riba. Bottom Left: Dr. Kundu receives his award from the chief residents. Top Right: Dr. Schaeffer presents Dr. Meeks with the RIBA House Staff Award Bottom Right:: NU Faculty members Dr. Robert Nadler and Dr. Kent Perry take to the podium to present Dr. Rebuck with his fellowship certificate. Other Awards. Resident Teaching: Valerie Gillis, PA-C Stephen Rohan, MD Student Teaching: Christopher Gonzalez, MD, MBA Ronald Kim, MD

7 Page 7 S T U D Y S H O W S A F R I C A N - A M E R I C A N M E N I N C H I C A G O A T H I G H E R R I S K F O R V I T A M I N D D E F I C I E N C Y If you re an African-American man living in an area with little sunlight, you may want to get your Vitamin D level checked. That s because in a recent study conducted by Adam Murphy, MD, MBA, African-American men living in typically overcast areas like Chicago or Seattle are 3 1/2 times more likely to have a Vitamin D deficiency than Caucasian men. Presented at September s American Association of Cancer Researchers Health Disparities Conference in DC, the study calls into serious question the standard recommended dose for 600 International Units of Vitamin D for all men, regardless of race or geographical location. The study shows that dosage prescriptions should be on a sliding scale. Skin color and sunlight exposure need to be considered for recommended daily allowances of Vitamin D, says Murphy. Murphy, who is based in Chicago, concentrated his studies in that area and found some astonishing numbers. The study revealed that 44% of Chicago area men were deficient in Vitamin D. While this number is high compared to other areas of the country which typically receive more sunlight, when broken down by race the gap jumps off the page. 63% of African American men were deficient versus 18% of European Americans. While it may not surprise you that skin color plays a factor in levels of Vitamin D, the fact that the Institute of Medicine recommends the same amount for all men is alarming. The study found that Caucasian men had an average level of 24.2 units of Vitamin D in their blood, while African American men recorded only 17.2 ng/ml, which is below the 20 ng/ml the Institute of Medicine recommends. While the difference in Vitamin D levels isn t an immediate threat, over time Vitamin D deficiency has been linked to rickets, which leads to muscular weakness and weak bones, and it has also been tied to many other types of illness such as cardiovascular disease and certain types of cancer. The study has received much press since it was presented and has been featured in US News and World Reports, Medscape.com, The Chicago Tribune, Scienceupdate.com, BET.com and more. Adam Murphy, MD, MBA D R. S C H A E F F E R W I N S A U A S C H O L A R A W A R D Anthony Schaeffer, MD, Herman L. Kretschmer Professor and Chair, was awarded the AUA Distinguished Scholar Alumni Award by his peers at the AUA Foundation Scholars Breakfast in The award recognizes his accomplishments as a researcher, urologist and mentor. The AUA was proud to present the award to Dr. Schaeffer, saying, You have continuously provided an excellent research environment, shared your wealth of knowledge, maintained and taught others to maintain impeccable medical standards, and earned the respect and admiration of the entire urologic research community, as well as the membership of the American Urological Association.

8 SAW PALMETTO NO BETTER THAN PLACEBO FOR PROSTATE CANCER Thanks to a recently published multi-institutional study, men with an enlarged prostate now know they can quit wasting their money on the common supplement known as saw palmetto. Findings showed it has no more effect than a sugar pill, even at three times the normal dose. It doesn t work any better than a placebo, said Kevin McVary, MD, FACS, who contributed to the study from Northwestern s Department of Urology. McVary, an expert on benign prostatic hyperplasia (BPH), went on to recommend that men with this condition discuss other options, including surgery, with their doctor. Around half of men at age 50 suffer from BPH and that number jumps to 75% by age 80. Department Notes The Vincent J. O Conor, Jr., M.D. Visiting Professor for 2011 was Dr. Dan Theodorescu, Paul Bunn Professor and Director of the NCI designated Comprehensive Cancer Center at the University of Colorado. Dr. Robert Brannigan participated in the fifth annual Oncofertility Consortium Conference 2011 investigating advances in cancer and fertility on Sept. 12, The study, which lasted 72 weeks and included 14 institutions spanning the United States and Canada, appeared in the September 28th, 2011 issue of the Journal of the American Medical Association. More than 300 men participated in the study, designed to extend treatment duration and up the dosage from previous studies. The lead author is Michael Barry, MD, of the Massachusetts General Hospital Department of Medicine. Kevin McVary, MD, FACS D R. J E S S I C A C A S E Y N E W A U A R E S I D E N T S C O M M I T T E E C H A I R The AUA has appointed Northwestern resident, Jessica Casey, MS, MD, as the new Residents Committee Chair. Possibly the most important aspect of the Residents Committee is the organization of the annual AUA Resident Forum, which is the single best opportunity for Urology residents to learn how to navigate job searches, personal and practice finances, job-related legal issues, and the trade -offs regarding specialty training versus private practice positions, says Casey. Casey s position will last though the academic year and will focus on a national organization of Urology programs, with primary focus based on regional resident education. Visit The Department of Urology on the web at: