By Jason Van Batavia, MD, Attending Pediatric Urologist
Over the last half of 2021 and the start of 2022, members of the Division of Urology at Children’s Hospital of Philadelphia (CHOP) have been busy advancing pediatric urology through research activities ranging from basic science discoveries to innovative 3D modeling of kidney cancers prior to surgery.
The Societies for Pediatric Urology Fall Congress in Miami
After two years of mostly virtual meetings, CHOP urology faculty members were excited to get back together in-person with colleagues from across the country at the Societies for Pediatric Urology Fall Congress held in Miami, Fla., this past December. CHOP faculty were represented on a total of 20 abstracts, including 12 podium presentations.
Given that there were 99 total podium presentations, CHOP faculty presentations made up approximately 12% of the accepted talks at the conference. This is an impressive number that reflects the productivity of the division despite the COVID pandemic.
One particular highlight of the conference was an invited lecture by CHOP Attending Pediatric Urologist Gregory Tasian, MD, MSc, entitled “Increasing the Impact of Clinical Research Through Patient Partnership: Experience from the Pediatric KIDney Stone (PKIDS) Care Improvement Network.” As the lead organizer/researcher of PKIDS, Dr. Tasian shared his insights on this multi-centered, international study focused on patient-centered outcomes and comparative effectiveness data on kidney stone treatment and surgery. As part of his talk, Dr. Tasian had one of his patients discuss his care. This was a truly unique opportunity for the audience to hear directly about the actual patient experience and a highlight of the conference.
On the second day of the conference, CHOP Urology’s basic science research led the way; in fact, CHOP Attending Pediatric Urologists Jason Van Batavia, MD, and Stephen Zderic, MD, presented the only session dedicated to basic science. Dr. Van Batavia’s work on using neuroscience techniques to manipulate brainstem regions that control voiding was voted Best Basic Science Abstract at the conference.
Overall, the conference was a chance for CHOP Urology to showcase the work we've done over the past two years.
Nephron-sparing surgery for Wilms tumor
Over the past decade, Attending Pediatric Urologist Thomas Kolon, MD, has pioneered the use of nephron-sparing surgery for Wilms tumor in children. While many institutions recommend removal of the entire kidney for pediatric Wilms tumor, Dr. Kolon has worked closely with our CHOP oncology and radiology colleagues to optimize partial nephrectomy.
From MRI images, CHOP radiologists fashion 3D models to aid in surgical planning, identification of vital blood vessels, and mapping of dissection planes prior to the actual procedure, with the goal of preserving healthy renal tissue. This technique is especially important in children with bilateral Wilms tumor to help prevent or delay the need for renal replacement therapy.
Dr. Kolon and fellow CHOP Attending Pediatric Urologists Christopher Long, MD, and Sameer Mittal, MD, recently published their experience in the Journal of the National Comprehensive Cancer Network. In addition, Dr. Kolon presented his experience during a plenary session at the American Urological Association’s annual conference in 2021 as part of the John W. Duckett, Jr., MD, Memorial Lecture.
Shining a light on brain-bladder connections
CHOP Urology’s basic science laboratory has been studying the neuronal pathways controlling bladder function by utilizing the modern neuroscience techniques of optogenetics. Optogenetics allows for the control (either activation or inhibition) of specific neurons by shining light onto these neurons.
Drs. Stephen Zderic and Jason Van Batavia have shown that activation of specific neurons in the pontine micturition center (PMC, or Barrington’s nucleus) that express corticotropin-releasing hormone (CRH) leads to inhibition of volitional voiding. This finding opens the door for a novel potential therapeutic targeting lower urinary tract dysfunction, especially voiding postponement, urinary retention, and underactive bladder.
This work was supported by the 2016-2017 Urology Care Foundation Research Scholar Award Program, the National Center for Advancing Translational Sciences of the National Institutes of Health Award KL2TR001879, the Urology Care Foundation Rising Stars in Urology Research Award Program, the Frank and Marion Hinman Urology Research Fund, and the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health Award K08DK120934.