Pelvic Reconst / Neurouro Research

Research in Reconstructive Urology and Pelvic Medicine

Faculty in the Division of Reconstructive Urology and Pelvic Medicine lead many research efforts to better understand, manage, and improve the health of individuals with genitourinary and pelvic conditions, including:

  • Urinary incontinence  
  • Overactive bladder 
  • Neurogenic lower urinary tract disfunction (neurourology)
  • Pelvic floor disorders (pelvic organ prolapse) 
  • Urinary infections 
  • Genitourinary reconstruction
  • Interstitial Cystitis and Bladder Pain Syndrome

Our multidisciplinary research studies include basic science, translational, clinical, and health services research projects, as well as projects that focus on quality improvement and outcomes.

We receive funding from organizations such as the National Institutes of Health, the Society of Urodynamics, Female Pelvic Medicine, and Urogenital Reconstruction (SUFU) and other professional and industry groups.

Our work often includes clinical trials that give patients access to the most advanced treatments. Findings from these projects are regularly presented at national and international scientific meetings and published in peer-reviewed journals.

Stem Cell Research for Incontinence

Roger Dmochowski, MD, MMHC; and Melissa Kaufman, MD, PhD, study stem cell therapy as a treatment for stress urinary incontinence in women and men.

Dr. Dmochowski and Dr. Kaufman also are leading a Phase III, randomized, double-blind, placebo-controlled clinical trial to test cellular stem cell technology by Cook MyoSite. Dr. Dmochowski serves as principal investigator for the Nashville site. Dr. Kaufman is study co-investigator at Vanderbilt and the national principal investigator for the entire trial.

Evidence shows that autologous stem cell therapies may prove to be a potential option for urethral sphincter rejuvenation/bulking. This treatment could be used for post-prostatectomy stress urinary incontinence and female stress urinary incontinence.

Overactive Bladder Research

W. Stuart Reynolds, MD, MPH receives funding from the NIH/NIDDK and from SUFU to study pain mechanisms, such as central sensitization, that may underlie overactive bladder syndrome in some patients.

  • Reynolds WS, Dmochowski RR, Wein A, Bruehl S.  Does central sensitization explain Idiopathic Overactive Bladder? Nature Reviews Urology. 2016, 13 (8): 481 – 491. PMID: 27245505, PMCID: PMC4969200. 
  • Reynolds WS, Brown ET, Danford JM, Kaufman MR, Wein A, Dmochowski RR, Bruehl S. Temporal summation to thermal stimuli is elevated in women with Overactive Bladder Syndrome. Neurourology & Urodynamics. 2017; 36(4):1108-1112. PMID: 27434229, PMCID: PMC5247414.  
  • Reynolds WS, Kowalik CG, Cohn J, Kaufman MR, Wein A, Dmochowski RR, Bruehl S. (2018) Women undergoing third line overactive bladder treatment demonstrate elevated thermal temporal summation. Journal of Urology; 200(4):856-861. PMID: 29746857. PMCID: PMC6146049

Melissa Kaufman, MD, PhD recently received funding from SUFU to study outcomes after bladder botulinum toxin injections for overactive bladder syndrome.

Health Services Research for Benign Lower Urinary Tract Disorders and Pelvic Reconstruction

Dr. Reynolds has partnered with the Vanderbilt Center for Surgical Quality and Outcomes Research to study patterns of healthcare utilization and outcomes related to urodynamics and reconstructive surgical devices and procedures.

  • Reynolds WS, Kaufman MR, Penson DF, Dmochowski RR. Trends in Urodynamics in U.S. Female Medicare Beneficiaries, 2000-2010. NeuroUrology & Urodynamics, 2015; 34(5):420-3. PMID: 24976252.  
  • Brown ET, Mock S, Osborn D, Ni S, Graves A, Milam L, Milam D, Kaufman M, Dmochowski RR, Reynolds WS. Temporal trends in conduit urinary diversion with concomitant cystectomy for benign indications: a population-based analysis. Urology. 2016, 98: 70-74. PMID: 27374730, PMCID: PMC5116247  
  • Reynolds WS, Gold K, Ni S, Kaufman M, Dmochowski R, Penson D. Immediate effects of the initial FDA notification on the use of surgical mesh for pelvic organ prolapse surgery in Medicare beneficiaries. NeuroUrology & Urodynamics, 2013; 32(4): 330-5. PMID: 23001605. PMCID: PMC3962985.

Male genitourinary trauma and reconstruction

Niels Johnsen, MD collaborates in multicenter studies on management of trauma patients and genitourinary reconstruction.

  • Johnsen NV, Moses RA, Elliott SP, Vanni AJ, Baradaran N, Greear G, Smith TG 3rd, Granieri MA, Alsikafi NF, Erickson BA, Myers JB, Breyer BN, Buckley JC, Zhao LC, Voelzke BB; Trauma Urologic Reconstruction Network of Surgeons(TURNS). Multicenter analysis of posterior urethroplasty complexity and outcomes following pelvic fracture urethral injury. World J Urol. 2019 May 29. doi: 10.1007/s00345-019-02824-5. [Epub ahead of print] 
  • Moses RA, Selph JP, Voelzke BB, Piotrowski J, Eswara JR, Erickson BA, Gupta S, Dmochowski RR, Johnsen NV, Shridharani A, Blaschko SD, Elliott SP, Schwartz I, Harris CR, Borawski K, Figler BD, Osterberg EC 3rd, Burks FN, Bihrle W 3rd, Miller B, Santucci RA, Breyer BN, Flynn B, Higuchi T, Kim FJ, Broghammer JA, Presson AP, Myers JB; from the Trauma and Urologic Reconstruction Network of Surgeons (TURNS). An American Association for the Surgery of Trauma (AAST) prospective multi-center research protocol: outcomes of urethral realignment versus suprapubic cystostomy after pelvic fracture urethral injury.  Transl Androl Urol. 2018 Aug;7(4):512-520. doi: 10.21037/tau.2017.11.07. 

Clinical Trials

Examples include:

  • Autologous Muscle Derived Cells for Female Urinary Sphincter Repair [link to https://clinicaltrials.gov/ct2/show/NCT01893138] This trial studies how well stem cell therapy works to improve incontinence in women. Investigator: Dr. Melissa Kaufman. 
     
  • Medtronic Registry Study [link to https://clinicaltrials.gov/ct2/show/NCT01524276]  Study Title:  Medtronic Product Surveillance Registry (PSR).  PI:  Melissa Kaufman, MD; Clinical Coordinators:  Carolyn Hicks, RN Begin date:  10/24/2016  Target enrollment:  unlimited  Enrolled:  80 
     
  • Cook Myosite [link to https://clinicaltrials.gov/ct2/show/NCT03104517] Study Title:  CELLEBRATE:  An Adaptive, Two-Stage, Double-Blind, Stratified, Randomized, Controlled Trial Comparing the Safety and Efficacy of AMDC-USR with Placebo in Female Subjects with Stress Urinary Incontinence.  PI:  Roger Dmochowski, MD; Clinical Coordinator:  Bree Leidy, RNBegin date:  5/1/2019Target enrollment:  7Enrolled:  0 
     
  • Allergan APOLLO Study [link to https://clinicaltrials.gov/ct2/show/NCT03320850]  Study Title:  A Phase 2, Multicenter, Randomized, Double-blind, Placebo-controlled, Single-treatment, 2-stage, Dose-finding Study Evaluating the Efficacy and Safety of BOTOX Intravesical Instillation in Participants with Overactive Bladder and Urinary Incontinence.  PI:  Roger Dmochowski, MD; Clinical Coordinator:  Pam Steele, RNBegin date:  7/25/2019Target enrollment:  5Enrolled:  0
     
  • Botox Injection Antibiotic Study [link to https://clinicaltrials.gov/ct2/show/NCT03508921] Study Title:  Comparison of Methods for Prevention of Urinary Tract Infection Following Botox Injection:  A Non-Inferiority Trial.  PI:  Melissa Kaufman, MD; Clinical Coordinator:  Bree Leidy, RNBegin date:  5/31/2018Target enrollment:  68Enrolled:  15