The Division of Urology at The University of Ottawa has long had a reputation of clinical excellence. Over the last 10 years this clinical excellence has been extended to include research excellence. This has occurred through the creation of the necessary research infrastructure required to create a solid research program and a culture of research.
In 2003, the Division of Urology hired a highly regarded database designer to create a state-of-the-art prostate cancer surgical database which now covers the years 1995 to 2013. We have since gone on to create bladder cancer, renal cell carcinoma (RCC) and upper tract urothelial cancer surgical databases. We now employ a full time database manager to update, ensure data quality as well as extract data from the databases. Databases also exist for male slings, urethral trauma, Peyronie’s disease and a number of pediatric urological illnesses. These databases are used to engage the residency program and enhance resident research. Residents are involved in all database research projects. During the academic year, weekly research rounds are conducted with the residents to assist and mentor them throughout the research process. Fellowship programs exist in urologic oncology, MIS, male health and pediatrics. Fellows are actively involved in research and further engage the residency program. Various members of the Division of Urology have a Masters in clinical epidemiology and education and have protected research time. With this infrastructure in place, the Division of Urology is in a strong position to carry out important research from observational to clinical trials. Another vital piece of infrastructure came in 2008 when the Division of Urology entered into a contract with The Ottawa Hospital Research Institute Methods Center. We now have established close working relationships with Dean Fergusson and Tim Ramsay, two scientists who provide full methodological and statistical support.
Using our research infrastructure the division has been active in clinical outcomes research.
We have studied risk factors of disease progression in prostate cancer such as capsular incision, prostate volume and tumor density. We have worked extensively in renal function outcomes following surgical intervention for RCC, comparing radical and partial nephrectomy (PN), examining predictors of renal function following PN, examining our results with PN in patients with solitary kidneys and validating measures of surgical complexity of PN procedures. The surgical oncology program is now leading a randomized controlled trial of renal hypothermia during partial nephrectomy and have received a $404 000 grant from CIHR. Results from this multi-center trial will have immediate impact on partial nephrectomy surgical technique. Other clinical trials at the design stage include assessing the effectiveness of antifibrinolytics in reducing the need for allogeneic blood transfusion in patients undergoing bladder surgery and an evaluation of radical versus partial nephrectomy.
"The surgical oncology program in the division of urology is currently involved in several research initiatives addressing kidney, bladder, prostate and testicle cancer including an evaluation on the use of MRI in prostate cancer and the role for surgery in testicular seminoma. In addition, the division is a leading contributor to evidence based urology with several recent publications on evidence based oncology."
We have a long-standing collaboration with the Ottawa Fertility Centre and are active in clinical research in all areas of male fertility including fertility preservation in cancer patients.
With the recent opening of the Ottawa Skills and Simulation Centre, we are developing a research program in the use of surgical simulation for both teaching and assessing technical skills, as well as developing assessment tools for use in the live OR setting.
The Division of Urology was instrumental in the creation of the Greta and John Hansen Chair in Men’s Health Research with active research in erectile dysfunction, Peyronie’s disease, the effects of low testosterone on men’s health, and genitourinary prosthetics. In the last 3 years we have expanded into basic science research to this point primarily in men’s health. Dr. Duane Hickling is undertaking basic research into urinary tract infection and the role of antimicrobial peptides in prevention and management.
Pediatric Urology Research
The CHEO Pediatric Urology Division has a reputation in clinical research in which the residents, medical students and fellows are actively involved. They are mentored by the faculty and present their work every year at national and international meetings of the specialty. The staff physicians and trainees have regular research rounds where ideas for new research and updates on the ongoing projects are discussed. The faculty of the Urology Division has expertise in basic and clinical research and clinical epidemiology. We have ample support from the CHEO Research Institute for all the steps of research from study design and grant application to statistical analysis.
Currently there are several lines of urology research under work at CHEO including funded randomized clinical trials:
Biofeedback for urinary incontinence in children.
Investigation of non-palpable undescended testis
Urodynamics in infants
Radiological assessment of intestinal constipation