Urology Newsletter Fall 2020

Volume 6 Fall 2020

Department of Urology

How You Can Support the Department of Urology

Many Strengths.

One Mission.

Dear Alumni and Friends, I am cautiously optimistic and relieved to share that although this year has come with unprecedented challenges caused by the COVID-19 pandemic, the urology department’s adaptability and perseverance enabled us to continue to provide needed urologic care to our community. The department came together with a plan to mitigate risk to our patients and caregivers and used a combination of telehealth visits, wise use of scarce testing resources and ”COVID-19 safe”, in-person visits to maintain needed access to care. We were prepared for a surge, with a plan that would best deploy our residents and faculty to take care of the urology-specific needs for a large group of ICU patients and help in other ways we could. I am very pleased to report that we were able to reach this point without illness in the residents, faculty or clinic staff. We felt that being a small department, it was incumbent to maintain our own health to allow patients access to care, as our patients have probably never been in more need of quality medical care, physician engagement, emotional support and communication.

This was a unique opportunity to care for, educate and comfort our patients during these uncertain times. We are now in to our COVID-19 pandemic routine.

Part of the adaptability was maintaining the educational program with appropriate social distancing.

Our residents have become “Zoom tech experts”, as we use teleconferencing for our grand rounds, didactic teaching conferences, research meetings and even Julie and Hilary’s residency graduation celebration.

Finding the positive in this huge change is that there is less travel required between sites and more people can participate in important conferences, such as teaching rounds on Tuesday afternoons.

Our residents and faculty have continued with research projects and are having to change plans for presentation and submission. The regional and national urology meetings are all adapting by incorporating a remote access, interactive webinar format. We are participating as best we can to exchange and present research projects that enhance and improve the science of urology and, ultimately, patient care. The department mentored five summer research students this year, and we have continued with completing projects and submitting papers for publications.

One thing is sure, no matter how optimistic I am, a Zoom-based western section AUA meeting is not as desirable as going to Hawaii for the meeting!

As you have all probably heard by now, the residency program received a complement increase from the ACGME, and we welcomed three new interns in July, Dr. Kevin Cheng, Dr. Ruby Kuang and Dr. Sikai Song.

We also welcomed a new PGY2 resident in April, Dr. Avi Assidon. This is a very important milestone, as it “right sizes” for our residency to meet current standards, though it will take five years to reach our full complement. The faculty and residents have been energized by achieving the complement increase.

We said farewell to our chief residents, Dr. Julie Cheng and Dr. Hillary Wagner, with a virtual graduation held via Zoom. There were over 70 faculty, alumni, residents and family members in attendance. Although graduation was much different this year, we upheld tradition with the yellow shoes signing and diploma presentation.

Please send your positive thoughts and prayers for a speedy recovery to Dr. Greg Lang. Greg was in a bicycle accident recently and has begun what will be a complete, but months-long, recovery to be back to work in surgery and to his active and athletic lifestyle.

Our prayers go to him for a steady recovery.

Thank you all for your support and friendship. As was reinforced by the pandemic, urology is a small specialty with a unique group of patient needs, and we are fortunate to have a skill set that can heal and comfort. We are certainly blessed to be needed and to have an opportunity to continue with our mission to continue the teaching and healing ministry of Jesus Christ in this time of stress.

Thank you and God bless each of you and your families.

Herbert Ruckle, MD, FACS Roger Barnes Chair and Professor of Urology Loma Linda University Health

Welcome New Urology Interns Kevin Cheng, MD Dr. Kevin Cheng joined general surgery on July 1, 2020. Kevin attended medical school at USC Keck School of Medicine. He is a lifelong Lakers fan, enjoys surfing and serves as a mentor to at-risk youth in his community. He will start his urology residency as a PGY2 on July 1, 2021.

Ruby Kuang, MD Dr. Ruby Kuang joined general surgery on July 1, 2020.

Ruby attended medical school at UCLA School of Medicine. She enjoys running and participating in half marathons, as well as cooking and trying new recipes. She will start her urology residency as a PGY2 on July 1, 2021.

Sikai Song, MD Dr. Sikai Song joined general surgery on July 1, 2020. Sikai attended medical school at the University of San Francisco, School of Medicine. Sikai enjoys learning new languages, painting, drawing and traveling. She will start her urology residency as a PGY2 on July 1, 2021.

Welcome our New Resident Avi Assidon, MD Dr. Avi Assidon joined the urology residency program as a PGY2 on April 1, 2020. Avi attended medical school at Florida State University College of Medicine. Avi completed his PGY1 general surgery internship at University of Chicago, Department of Surgery. Avi completed his PGY2 general surgery year at Stanford Department of Surgery.

Prior to his start with our program, Avi was a visiting research fellow at Stanford School of Medicine. Avi enjoys weightlifting, yoga and long-distance running. lomalindaurology.org

Loma Linda University Health

Resident Poster Presentations at the 2020 Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction Winter Meeting Dr. Ruth Belay and Dr. Jon Maldonado presented findings of a retrospective review demonstrating that a full-stage SNM implantation should be considered in patients with OAB in order to save time, cost and patient mobility.

Photo Left to Right: Jon Maldonado, MD, Andrea Staack, MD and Ruth Belay, MD

Patient Testimonial – Jan Michaelis For the ten-week anniversary of my prostate surgery, I rode 53 miles on the road bicycle on Sunday.

I am doing well and feeling fine. Thank you for doing a great job on me. I put a lot of work into getting in shape for surgery, and it paid off during my recovery. Then there was that fine robotic work that the robotic team did during the surgery.

Photo: Jan Michaelis

lomalindaurology.org

Dr. Ruckle, Dr. Roger Hadley, Janelle Warren and the entire urology team have been fabulous throughout my pre-surgery and post-surgery experience.

Loma Linda University Health

Graduating Chiefs, Dr. Hillary Wagner and Dr. Julie Cheng Congratulations to our 2020 chief residents Dr. Hillary Wagner and Dr. Julie Cheng. Our graduation looked much different this year as we celebrated with a Zoom graduation on Sunday, June 7. We held a small gathering at the Faculty Medical Offices parking lot to present Dr. Cheng and Dr. Wagner with their diplomas, and we kept tradition with the “yellow shoes” signing.

Photo Left to Right: Julie Cheng, MD, and Hillary Wagner, MD

Photo: The “Yellow Shoes”

Dr. Wagner joined Loma Linda University Department of Urology as a female pelvic medicine and reconstructive surgery fellow on July 1, 2020. Dr. Cheng joined Children’s Hospital Seattle as a pediatric urology fellow on July 1, 2020.

THANK YOU to Dunn Edwards in Colton for Donating N95 Masks!

Thank you to Dunn Edwards in Colton for the incredible donation of much-needed N95 masks to the urology department. Our faculty, resident physicians and clinic staff continue to provide patient care on the front lines, and this PPE came to us at the beginning of the pandemic, when we needed it the most. We are so grateful to Dunn Edwards and the community for coming together to support us during these uncertain times. lomalindaurology.org

Loma Linda University Health

How You Can Support the Department of Urology Loma Linda University Health Department of Urology is a leading center and resource for urological patient care, training and research in our region. In today’s environment, charitable support for the department’s mission is very important to our continued success. We are blessed to have a busy clinical practice that allows for excellent residency education and is a fertile incubator for innovation and research to advance our specialty. As seen by our projects, we are keenly interested in research that is rapidly translated to the bedside, for better patient care.

Contributions may be made for general academic support, restricted to a specific area within the Department of Urology (i.e., to support training, specific disease research, equipment), or to support a specific memorial chair, professorship or the Roger Barnes Endowment Fund. Any gift allows us to support our “triple aim” of education, research and innovative patient care and progress in our quest to find cures for urological diseases, improve lives and remain dedicated to our motto “to make man whole”.

Our recent presentations and publications are evidence of the outstanding and collaborative work of our students, residents and faculty, supported by our Barnes Research Endowment. Our recent project, the MRI/ultrasound fusion prostate biopsy program, has been very successful, and we thank our donors who brought the project to fruition. We are deeply grateful for the generous charitable donations from alumni, patients and friends. Thank you to Linda and Chuck Garber of The Pryke Foundation, The Hedco Foundation, Thomas Hendrix and Dr. Edward Allred for your recent and ongoing support and for helping the MRI fusion and other projects move forward.

Congratulations to Dr. Ed Ko and Dr. Cayde Ritchie Dr. Ed Ko and Dr. Cayde Ritchie published in the First International Journal of Andrology Andrologia Oxidative stress in the pathophysiology of male infertility Abstract: The effects of reactive oxygen species on male fertility are governed by the oxidative paradox, defined by a delicate balance between oxidative stress and antioxidant capacity.

When regulated appropriately, reactive oxygen species ensure effective function; however, when uninhibited, they represent key players in male factor infertility. Mechanisms responsible for this include oxidative destruction of sperm lipid membranes, damage to gamete DNA both by gene mutation and by direct breakdown of the DNA backbone, mitochondrial dysfunction and apoptotic cell death. Utilizing various male pathologies as case studies, we see ways in which oxidative stress has the potential to impact fertility in a negative way. Varicocele, erectile dysfunction, testicular cancer and even idiopathic male infertility highlight common mechanistic pathways, as well as subtle variations in the ways reactive oxygen species can operate. Oxidative biomarkers have emerged to better study male infertility, predict reproductive success and modify assisted reproductive technologies to minimize oxidative stress.

LLUHMKT#5627-SH-20/1120/1

Ritchie, Cayde, and Edmund Y. Ko. 2020. “Oxidative Stress In The Pathophysiology Of Male Infertility”. Andrologia. doi:10.1111/and.13581.