Curriculum

Endourology/General Urology

The Stone/Endourology Service is a high-volume rotation that receives many complex referrals. Fellows work intimately with Dr. Murphy and Dr. Bellman, the regional stone specialists. Fellows receive exposure to numerous cases requiring extracorporeal shock wave lithotripsy (ESWL) which uses sound waves to break a kidney stone into small pieces, and rigid and flexible ureteroscopy. Residents perform a large number of laparoscopic surgeries, including prostatectomy, adrenalectomy, nephrectomy, pyeloplasty, and renal cyst excision is provided.

As a fellow, you will become highly proficient in the use of various stone baskets as well as the Candela and holmium lasers. Learning the indications for surgical intervention for stone disease, the various endoscopic techniques, and the metabolic studies needed to determine the etiology of urolithiasis is vital to the fellows. Residents and fellows on the Endourology Service learn the pathophysiology and diagnosis of urolithiasis and urinary obstruction, and how to manage patients medically to prevent stone formation.

Clinical Experiences and Rotation

There are educational conferences in the form of clinical presentations, lectures, reviews of recent literature, discussions of research projects, and pathology reviews. Patient rounds are made daily, and grand rounds are held weekly during which resident and attending physicians are free from all clinical duties. There is a basic science conference weekly, and a pathology conference with a genitourinary pathologist monthly. Visiting professors are scheduled on a regular basis, and residents are strongly encouraged to attend outside meetings and conferences. The department of urology hosts an annual symposium which attracts participants from around the world.

Neurourology and Reconstructive Surgery

Junior and chief residents work intimately with Dr. Aboseif on the Neurourology and Reconstructive Service at the LAMC. Residents learn the most advanced techniques for the diagnosis of urinary incontinence, voiding dysfunction, chronic pelvic pain, and male sexual dysfunction. In addition, the service has special expertise in managing patients with chronic neurologic disorders such as multiple sclerosis, spinal cord injuries, and myelomeningocele. Dr. Aboseif utilizes cutting edge technology including videourodynamics, ultrasound and flexible endoscopy. Residents assist Dr. Aboseif to perform more than 50 diagnostic studies every month on both men and women. At the end of training, residents are expected to be familiar with urodynamic equipment and can perform and interpret various studies in evaluation of incontinence. A wide variety of surgical procedures for the treatment of urinary incontinence and voiding dysfunction are performed in this service, including abdominal and vaginal suspensions, sling procedures, collagen injection, reconstructive surgery with bowel segments, and prosthetic surgery. Additionally, residents have a generous exposure to the diagnosis, workup, and treatment of male sexual dysfunction. Residents learn penile color Doppler ultrasound, cavernosometry/cavernosography, and pharmacological testing of erectile dysfunction. Microvascular surgery for selected cases of vasculogenic impotence and various types of penile implants are also performed. The service is also the regional referral center for all cases of penile curvature and Peyronie’s disease as well as various types of urethral stricture disease.

Male Infertility and Infectious Disease

Residents work closely with Dr. Shapiro who performs microsurgery for male infertility. Residents learn and perform vasectomy reversal, vasoepidiymostomy, and microscopic varicocele repair. In association with Dr. Shapiro, residents spend time in the urology clinic seeing patients with a wide spectrum of urologic diseases in addition to patients referred specifically for evaluation of possible male factor infertility. Residents learn diagnosis and treatment techniques for these patients and gain operative experience in general open and endoscopic procedures.