Stories about: urology

Why are males more prone to bladder cancer than females?

A microscopic view of human testis tissue. Researchers have discovered why males are more likely to get bladder cancer than females.
A microscopic view of human testis tissue. Researchers have discovered why males are more likely to get bladder cancer than females. IMAGE: ADOBE STOCK

New research helps explain why men are three to five times more likely to develop bladder cancer than women.

Using mouse models and human patient data, Boston Children’s Hospital researchers in the urology department, Xue Sean Li, PhD, and Satoshi Kaneko, PhD, found that inherent genomic differences contribute to the contrast in bladder cancer rate between males and females.

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Five devices for pediatrics get help in advancing to market

kids with pediatric devices playing doctor

Medical devices for children tend to have small markets, so development can lag up to a decade behind similar devices for adults. The Boston Pediatric Device Consortium (BPDC), formed through an FDA initiative, aims to change that math.

This month, the BPDC and the Innovation and Digital Health Accelerator at Boston Children’s Hospital announced five winners of a national pediatric device challenge. Each winner will receive a combination of up to $50,000 in funding per grant award and/or in-kind support from leading medical device strategic partners, including Boston Scientific, CryoLife, Edwards Lifesciences, Health Advances, Johnson & Johnson Innovation, Medtronic, Smithwise, Ximedica and the Boston Children’s Simulator Program. These organizations will provide mentorship, product manufacturing and design services, simulation testing, business plan development, partnering opportunities and more.

“We have a major unmet need for pediatric medical devices that are specifically designed to address the demands of a growing, active child,” said BPDC leader Pedro del Nido, MD, chief of Cardiac Surgery at Boston Children’s, in a press release. “We are pleased to support these teams as they work toward accelerating their technologies from concept to market.”

The five Challenge winners are:

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Nerve-growth agent could treat incontinence caused by spinal cord injury

Image of Rosalyn Adam, a urology researcher hoping to develop new treatments for incontinence, working in the laboratory
Rosalyn Adam is the director of urology research at Boston Children’s Hospital.

When the nerves between the brain and the spinal cord aren’t working properly, bladder control can suffer, resulting in a condition called neurogenic bladder. It’s a common complication of spinal cord injury; in fact, most people with spina bifida or spinal cord injury develop neurogenic bladders. Spontaneous activity of the smooth muscle in the wall of the bladder — called the detrusor muscle — commonly causes urine leakage and incontinence in people with neurogenic bladders.

“For children and adults, incontinence can be one of the most socially and psychologically detrimental complications of spinal cord injury,” says Rosalyn Adam, PhD, who is director of urology research at Boston Children’s Hospital. “The ultimate goal of our research is to return bladder control to the millions of Americans with neurogenic bladders.”

Now, Adam and a team of researchers think that they may have found a practical way to treat neurogenic detrusor overactivity by delivering medication directly into the bladder through self-catheterization, a practice that many people with neurogenic bladders already need to perform regularly.

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News Notes: Pediatric science roundup

A quick look at recent research Vector finds noteworthy.

Tracking infants’ microbiomes

cute microbes-shutterstock_317080235-croppedMicrobiome studies are blooming as rapidly as bacteria in an immunocompromised host. But few studies have been done in children, whose microbiomes are actively forming and vulnerable to outside influences. Two studies in Science Translational Medicine on June 15 tracked infants’ gut microbiomes prospectively over time. The first, led by researchers at the Broad Institute and Massachusetts General Hospital, analyzed DNA from monthly stool samples from 39 Finnish infants, starting at 2 months of age. Over the next three years, 20 of the children received at least one course of antibiotics. Those who were repeatedly dosed had fewer “good” bacteria, including microbes important in training the immune system. Overall, their microbiomes were less diverse and less stable, and their gut microbes had more antibiotic resistance genes, some of which lingered even after antibiotic treatment. Delivery mode (cesarean vs. vaginal) also affected microbial diversity. A second study at NYU Langone Medical Center tracked 43 U.S. infants for two years and similarly found disturbances in microbiome development associated with antibiotic treatment, delivery by cesarean section and formula feeding versus breastfeeding.

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The silk scaffold: A promising road to hollow organ reconstruction

Silk photo_black backgroundSilk production and global interest in the lustrous fiber date back to prehistoric times. Today, the natural protein is solidifying itself as a biomaterials alternative in the world of regenerative medicine.

A recent study conducted by Boston Children’s Hospital urologist Carlos Estrada, MD and bioengineer Joshua Mauney, PhD, shows two-layer, biodegradable silk scaffolds to be a promising cell-free, “off-the-shelf” alternative to traditional implants for the reconstruction of hollow gastrointestinal structures such as the esophagus.

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Silk: a cell-free alternative for regenerating bladder tissue

Silk worms could create tissues needed for urinary tract reconstruction.Scaffolds made of silk could give doctors a simple, more effective material for performing bladder augmentation in people with urinary tract defects—to relieve incontinence and prevent kidney damage in children born with small bladders, for example. Rather than using cells to augment the bladder, a complicated process, silk could provide an “off the shelf” option, says Carlos Estrada, MD, a urologist at Boston Children’s Hospital.

Recent research by Estrada and Joshua Mauney, PhD, shows that scaffolds made of fibroin (the protein that makes up raw silk) have worked well in augmenting bladders in animal models—without the need for cells.

Estrada and Mauney built on the work of Anthony Atala, MD, who became head of the Institute for Regenerative Medicine at Wake Forest after undertaking pioneer work in tissue engineering in Boston Children’s Urology Department.

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Reducing radiation exposure in kids with kidney stones

A kidney stone seen on CT (James Heilman/Wikimedia Commons)
A kidney stone seen on CT (James Heilman/Wikimedia Commons)
Two national trends have preoccupied Caleb Nelson, MD, MPH, and his colleagues in the Boston Children’s Hospital’s Urology Department over the past few years. One is the rise in overall exposure to medical radiation. The second is specifically the increased use of computed tomography (CT) scans—rather than clinician-preferred ultrasound—in children with kidney stones.

“We see a lot of kids with stones, and there is a clinical need to better manage their condition,” Nelson explains. “Medical radiation is a risk factor for problems down the road, and we know that the amount of radiation people are receiving has gone through the roof in recent years.”

How big is the problem? Nelson cites data collected on radiation exposure on the U.S. population from 1987 to 2006 by the National Council on Radiation Protection and Measurements (NCRP). At the beginning of the study, about 18 percent of all radiation exposure was medical. By 2006, that number had grown to 48 percent (see chart below).

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Cancer treatment and fertility: Acting now to have children later

While many childhood cancers are readily curable, those cures can come at a cost to future fertility. Sara Barton and Richard Yu want to help lower that cost. (Wikimedia Commons)

With over 75 percent of children diagnosed with cancer surviving into adulthood, more and more parents ask questions about the quality of life survivors can expect in the future, including: Will my child be able to have children down the road?

They’re right to be concerned. The therapies that are so effective at saving children’s lives can themselves cause a host of problems that don’t manifest until years later. These late effects of cancer treatment include particularly harsh impacts on fertility.

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The incredible shrinking hamster prostate

For most men, it’s just a matter of time until an enlarged prostate compels more frequent trips to the bathroom, day and night. A new study from Children’s researchers and colleagues implicates circulating cholesterol and suggests a potential new prevention and therapeutic strategy. The findings are reported in the October Journal of Urology.

The paper is an interesting culmination of a story that goes back nearly 40 years. And granted, it’s a hamster study, but if the research is able to go forward, it could mean a new use for an existing cholesterol-lowering drug.

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