High risk, non-muscle invasive bladder is traditionally initially treated with intravesical BCG. However, approximately 50% of patients treated will eventually relapse and they often require a radical cystectomy. Our initial research demonstrated that an intravesical taxane, docetaxel, was highly effective in providing these patients with a therapeutic salvage, thereby avoiding the need for major surgery and the quality of life impact of bladder removal. Our team has discovered the molecular mechanism of taxane resistance in bladder cancer cell lines. The tau and stathmin proteins convey taxane resistance and this information is being used to identify patients who are likely to respond and more importantly, those who will not since they will require more aggressive therapy which can then be instituted earlier. This observation is now leading to bedside to bench research to determine how to circumvent this resistance.

During this past year, T.J. Martell funds were also used to support new investigations into the aggressive nature of prostate cancers in African-American men, a study that has also attracted critical seed support from the U.S. Department of Defense. Currently, we are investigating prostate cancer in Caribbean men to determine if their high incidence (highest incidence in the world) can be explained by infectious (viral) or a specific inflammatory response to infection.

Principal Investigator

Mitchell C. Benson, M.D.
Professor and Chair, Department of Urology

Co-Investigators:

Cory Abate-Shen, Ph.D.
Professor, Department of Urology and Pathology

Cathy Mendelsohn, Ph.D.
Associate Professor, Departments of Urology and Genetics

Daniel Petrylak, M.D.
Associate Professor, Department of Medicine

Dr. Hensle, who is The Given Foundation Professor of Urology at The Columbia University College of Physicians and Surgeons, described the change as significant in terms of patient care and postoperative management. The majority of patients undergoing a tubularized incised plate urethroplasty (TIP) repair have the catheter left in somewhere between 3 and 7 days. Dr. Chad Ritch, another one of the investigators, described the widespread acceptance on the part of parents having only short term catheterization for their child following this kind of surgery.

The group looked at overall success rate, including complications, and found that the overall group had a urethrocutaneous fistula rate of 6%, which is lower than most reported series where the catheter is left in for a much longer period of time. There was no evidence of other postoperative complications, such as postoperative meatal stenosis or bleeding. Dr. Hensle described the change in postoperative management as significant and the real benefit not only for the child, but for the parents undergoing this kind of stressful and often complicated postoperative care.

At present, all patients undergoing primary hypospadias repair will have short term catheterizations, unless there is some contraindication such as those having had previous urethral surgery or complex proximal primary hypospadias lesions. Further information can be obtained through the Division of Pediatric Urology at 212-305-8510 or by contacting Dr. Hensle directly by email at twhenslemd@aol.com.