Overview

Our fellowship is organized around genitourinary injury and reconstructive urologic surgery. It is run through the adult division of urology at University of Utah and the Center for Men’s Health. The fellowship is directed by Dr. Jeremy Myers.

Vision statement

To create one of the leading fellowships in the country based upon operative experience, teaching excellence, and research opportunities.

Duration

The reconstructive urology fellowship will be one or two years in duration, depending upon the fellow’s goals.

Salary, Benefits, & Other Associated Expenses

The salary for the reconstructive urology fellow is based upon the current salary for a post-graduate year six or seven resident at the University of Utah (depending upon whether fellows have completed a 5 or 6-year residency). The fellow will be expected to attend two meetings during the course of the year. The expected meetings will the AUA and one other national meeting. Attending other meetings will depend upon the fellow’s research interests and academic productivity.

Structure

The fellowship is structured upon three main pillars: Operative experience, teaching, and research.

Operative experience 

Fellows will gain experience in reconstructive urology, genitourinary injury, urinary diversion, prosthetics, male sexual medicine, andrology, female urology, and robotics.

  • Reconstructive urology
    • Urethroplasty
    • Buried penis / split thickness skin grafting genitlia
    • Ureteral repair
  • Genitourinary injury
    • Acute trauma management: University of Utah is one of two level-1 trauma centers in a huge geographic area and treats close to 3,000 trauma cases per year.
    • Radiation injury: managing the full spectrum of injury from conservative to urinary diversion for complications associated with prostate, colorectal, and gynecologic radiation.
    • Surgical: ureteral, bladder injuries associated with recent surgery
    • Spinal cord injury / disease: University of Utah has a strong collaboration with rehabilitation medicine, which serves as a large tertiary rehabilitation center for SCI patients throughout the intermountain west. Augmentation and surgical revision of neurogenic bladder patients are common
  • Urinary diversion
    • Orthotopic neobladder: In bladder cancer patients treated with radical cystectomy
    • Continent catheterizable pouch in patients after cystectomy for bladder cancer and for complications of benign disease
    • Conduit urinary diversion: for benign disease
  • Prosthetics
    • Male urethral sling
    • Artificial urinary sphincter volumes make University of Utah the leading implant site for the entire Mountain West.
  • Female urology
    • Pubovaginal sling
    • Vesico-vaginal fistula
    • Complex mesh excision/revision
  • Robotics
    • Ureteral repair
    • Treatment of ureteropelvic junction obstruction
    • Pelvic reconstruction for bladder neck contracture
  • Gender affirming surgery
    • Vaginoplasty / vulvoplasty
    • Phalloplasty
    • Complications of gender affirming surgery

Additional clinical experience: The fellow will work with Dr. James Hotaling once every other week. This will provide the fellow with experience in andrology / microsurgery, penile prosthesis placement, and penile reconstruction.

Teaching

A major part of fellowship training is learning how to teach surgery effectively. Fellows will have graduated responsibility in the operating room and a major component of this is learning how teach residents. Additional expectations are routine lectures to residents in areas of benign urologic disease. These didactic sessions are focused upon improving the residents’ urologic knowledge base, in order to prepare them for the yearly inservice exam, clinical experiences, and ultimately the urology board exam.

Research

There are many areas that the fellow may choose to work, depending which projects are current, and the fellow’s interest. Some of the current projects underway are the following:

  • Reconstructive urology
    • Full availability of the Trauma and Urologic Reconstruction Network of Surgeonsdatabase. This data source pools data from 12 or more tertiary reconstructive centers in North America and can be used to investigate many aspects of clinical outcomes in urethral stricture and incontinence treatment.
  • Trauma
  • SCI and Neurogenic bladder
    • PCORI grant – A grant entitled “Bladder Management in Patients with Spinal Cord Injury” started in August 2015. This is a multi-institutional study, which Utah serves as the primary investigative site.  The grant’s goal is to assess current trends in SCI bladder management and patient reported outcomes with different bladder managements. A large database has been assembled with many areas of potential investigation.
    • DoD grant – A grant entitled “The Effectiveness of Early Sacral Nerve Stimulation in Preserving Bladder Health and Quality of Life After Acute Traumatic Spinal Cord Injury” began September 2016 and will randomize patients after acute spinal cord injury to SNM placement versus usual care. There are multiple opportunities to use data from this project to describe bladder dynamics after SCI.
    • The Neurogenic Bladder Research Group is a new group of dedicated centers, focused upon meaningful studies in neurogenic bladder. A database is under current development and the group is open to ideas for meaningful studies in the years to come.
  • Utah Population Database
    • The UPDB houses full medical records and pedigree data on 85% of all Utahns. This database is unique and can be used to conduct powerful population based studies. Current areas of investigation in urology are prostate cancer inheritance and treatment, management of urethral strictures, outcomes in pediatric urologic disease, and incidence an impact of radiation injury. The possibilities for meaningful health services research are virtually endless.
    • AUA data grant - We received and AUA data grant in 2018 for the study of radiation injury after treatment of prostate cancer and are currently creating a database for the study of multiple aspects of this problem.

Two-Year Felowship

We are open to the possibility of a two-year fellowship. A year-long extension could help the fellow achieve important goals to further his/her career. These might involve a more in depth exposure to one area of the clinical fellowship, such as gaining additional experience with andrology and infertility, or transitional urology. Other possibilities include an extension, in order to complete a Master’s degree in clinical investigation or education.

Sample Fellowship Schedule

The schedule may vary year to year depending upon interests of the fellow, availability of certain operative/clinical rotations and incorporation of a second-year fellow.

Monday Tuesday Wednesday Thursday Friday
Week 1 Gender Affirmation Surgery OR Clinic Myers OR Myers Academic OR Myers/ Lenherr
Week 2 Burn Surgery Clinic Clinic Myers OR Myers Academic OR Myers/ Lenherr
Week 3 Gender Affirmation Surgery OR Clinic Myers OR Myers Academic OR Myers/ Lenherr
Week 4 Burn Surgery OR Clinic Myers OR Myers Academic OR Myers/ Lenherr

Volumes & Cases

case log update

*The above represents the case numbers of the fellowship in 2018-2019.  During this year Drs. James Hotaling and Jeremy Myers shared the fellowship so it would be expected that there would be a decline in penile prosthetics and reconstruction since there is now a separate andrology and men’s health fellowship.  The fellow should still gain a basic experience with these aspects of men’s health since they will rotate with Dr. Hotaling twice a month.

Program Director

Jeremy B. Myers, MD, FACS


Other Staff

Jim Hotaling, MD, MS, FECSM (Andrology/Men's Health)
Alexander Pastuszak, MD, PhD (Andrology/Men's Health)
Sara Lenherr, MD, MS, FPMRS (Female Pelvic Reconstruction)

Contact Us

For more information, contact the following:

Ashlea Wilkes
Fellowship Coordinator
Phone: 801-587-1336
Email: Ashlea.Wilkes@hsc.utah.edu