Geriatric Urology, Neurourology and Voiding Dysfunction

LOCATION: Ruby Memorial Hospital, Morgantown, West Virginia
PRECEPTORS: Stanley Zaslau, MD 
DURATION: 2 weeks minimum
OFFERED: Continuously
MAXIMUM ENROLLMENT: 1 student
STATUS: Elective

Objectives

This elective is designed to provide students with an overview of geriatric urology, neurourology and voiding dysfunction. Students interested in pursuing the following disciplines might be particularly interested in this rotation: Obstetrics and Gynecology, Neurourology, Internal Medicine, Geriatric Medicine, Family Medicine, and Rehabilitation Medicine.

Students will gain competence in the evaluation of the male and female urogenital system; learn the important diagnostic steps in urologic evaluation; to formulate a pertinent differential diagnosis and treatment plan for patients with voiding dysfunction including but not limited to benign prostatic hyperplasia, spinal cord injury, urge and stress urinary incontinence, detrusor hypocontractile states; obtain exposure to complex urodynamic evaluation of the neurogenic bladder; obtain exposure to various nonsurgical and surgical modalities used in the management of neurogenic bladder including sacral neuromodulation.

Methods to Achieve Objectives

Students will function as the primary physician for selected in-patients and out-patients on the urology service who have neurogenic bladder and voiding dysfunction. Students will be supervised by urology residents and faculty. They will evaluate out-patients, in-patients, and consultations as appropriate. They will interview patients, perform physical examinations, formulate differential diagnosis and treatment plans commensurate with their knowledge base and skill level. In addition, they will learn pre-operative and post-operative care and assist with urologic surgery. They will receive intensive individualized instruction in the performance and interpretation on urodynamic studies.

Examination Procedures and Evaluation Criteria

A comprehensive syllabus and core textbook will provide students with didactic information that covers the broad discipline of urology. Voiding Dysfunction: Diagnosis and Treatment (Appell, 2000) is the designated textbook for this course. The following topic areas will be reviewed by the student and faculty during the rotation:

  • Pathophysiology and Classification of Voiding Dysfunction
  • Neurogenic voiding dysfunction: stroke, multiple sclerosis, spinal cord injuries, diabetic cystopathy, lumbar disc disease
  • Female voiding dysfunction: stress incontinence and urinary retention
  • Male voiding dysfunction: bladder outlet obstruction and post-prostatectomy incontinence
  • Clinical pharmacology
  • Treatment of detrusor instability: electrostimulation and augmentation cystoplasty

Students are evaluated by demonstrating proficiency in the above mentioned subject areas as evidenced by a thorough understanding of the material through informal one-to-one conferences with the attending faculty. Students will also be evaluated on their ability to formulate a differential diagnosis and treatment plan, and their ability to deliver effective patient care.

Pre-Rotation Instructions

Please contact Dr. Zaslau two weeks prior to rotation start date. szaslau@hsc.wvu.edu

On first day of rotation, report to Dr. Zaslau, Section of Urology, on the 6th floor of the Health Sciences Center South at 8:00 a.m.