Lucas R. Wiegand1, Jin Ye Yeo2
1University of South Florida, Tampa, FL, USA; 2AMJ Editorial Office, AME Publishing Company
Correspondence to: Jin Ye Yeo. AMJ Editorial Office, AME Publishing Company. Email: amj@amegroups.com
Editor’s Note
AME Medical Journal (AMJ) has published a number of special series in recent years, receiving overwhelming responses from academic readers around the world. Our success cannot be achieved without the contribution of our distinguished guest editors. This year AMJ launched a new column, “Interviews with Guest Editors”, to better present our guest editors and to further promote the special series. We also hope to express our heartfelt gratitude for their tremendous effort and to further uncover the stories behind the special series.
The special series "Radiation Urologic Reconstruction" (1) led by Dr. Lucas Wiegand (Figure 1) from the University of South Florida has attracted many readers since its publication. While radiation has excellent outcomes from an oncologic standpoint, the late effects can be devastating. This special series offers some guidelines for the evaluation and treatment of patients with prostate cancer, in addition to other survivors of radiation for different cancers. At this moment, we are honored to have an interview with Dr. Wiegand to share his scientific career experience and insights on this special series.
Figure 1 Dr. Lucas Wiegand
Expert Introduction
Dr. Lucas Wiegand is a board-certified urologist with Orlando Health Medical Group Urology specializing in reconstructive urology. His clinical and research interests include urethral and ureteral stricture disease, neurogenic bladder, incontinence and voiding dysfunction, urologic fistulae, robotics and minimally-invasive urology, and urologic trauma. He is an Associate Professor at the University of South Florida Morsani College of Medicine and practices at Tampa General Hospital. With more than 18 years of experience, he is highly sought after for second opinions and complex case referrals.
Dr. Wiegand earned his medical degree and completed his urology residency at the University of South Florida Morsani College of Medicine in Tampa. He was the chief resident in his final year. Dr. Wiegand performed his fellowship in reconstructive urology at Washington University in St. Louis, where he supervised residents in general urology and reconstructive urologic procedures.
Before joining Orlando Health, Dr. Wiegand was vice chair of urology research and outreach at the University of South Florida, where he also served as associate professor of urology. He was a medical staff officer and chief of urology at Tampa General Hospital. He currently serves as assistant editor of the Video Journal of Prosthetic Urology, and is the author of several medical textbook chapters and a frequent contributor to peer-reviewed journals.
Dr. Wiegand is board-certified by the American Board of Urology. He is a member of several professional organizations, such as the American Urologic Association, Florida Urological Society, and the Society of Genitourinary Reconstructive Surgeons.
Interview
1. What drove you into the field of urology?
Dr. Wiegand: I am so fortunate to have been chosen to be a urologist. When I first started trying to figure out what specialty I wanted to dedicate my life to, I met some of the nicest people, genuinely caring physicians and skilled surgeons. I wanted to be like them. One of the greatest of them all is Jorge Lockhart, the chairman at the University of South Florida when I was a resident and also a faculty member. He will forever be a mentor and someone that I model my career after.
2. Has there been any exciting new advances in radiation therapy in the past two years? How have these advances impacted the field of reconstructive urology?
Dr. Wiegand: One of the biggest advances in caring for the radiated patient as a reconstructive urologist is the great data coming out that shows hyperbaric oxygen as a way to reverse some of the damage of radiation therapy. I am now seeing many patients who previously received hyperbaric oxygen treatment before they got to me for reconstruction. The word is out to the community of urologists and they see the benefits in their patients.
3. What are some significant challenges of radiation urologic reconstruction?
Dr. Wiegand: The major issue with reconstruction in the radiated patient remains to be the ability to perform adequate dissection while maintaining blood supply. Hyperbaric oxygen has helped, but the tissue is never as healthy as a non-radiated patient. Indocyanine green has helped with identifying which tissue is perfused, but the poor blood supply still makes outcomes worse for the radiated patient as compared to their non-radiated counterparts.
4. Could you share more about your current research works?
Dr. Wiegand: Two projects are important in regard to radiation and the field of reconstructive urology. First, drug-coated balloon dilation for the radiated posterior urethral stricture has been a game-changer in my practice. Before the Optilume balloon, these patients were doing self-catheterization or undergoing complex reconstructions that often led to incontinence. The Optilume balloon is changing that and my data will be published soon.
Secondly, the Single Port robot by Intuitive is a much less invasive way to reconstruct patients with radiated ureteral stricture and bladder neck stenosis. Before, these patients would have been relegated to living with a catheter. Now, an outpatient procedure can correct major issues and prevent significant urologic problems, especially in an aging patient.
5. What are some of your aspirations for the future of urology research? How has the direction of your past/current research works changed to reach your research goals?
Dr. Wiegand: I would like to see more work done for minimally-invasive treatments of these complex issues and I have shaped my career to help with this goal.
6. If given the opportunity to update this special series, what would you like to moderate, add, or emphasize to provide a more comprehensive series?
Dr. Wiegand: I think that prevention is more important than cure. I would like to see more research done and more discussion around whether radiation is needed at all for patients with low-risk prostate cancer and possibly even other diseases outside of the urologic domain.
Reference
- Radiation Urologic Reconstruction. Available online: https://amj.amegroups.org/post/view/radiation-urologic-reconstruction