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Reconstructive Urology Fellowship Program


The Reconstructive Urology Fellowship at the University of Colorado Denver School of Medicine is a one-year clinical fellowship under the mentorship of Brian J. Flynn MD, Associate Professor of Surgery in the Division of Urology. 

This clinical fellowship includes mentored graduated experience focusing on reconstructive urologic surgery including pre-operative evaluation, intraoperative management with familiarity in reconstructive techniques, instrumentation, retractors, and post-operative management and care. The prospective fellow will have privileges at University of Colorado Hospital, be responsible for his/her own clinic, have the ability to book cases and manage the care of patients. In addition, the fellow will be involved in all related clinical research activities during the training period.

Pre-requisites For Admission 
The fellowship is open to persons who have completed an accredited Urology residency training program in the United States, are licensable in the State of Colorado and are board eligible in Urology. The applicant must have a letter of support from their Program Director attesting to the successful completion of the urology training program and recommending them for the fellowship. Two additional letters of recommendation are required.

One trainee per year will be accepted into the fellowship training program.

Please note: Residents in our program must be a U.S. citizen, lawful permanent resident, refugee, asylee, or possess the appropriate documentation to allow Resident to legally train at the University of Colorado Denver School of Medicine.

Learning Objectives 

  1. Management of Female Urinary Incontinence
  2. Pelvic Organ Prolapse Surgery
  3. Fistula Surgery
  4. Male Incontinence Surgery
  5. Management of Neurogenic Bladder
  6. Management of Urethral Stricture Disease
  7. Management of Ureteral Stricture Disease
  8. Bladder Reconstructive Techniques
  9. Urodynamics

Overall Program Goals
At the end of this fellowship in Reconstructive Urology, the fellow will have obtained knowledge in the core reconstructive urologic procedures. The fellow will be knowledgeable especially in the following areas:

Uro-gynecology, Female Reconstructive Surgery

  • Female Urinary Incontinence including stress urinary incontinence, urgency incontinence
  • Reconstructive surgery for pelvic organ prolapse
  • Reconstructive surgery for urethral diverticulum and vesico vaginal fistula

Male Reconstructive Surgery

  • The management of male stress urinary incontinence and proficiency in artificial urinary sphincter implantation
  • Management of urethral stricture disease including urethroplasty and substitution urethroplasty using grafts and flaps (both local flaps as well as extra-genital flaps)
  • Fellow will be proficient in management of urethral fistulas including rectal-urethral fistula and urethro-cutaneous fistula

Bladder and Ureteral Reconstruction

  • Fellow will demonstrate knowledge in ureteral reconstruction and be adept in the full array of reconstructive procedures including ureteral re-implantation, uretero-ureterostomy, transuretero-ureterostomy, ileal uretero substitution, boari flap, and pyeloplasty (both open and laparoscopic)
  • Bladder reconstruction including bladder augmentation, creation of catherizable urinary stomas, urinary diversion

Research
The fellow will be involved in all related clinical research activities. The fellow will be able to select three (3) ongoing projects to be directly involved in. The expectations are that these projects will be completed at years end in the form of a manuscript that is prepared for publication in a peer-reviewed journal. Additionally, the research will be presented at a local as well as a national urologic meeting.

Furthermore, the fellow is encouraged to develop one or two projects independently and be mentored by the Program Director on these projects with similar goals in terms of publication and presentation. The fellow will be provided with a broad array of ongoing projects that are pertinent to the fellowship training in reconstructive urology and from these will be expected to select his topics.

Program Summary
"In short the fellowship is a 50/50 mix of male and female reconstruction. I perform about 400 cases/year and a fellow and/or resident is involved in most of those cases (especially at the VA, TCH Denver, and Denver health are resident cases). It is delicate balance but we are able to make it work, occasionally some friction but that will occur anywhere. My philosophy is if it is a case a non-fellowship trained Urologist should be capable of doing after graduation then they are the first assistant (TVT, sling revision, prolift, AUS, IPP, EPA, interstim, etc..) if it is a case only a fellowship trained reconstructive urologist should do following graduation then the fellow is assisting (RU fistula, posterior urethroplasty, anterior urethroplasty with BMG, complex bladder or ureteral reconstruction, VVF, UVF, etc.)

Additionally, the fellow will have attending privileges and will have their own clinic (4 clinics/month) and cases of his own that he will function as the staff (about 4-8 cases/month). Also, as the year progresses he will function as the staff on combined cases (for example the fellow harvests the graft while I work on the urethra, or vice versa). We do a number on large recon cases (3-5/month). In such cases, the fellow will be the attending for a significant portion of the procedure or even all of the procedure if he or she is capable (after the 3rd month of the year). Cases on radiated patients are often a 6-8 hr tour-de-force. The fellow may remove the bladder and complete the diversion, while I do the vaginal reconstruction. In the NGB pt the fellow will do the augmentation, while I place a sling, and we will then perform the monti tube or mitrofanoff together."

Feel free to call me on my cell (720-394-6481) or email for more information.

Brian J. Flynn, M.D.
Director of Urogynecology, Reconstructive Urology and Urodynamics
Associate Professor of Surgery/Urology
University of Colorado Denver
Email: Brian.Flynn@UCdenver.edu

Useful websites
http://www.sufuorg.com
http://www.societygurs.org
http://www.augs.org
http://www.auanet.org
http://www.siu-urology.org

Current Fellow 2010 - 2011

David A. Hadley, MD

Past Fellows
2009-2010 - Christopher R. Knopick, MD
2008-2009 - Ryan P. Terlecki, MD

TO APPLY:
Click here for the application form.
Applications are now being accepted for a fellowship beginning July 1, 2012. Deadline for completed applications is January 1, 2011.