Bolstering the Field of Urology with Advanced Research Studies

Michael Harrison Hsieh is a practicing pediatric neurologist, director of research in the division of pediatric urology, and head of the male fertility preservation program at Children's National Hospital. Hsieh is actively involved in patient care, diagnosing congenital and acquired urologic issues in children, facilitating research seminars, and teaching medical students. His research predominantly concerns parasitic infections that disproportionately affect children in endemic areas and common bacterial urinary tract infections.

In an interview with MedTech Outlook, Hsieh highlights the challenges and developments in research and academic studies. He also shares insights into his patient care and urology initiatives.

What are some of the challenges you encounter as a research director?

Securing ample research funding is always challenging; the National Institutes of Health funded my research group after many challenges.

Another challenge is the increasing pressure to be clinically productive along with the research and help the hospital’s bottom line. Clinicians are expected to deliver patient care along with their studies as the demand has significantly risen after the pandemic as hospitals are trying to recover from financial predicaments.

With constant research and academic studies happening, how do you stay up to date with the new developments in the industry?

The best way to keep up with the latest research and developments is to read the latest medical literature and journals. I use automated literature searches on PubMed and read them, attend conferences, follow cutting-edge research studies conducted by my colleagues, and invite speakers to my division’s research seminars so we can all learn from them.

Are there any recent projects, new research initiatives, or projects you have been working on lately?

Our male fertility preservation program, part of a multicenter clinical trial based at the University of Pittsburgh, facilitates a unique way to restore fertility. Instead of testicular tissue crowd preservation, which can be uncomfortable and frightening for young boys, we make a scrotum incision and freeze a small piece of their testicles so the tissue can be used in the future for fertility restoration.

Our other area of interest is developing better diagnostics for urinary tract infections (UTIs). Currently, we rely on urine cultures to diagnose UTIs, which take many days to return results, and the treatment becomes empiric, especially antibiotic selection. In addition, there have been clinical scenarios where urine culture results were negative even when the patient had a UTI.

The entire urology field is attempting to develop better UTI diagnostics using molecular methods such as PCR or sequencing for bacterial DNA. However, there are legitimate criticisms against the process as relic DNA, DNA from long-dead bacteria, may be detected through these methods, leading to misdiagnosis and inappropriate treatment. 

It is important to counter the disadvantages of current UTI diagnoses by developing methods that combine the precision of molecular techniques and the benefits of urine culture without the downsides.

Talking about your patient care duties, what are some of the strategies you adopt to ensure efficiency?

A facility with electronic medical record (EMR) systems is extremely important for efficient patient care delivery. Accurate patient health data minimizes medical errors and upgrades the quality of medical care.

Examining patient schedule templates and consistently improving them to alleviate delays is also vital as hybrid patient care, where it is sometimes in–person and occasionally virtual, is becoming popular.

What would be your advice to peers and colleagues in the industry?

The challenges in academic pediatric urology, like securing and maintaining funds and delivering patient care, have always been there. All you must do is stay persistent throughout the process for research grants. To provide quality care, ensure you have a strong connection with good practice partners to support each other.