Dr Warren Snodgrass is internationally known for his innovations in hypospadias surgery and his evidence-based approach to pediatric urology. An analysis of peer-reviewed literature on hypospadias published from 1945 to 2013 reported he was the most cited author.
Snodgrass developed the TIP repair for distal hypospadias in 1989, 3 years after completing urology residency training and while working as a general urologist in a private practice in west Texas. He published the first series of patients in 1994, and was the lead author in a multicenter report using TIP for proximal hypospadias in 1998.
To determine the limitations for TIP repair, he left general practice and specialized in pediatric urology, first spending a year of fellowship training with Dr Mike Mitchell in Seattle, Washington. Then Snodgrass moved to Dallas, joining the Department of Urology at UT Southwestern Medical School. Shortly thereafter he was named Chief of Pediatric Urology at Children’s Medical Center.
When he arrived in Dallas, Snodgrass organized an Excel spreadsheet database to record data from his original series of TIP repairs. Recognizing the power of being able to rapidly determine his volume of cases and their outcomes, he added to the database day by day information on new patients he managed.
Meanwhile, he built a highly regarded pediatric urology program and fellowship training center at Children’s Medical Center. Members of that group subspecialized into proximal and reoperative hypospadias repair, robotic surgery, female genital reconstruction, spina bifida management, and bladder exstrophy closure to concentrate uncommon conditions into fewer hands so that they could achieve and maintain expertise.
In 2007 Dr Nicol Bush reorganized his entire database, “dummy coding” the information to facilitate SAS analysis. Lessons learned from periodic review of this prospectively collected data, and the subsequent changes in practice it stimulated, became known as the “3Ps” for quality assessment and practice improvement that Snodgrass has described in several publications and in lectures worldwide.
Dr Snodgrass returned to private practice with Dr Bush in 2014 to establish PARC Urology, specializing in complex hypospadias surgery. They also created a charity, Operation Happenis, to increase public awareness of penile birth defects and to promote post-graduate surgical education in hypospadias repair. Together they wrote and published HYPOSPADIOLOGY, a new, comprehensive textbook for surgeons and trainees.
Dr Nicol Bush earned a Master’s Degree in Clinical Sciences from UT Southwestern Medical School after completing her pediatric urology fellowship. Using that advanced training, she re-organized the division’s clinical research program, including advanced statistical analysis of Dr Snodgrass’ hypospadias database.
Her work identified small glans size as a new, independent risk factor for urethroplasty complications. Bush then found preoperative testosterone given to increase glans diameter did not reduce these complications, but a technical modification in glansplasty did.
Beginning in 2010, Snodgrass and Bush co-directed a live-surgery workshop and webinar for hypospadias repair, and later taught the American Urological Association’s Course in Hypospadias. In 2012 Snodgrass and Bush became a surgical team, working together to combine their expertise for proximal and reoperative hypospadias repair. She then applied lessons learned from that initial experience to create PARC Urology as a center for complex hypospadias surgery.
Bush first recognized the emotional impact of hypospadias on both patients and families, and recruited a certified therapist to join Operation Happenis to better understand and provide counseling to address these issues.
Despite significant improvement in outcomes from primary proximal repairs achieved by the surgical team of Bush and Snodgrass, her analysis of reoperations found persistently higher complications. This suggested need for innovations in management beyond refinements in surgical technique, and Bush recommended perioperative hyperbaric oxygen therapy to improve wound healing in a study that is on-going after notable early success.
Dr. Anthony Caldamone is the Director of Pediatric Urology, Hasbro Children's Hospital, and Professor of Surgery (Urology) and Pediatrics, Hasbro Children's Hospital / Warren Alpert Medical School of Brown University in Providence, Rhode Island. Dr. Caldamone has been the Program Director of the urology residency program in Providence since 1990.
Dr. Caldamone graduated from Brown University and Brown University School of Medicine in the first graduating class of the modern day school of medicine. He was the first graduate of the medical school to become full professor at the institution. Dr. Caldamone did his internship and urology residency training at Strong Memorial Hospital in Rochester, New York from 1975-1981. He then did his Pediatric Urology Fellowship at the Children’s Hospital of Philadelphia with Dr. John Duckett from 1981-1982. After the completion of his Pediatric Urology Fellowship in 1982, Dr. Caldamone then consulted at The Hospital for Sick Children on Great Ormond Street in London.
He has serviced as the President of the New England Section of the American Urological Association and also served as the Secretary-Treasurer and President of the Society for Pediatric Urology. He is currently Chairman of the Pediatric Subspecialty Certification Exam Committee, Executive Secretary of the Pediatric Urology Advisory Council and a member of the Examination Committee of the American Board of Urology (ABU) since 2005. In 2012, Dr. Caldamone was the recipient of the University of Rochester Humanitarian Award.
He has been on 14 medical missions to the Middle East, South American, and Bangladesh and has served on the Board of Directors of the Physicians for Peace. He has been a visiting professor and invited lecturer (both nationally and internationally) to 53 institutions and 12 countries. He has contributed over 203 articles and chapters and edited 15 books. He is currently the Editor-in-Chief of the Journal of Pediatric Urology and served as past Editor-in-Chief of the Dialogues in Pediatric Urology from 2005-2012.
Mikel LaPorte, a licensed professional counselor, is a recent graduate of SMU’s Masters in Counseling program. Mikel joins the counseling profession after spending 21 years in the business world. After spending several years in the administration side of healthcare, he longed for more interaction with patients and their families. He is passionate about helping people, and is most fulfilled when he is working directly with patients and families as they strive for the best possible outcomes.
Mikel understands the struggles and strain that a medical condition can have on an individual and on their caregivers. Mikel’s father is legally blind due to complications arising from Type-1 diabetes, and he lost his paternal grandparents at an early age to terminal illnesses. Having the experience of seeing loved ones deal with complications arising from these various illnesses, he understands the compassion, care, and commitment needed to walk with families as they go through these difficult times.