Innovations from the Front Lines in Urology

Innovations in Urology | Fall 2025

It’s a perfect storm: demand for urology care is rising, due in large part to an aging population. The U.S. is facing a shortage of urologists that will only worsen; the urology workforce is already one of the oldest medical specialty areas. And, according to the American Urological Association, more than 60 percent of U.S. counties do not have a practicing urologist.

Lee Ponsky, MD

This well-documented imbalance between need and resources requires creative and innovative solutions.

At ground zero, the increasing daily demands placed on physicians is exacerbating the problem, says Lee Ponsky, MD, Chair of the Department of Urology at University Hospitals Cleveland Medical Center, Director of the University Hospitals Urology Institute.

“As these national trends play out, our physicians are also unduly burdened with requirements for documentation, compliance, billing and more,” Dr. Ponsky says. “After some analysis, I found that if a physician did everything expected of them, they would spend 30 to 35 hours a day working. Furthermore, internal studies show that 85 percent of urologists’ time is not spent with patients. It’s becoming impossible for providers to keep up, increasing physician burnout.”

Part of the solution, Dr. Ponsky says, is to focus on top of license, relieving physicians of duties that don’t require their medical expertise so they can focus where they can bring the most value. The UI is implementing alternative approaches, such as using scribes for documentation, coding experts for accurate billing and relying on statisticians to help in research studies.

“We’re finding that prioritizing physician time and using other resources where appropriate has led to more time with patients, improved efficiencies and throughput, and – most importantly – dramatic improvements in physician and patient satisfaction,” he says. “This helps in research as well. Over the past six years, we’ve tripled our publications and grown from $50,000 in grants to $38 million. Focusing on how we can be innovative in helping urologists practice at top of license definitely pays off.”

The UH Urology Institute is moving the needle in several other important areas as well.

Female Pelvic Medicine and Sexual Health

Under the leadership of David Sheyn, MD, and Adonis Hijaz, MD, the division of Female Pelvic Medicine is leading the way, both at UH and on an international level. The division demonstrates the true physician scientist model of high volume, outstanding care to patients and leading what Dr. Ponsky calls “elegant” research.

“These physicians are being awarded some of the most high-profile national and international grants to support their work and are setting an example for our residents and fellows,” he says. “We’re lucky to have them.

“Rachel Pope, MD, MPH, is a trailblazer in the area of female sexual health and UH is one of the few urology departments in the country with a division of female sexual health,” Dr Ponsky adds. “Dr. Pope has developed a phenomenal reputation for her management of perimenopausal women and those who have concerns related to female sexual health and don’t know where to turn.”

Dr. Pope and her colleague, Shubham Gupta, MD, FASC, are Roe Green Scholars, recipients of grants from UH’s Roe Green Center for Travel Medicine and Global Health to clinicians working in global health. In addition to their own outstanding international work, Drs. Pope and Gupta bring trainees, exposing them to different aspects of global care.

Lifelong Care for Congenital Abnormalities

Children born with congenital urological abnormalities typically require lifelong care, which is part of the magic of UH Rainbow Babies & Children’s groundbreaking Bladder Exstrophy Program: it integrates seamlessly with UH’s adult hospital.

“This continuity of care really differentiates UH from other pediatric urology programs in the U.S. and provides comfort for parents that UH is a destination for their child’s lifelong care,” Dr. Ponsky says. “Over time, these children may need surgical revisions and attention to other issues associated with bladder exstrophy. We have paired our pediatric urology team with our adult reconstructive team, fertility team and cancer management team, so we provide seamless, enduring care.”

Furthermore, Marc-David Leclair, MD, Professor of Pediatric Surgery at France’s Mother-Child Hospital and an international expert in treating complex urological congenital abnormalities, is helping UH create a center in the U.S. for care of patients with bladder exstrophy. Dr. Leclair is also training UH urology surgeons in the highly technical Kelly Procedure, which so far has only been performed in Europe.

The Human Touch: Just What the Doctor Ordered

While surgeons are revered for their technical expertise, they tend to have a reputation for aloofness. Not so at UH.

Two doctors at University Hospitals Rainbow Babies & Children Hospital —

Pedro-Jose Lopez, MD, Division Chief of Pediatric Urology, and Juan Manuel Moldes, MD, a pediatric urologist — have introduced the Compassionate Care approach to surgery. This approach includes time in the operating room to introduce the medical team to the patient, learn more about them, recognize their understandable fears going into surgery and acknowledging the high level of trust they place in a surgeon’s hands.

“This approach has resonated with patients like I’ve never seen,” Dr. Ponsky says. “The humanization and connection this fosters is powerful. Drs. Lopez and Moldes have introduced Compassionate Care throughout UH, and are now publishing their results internationally. It really is an impressive program.”

For more information about any UH Urology Institute programs, call Dr. Ponsky at 440-508-2187.

Contributing Expert:
Lee Ponsky, MD
Chair, Department of Urology
Leo and Charlotte Goldberg Chair in Advanced Surgical Therapies
University Hospitals Cleveland Medical Center
Director, University Hospitals Urology Institute
Director, Urologic Oncology Center
Master Clinician in Urologic Oncology
University Hospitals Seidman Cancer Center
Professor
Case Western Reserve University School of Medicine