Research Summary1. The role of heat therapy in the management of symptomatic Benign Prostatic Hyperplasia (BPH) 2. The role of urodynamic evaluation in symptomatic BPH 3. Ileal neobladder following cystoprostatectomy in bilharzial bladder cancer 4. Urinary incontinence following radical prostatectomy 5. The epidemiology of testis cancer Projects: 1. Dr. Steele investigated the role of radiofrequency wave energy in the treatment of Benign Prostatic Hyperplasia (BPH) using Transurethral Needle Ablation of the Prostate. This technique was shown in a long term urodynamics based study to produce durable objective improvements in voiding pressures and flow rates. Research was subsequently expanded to define the role of radiofrequency technology in urinary retention due to BPH. 2. Dr. Steele conducted a prospective urodynamics based study on the mechanism of urinary continence and the pathogenesis of urinary incontinence via an analysis of urodynamic changes following radical prostatectomy. This research showed the importance of the intrinsic sphincter zone length in urinary continence following radical prostatectomy and the need for urethral length preservation during radical prostatectomy. 3. The diagnosis of detrusor instability (DI) is often inferred from clinical history despite lack of urodynamic evidence of the presence of DI. Dr. Steele found isometric detrusor pressure (Piso) in the absence of obstruction to be a reliable predictor of DI even in patients who did not demonstrate DI during the cystometry phase of the urodynamic study. 4. Dr. Steele researched the role of urodynamic studies in male patients with Benign Prostatic Hyperplasia (BPH) and lower urinary tract symptoms (LUTS). He prospectively performed comprehensive urodynamic studies on a large group of patients who were divided into obstructed and non-obstructed groups based on voiding pressure at maximum flow rate (PdetQmax). Other parameters measured were prostate volume and urinary flow rates, and used in combination with the AUA symptom index (AUASI)to determine accuracy of predicting outlet obstruction. A combination of AUASI > 20, prostate volume > 40 grams and maximum urinary flow rate of < 10 predicted bladder outlet obstruction in 100% of patients with these parameters. 5. The role of detrusor pressure at maximum urinary flow rate (PdetQmax) is the gold standard for defining bladder obstruction in male patients with Benign Prostatic Hyperplasia (BPH). Recent reports of Detrusor contraction duration as a more reliable parameter seemed counterintuitive. Dr. Steele subsequently measured Detrusor contraction duration in a large cohort of men with lower urinary tract symptoms (LUTS) and enlarged prostates and found little correlation between Detrusor contraction duration and presence or absence of bladder outlet obstruction. Back to the top | 
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