Emerging Therapies and Evolving Practice in Urology: A Q&A With Marah Hehemann, MD
Urologists continue to advance treatments that address men’s most pressing health concerns. In this Q&A, fellowship-trained Marah Hehemann, MD, discusses emerging therapies for prostate cancer survivors, the influence of international surgical techniques on her practice and why she doesn’t mind the longer line for the women’s bathroom at urology conferences.
Q. What promising urologic surgery innovations are you seeing right now?
Dr. Hehemann: I’m particularly interested in new surgical therapies for prostate cancer survivors, many of whom deal with sexual dysfunction and incontinence. It’s such an underserved population. I recently cared for a patient who had been leaking for a decade and never knew treatment was available.
While medications may be ineffective for erectile dysfunction and for urinary issues after prostate cancer treatment, some patients require alternatives, such as intracavernosal injections and intraurethral gels. Surgical options include penile implants for sexual dysfunction and prosthetics for urinary control. I anticipate that innovations like a Bluetooth-controlled penile implant may be on the market in the next three to five years.
Q. You also have a clinical interest in Peyronie’s disease. What can you tell us about that?
Dr. Hehemann: Peyronie’s disease is more common than we thought — as many as 1 in 10 men have this condition. Reconstructive techniques, including the use of prosthetics, can help correct the curvature of the penis. The field is evolving quickly, and surgeons benefit from shared expertise.
That’s one reason I serve as a co-editor of the Video Journal of Sexual Medicine. It’s an online, peer-reviewed video journal of the International Society for Sexual Medicine (ISSM) that allows urologists worldwide to demonstrate their techniques. The journal is available in an open-source format, allowing us to demonstrate our techniques in real time.
Q. What trends do you notice in the field of Men’s Health?
Dr. Hehemann: I believe one of the most exciting trends is the increasing number of women entering the field. Until recently, only 10% of practicing urologists were women, but that’s changing. This year, 60% of UW Medicine urology residents are women and we continue to see the number of women applying to Men’s Health fellowships increasing. Certainly, there’s an even longer line for the women’s bathroom at our subspecialty society meetings.
The greater the diversity in our field, the more we can evolve in our practice. In addition, women connect with male patients differently from their male colleagues. We’ve seen that women can take longer with patients, and women can sometimes provide more empathetic care around sexual dysfunction, infertility and quality of life.
Q. After your fellowship at UW Medicine, you went to Chicago. Why did you decide to return to Seattle?
Dr. Hehemann: UW Medicine is at the cutting edge of urology research and therapies, with physicians pioneering the latest approaches, from focal therapy for prostate cancer to urologic reconstructive techniques to novel methods for treatment of kidney stones. We are a high-volume surgical center, which means our team often gets to see new technologies first. We are on the inside track of what’s going on with the research and development of those technologies.
Q. When is a referral to UW Medicine appropriate?
Dr. Hehemann: People in the five-state WWAMI region (Washington, Wyoming, Alaska, Montana, Idaho) are fortunate to have access to excellent general urologists who treat a wide range of conditions. For patients with complex concerns or those not responding to traditional therapies, UW Medicine offers additional options. We collaborate with community urologists to ensure the best outcomes and remain available as a resource once patients return to your care.
Marah Hehemann, MD, Associate Professor, is a fellowship-trained urologist at the Men’s Health Center at UW Medical Center – Roosevelt. She is also associate program director for the urology residency and associate director for the Andrology fellowship at UW Medicine. You can reach Dr. Hehemann directly at hehemann@uw.edu.
