Dr. Dirk Lange is the Basic Science Director of the Centre and is dedicated to understanding various translational research topics in the field of endourology that compliment and support the overall vision of the centre by providing a critical understanding of molecular mechanisms for kidney stone disease and associated complications, that in close collaboration with the centres clinical experts drive the development of novel treatment and preventative strategies for kidney stone disease. Our basic science research program focuses on:

• Ureteral stent pain—any patient how has had a stent knows how painful it is. The lab is improving our understanding of molecular mechanisms that cause, pain, urinary tract infection and discomfort from ureteral stents to find a solution to this common problem.
• Why kidney stones form and the role of the intestinal and urinary microbiome. Our lab has identified stone patients to be deficient of butyrate-producing bacteria in the gut. We have a clinical study looking at dietary supplementation to change the microbiome to determine if this will decrease kidney stone formation. Our pre-clinical work shows that butyrate supplementation decreases calcium oxalate crystal formation.
• This expertise in gut microbiome is being extended across the Institute to also examine bladder cancer and kidney transplant rejection.

Our world-recognized translational expertise with collaborators in complementary fields, the centre’s significant contributions to the field include the development of novel material coatings for indwelling medical devices including ureteral stents and catheters that prevent bacterial colonization, biofilm formation and infection. Furthermore, our centre is the first to characterize and understand how the ureter responds to indwelling stents, leading to the identification of targets for novel therapies to improve stent function and prevent associated pain and discomfort. As a part of this work, we are the first to identify biomarkers in urine that may be used to identify patients at greatest risk for stent-associated complications.

The recent addition of Dr. Connor Forbes to the Centre for Stones and Minimally Invasive Surgery, a new pillar was added to the research program which involves understanding the pathophysiology, experience, and treatment of Benign Prostate Hyperplasia (BPH). Clinical research focuses on novel treatments including comparison of major Minimally Invasive Surgical Treatments (MISTs) such as iTINDTM (Olympus) and REZUMTM (Boston Scientific). Dr Forbes runs a basic science laboratory focusing on understanding hormonal pathways in BPH, aiming to improve prognostication, prevention, and novel treatment for this common ailment that affects all men as they age. In particular, he is working with organoids—artificially grown cells that resemble and organ to facilitate scientific research to better understand BPH and its origins.