Breyer Research Program

Breyer Research Program

Healing of donor-site
buccal mucosa

We show a unique buccal donor site video and pictures taken daily by the patient after buccal urethroplasty, demonstrating the healing process over time for the first month post-operatively where only the anterior half of the wound was closed, allowing real-time observation of wound healing.  Full story


Featured project: 
Computational  fluid  dynamics  (CFD)  has  paradigm  shifting  potential  in  understanding the  physiological  flow of  fluids  within  the  human  body.  We  evaluated  the  feasibility  of  CFD  for  modeling  the  flow  of  urine in patients with urethral stricture disease. Manuscript under review.  Click here for more information Computational Fluid Dynamic Modeling of Urethral Strictures 

Contact Information
San Francisco General Hospital
1001 Potrero Ave, Suite 3A20
San Francisco, CA 94110-1444
415.476.3372 (Phone)
415.206.5153 (Fax)

Dr. Breyer’s research is focused on improving the understanding and treatment of benign (non cancerous) urologic disease. His research team is particularly interested in:

  • lower urinary tract symptoms (LUTS) and sexual dysfunction caused by benign bladder and prostate disease and by mood disorders, anxiety and post traumatic stress disorder.
  • improving the understanding and treatment of reconstructive techniques  for traumatic urological injuries.
  • the role of Internet search tools in the study of disease epidemiology.

Urinary symptoms and sexual dysfunction
Dr. Breyer is engaged in several investigations examining the influence of mood disorders, anxiety and posttraumatic stress disorder (PTSD) on lower urinary tract symptoms (LUTS) and sexual dysfunction.   Key projects include:

  • A study of the effect of PTSD on LUTS and sexual dysfunction in U.S. veterans who have served in Afghanistan and Iraq. This work is based on data from the Veterans Administration hospitals and is being performed in conjunction with two experts in PTSD: Karen Seal, MD, and Thomas Neylan, MD.
  • A study of depression, suicide and LUTS in a broader population, using data gathered through the CDC’s National Health and Nutrition Examination Survey (NHANES).

Trauma and reconstructive disorders
Many people sustain genitourinary injuries from common consumer products. Using data from the US Consumer Product Safety Commission National Electronic Injury Surveillance System, Breyer and professor Jack W. McAninch, MD, have reviewed emergency department records to track the epidemiology of adult and pediatric genitourinary injuries from such objects as toilet seats, zippers and grooming. The team is currently reviewing genital injuries related to bicycling, other sports, and playground equipment.

The Internet provides a useful tool for collecting demographic data that can suggest patterns of disease. Breyer and his colleagues have used a Google search analysis tool (Insights for Search) to track the incidence of diabetes, myocardial infarction and high blood pressure. Their most recent work used this tool to look for patterns in seasonal and geographic kidney stone incidence in the United States. They found that Internet search volume activity for “kidney stones” correlated with seasonal and regional kidney stone insurance claims data.  Their findings suggest that with refinements in search algorithms, Internet search volume has the potential to serve as a reliable marker of kidney stone incidence.

Health literacy
Dr. Breyer's work in a health safety net population has led him to focus on the unique characteristics of this population, including compromised health literacy. His most recent work to alleviate this challenge has focused on the use of the Visual Prostate Symptom Score (VPSS, (c) Stellenbosch University), a simplified pictographic assessment of lower urinary tract symptoms (LUTS). His findings suggest the VPSS may have improved comprehension compared to the traditional International Prostate Symptom Score in these men.