Urologic Subspecialties (Adult Non-Cancer)

Our research group studies ways to improve urinary and sexual wellness. We study topics focused on genitourinary reconstruction, trauma, sexual medicine, health equity, lower urinary tract symptoms and health services research. We frequently use large data and epidemiologic techniques. We have published extensively on patient reported outcomes in urethral stricture disease, incontinence and trauma. We have investigated national trends and cost of bicycle trauma and the impact of cycling on urinary and sexual health.

Our research group studies patient decision making and regret, as well as continuity of care for patients diagnosed with congenital urology conditions as they transition from pediatric to adult urology. We study topics focused on complex urological conditions, quality of life, resilience, emotional health and well-being, and decisional-regret. This research is conducting primarily through longitudinal and prospective registries, as well as retrospective self-report data during qualitative interviews.

Current research focuses include stem cell research, the molecular mechanisms of impotence, molecular mechanisms of female stress urinary incontinence, molecular mechanisms of Peyronie's Disease, molecular mechanisms of PDE5A gene regulation, molecular marker of prostate and bladder cancer and roles of integrins in cancer and urological diseases.

The Roan Lab studies the molecular interactions between RNA viruses and T cells, in the context of viral immunity, persistence, and pathogenesis. We study the mechanisms by which intracellular and extracellular factors in the tissue microenvironment that can affect HIV transmission through mucosal sites. We use a variety of multi-omics single-cell analysis approaches, including CyTOF and single-cell sequencing, paired with bioinformatics analyses, to characterize the mechanisms by which HIV persists in people living with HIV despite suppressive antiretroviral therapy (ART), and to discover ways to achieve ART-free HIV control. Multi-omics tools are also being used to characterize T cell immunity in the context of SARS-CoV-2 infection and vaccination, as well as immunopathogenesis in the context of acute COVID-19 and post-acute sequelae of SARS-CoV-2 in COVID-19. Another research interest of the lab is to understand the cross-talk between endometrial lymphocytes, decidual cells, and soluble factors in seminal plasma in the context of reproductive health, and how these interactions can become dysregulated in diseases associated with female infertility or sub-fertility.

My clinical and research efforts continue to be centered around the treatment and understanding the pathogenesis of urinary stone disease.

Biomineralization is a dynamic process in both normal and pathologic human tissues and plays a vital role in health and disease. Often times, it is difficult to “fix” a pathology with limited knowledge about affected tissues. The Program in Biomineralization Studies (PiBiomS) at UCSF (collaboration between Schools of Medicine (Urology) and Dentistry (PRDS), Lawrence Berkeley National Laboratory, and Stanford Linear Accelerator Center) has two principal goals: 1. To establish patient-guided protocols that would directly address clinically diagnosed problems related to pathological biomineralization (organic and inorganic "culprits" that form biominerals) 2. To disseminate knowledge to patients, residents, graduate students by building education platforms central to biomineralization, both in health and disease states. Currently, biominerals from various tissues including blood vessels, ligaments, penis, kidney, and cartilage are routinely prepared for imaging and are visualized using various microscopy and spectroscopy techniques.