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Edward Diaz, MD

  • Edward Clare Diaz
  • “The bond between a parent and a child is one of the most powerful things you’ll ever encounter in this world.”

Working with children is the best thing about my job. Children see and point out things that we, adults, commonly take for granted. This refreshing perspective makes my days so enjoyable.

As a pediatric specialist, I believe that parents are one of the strongest assets we have when caring for a child. The bond between a parent and child is one of the most powerful things you'll ever encounter in this world. I have routinely seen parents help their children overcome illness and fear, and the innate love and selflessness is a thing of beauty.

Being a parent myself, I understand that picking your doctor is a very important decision. When a parent comes to me with their child, I understand that they are inviting me into their lives and that is a privilege. I work hard to make children and parents comfortable, and do my best to make sure everyone leaves with a better understanding of the problem and a care plan that incorporates the most up to date evidence in our medical literature.

Specialties

Urology

Work and Education

Professional Education

University of Southern California Keck School of Medicine, Los Angeles, CA, 06/01/2007

Internship

Cleveland Clinic Foundation, Cleveland, OH, 6/30/2008

Residency

Cleveland Clinic Foundation, Cleveland, OH, 6/30/2013

Fellowship

Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, 6/30/2015

Board Certifications

Urology, American Board of Urology

Services

Urology

All Publications

Pediatric penile reconstruction using autologous split-thickness skin graft JOURNAL OF PEDIATRIC UROLOGY Diaz, E. C., Corcoran, J. F., Johnson, E. K. 2016; 12 (3): 185-186

Abstract

This video provides a case report of penis entrapment secondary to excessive skin removal during circumcision. It highlights the technical aspects of pediatric penile reconstruction using autologous split-thickness skin graft (STSG). Key points include: 1. Infection prevention is paramount and antibiotic prophylaxis is routine. 2. The usual harvest site for the STSG is the lateral thigh because of its source of glabrous skin and convenient proximity to the penis. The lateral thigh is also outside of the diapered area, which helps lessen postoperative pain and infectious risks. 3. A dermatome is used to harvest the STSG. Skin thickness for penis coverage at this age is usually 10-12/1000 of an inch. 4. Direct contact of the graft and wound bed is essential for graft uptake. Hemostasis of the wound bed is critical to prevent hematoma formation. Elimination of redundant tissue is also important to ensure maximal contact between the graft and underlying wound bed. 5. A pressure dressing or bolster is used to prevent shear, and provide contact between the graft and wound bed for at least the first 5 days. 6. A semi-occlusive dressing, Tegaderm, was used on the donor site and it is believed that it provides a moist environment conducive for epithelial and dermal healing. 7. Lymphedema can result if excess distal penile skin is not excised. It is prudent to limit the amount of mucosal collar or consider direct anastomosis to the glans.

View details for DOI 10.1016/j.jpurol.2016.02.022

View details for Web of Science ID 000378522500036

View details for PubMedID 27155806

Catheter-Associated Urinary Tract Infections: If You Hear Hoofbeats... . Annals of emergency medicine Diaz, E. C., Kimball, D. L., Jhun, P., Bright, A., Herbert, M. 2015; 66 (4): 437-440

View details for DOI 10.1016/j.annemergmed.2015.08.003

View details for PubMedID 26398176

The Role of Genetically Modified Mesenchymal Stem Cells in Urinary Bladder Regeneration PLOS ONE Snow-Lisy, D. C., Diaz, E. C., Bury, M. I., Fuller, N. J., Hannick, J. H., Ahmad, N., Sharma, A. K. 2015; 10 (9)

Abstract

Recent studies have demonstrated that mesenchymal stem cells (MSCs) combined with CD34+ hematopoietic/stem progenitor cells (HSPCs) can function as surrogate urinary bladder cells to synergistically promote multi-faceted bladder tissue regeneration. However, the molecular pathways governing these events are unknown. The pleiotropic effects of Wnt5a and Cyr61 are known to affect aspects of hematopoiesis, angiogenesis, and muscle and nerve regeneration. Within this study, the effects of Cyr61 and Wnt5a on bladder tissue regeneration were evaluated by grafting scaffolds containing modified human bone marrow derived MSCs. These cell lines were engineered to independently over-express Wnt5a or Cyr61, or to exhibit reduced expression of Cyr61 within the context of a nude rat bladder augmentation model. At 4 weeks post-surgery, data demonstrated increased vessel number (~250 vs ~109 vessels/mm2) and bladder smooth muscle content (~42% vs ~36%) in Cyr61OX (over-expressing) vs Cyr61KD (knock-down) groups. Muscle content decreased to ~25% at 10 weeks in Cyr61KD groups. Wnt5aOX resulted in high numbers of vessels and muscle content (~206 vessels/mm2 and ~51%, respectively) at 4 weeks. Over-expressing cell constructs resulted in peripheral nerve regeneration while Cyr61KD animals were devoid of peripheral nerve regeneration at 4 weeks. At 10 weeks post-grafting, peripheral nerve regeneration was at a minimal level for both Cyr61OX and Wnt5aOX cell lines. Blood vessel and bladder functionality were evident at both time-points in all animals. Results from this study indicate that MSC-based Cyr61OX and Wnt5aOX cell lines play pivotal roles with regards to increasing the levels of functional vasculature, influencing muscle regeneration, and the regeneration of peripheral nerves in a model of bladder augmentation. Wnt5aOX constructs closely approximated the outcomes previously observed with the co-transplantation of MSCs with CD34+ HSPCs and may be specifically targeted as an alternate means to achieve functional bladder regeneration.

View details for DOI 10.1371/journal.pone.0138643

View details for Web of Science ID 000361797500087

View details for PubMedID 26398705

Carbon dioxide laser for detrusor tunnel creation in robot-assisted laparoscopic extravesical ureteral reimplant JOURNAL OF PEDIATRIC UROLOGY Diaz, E. C., Lindgren, B. W., Gong, E. M. 2014; 10 (6)

Abstract

Demonstrate and report initial results using a carbon dioxide (CO2) laser for detrusor tunnel creation in robot-assisted laparoscopic extravesical ureteral reimplant (RALUR).Retrospective chart review was performed for cases of RALUR from 2011 to 2014. Patients undergoing complex reconstruction (ureteral tailoring, dismembered reimplant, concomitant ureteroureterostomy), and those who had incomplete follow-up were excluded. Variables, including use of the CO2 laser, were collected and correlated with outcomes.23 patients representing 40 ureteral units were included for analysis. A CO2 laser was used in 9/23 (39%) patients and 16/40 (40%) ureteral units. Intraoperative mucosotomy was reported in 3/14 (21%) patients for the electrocautery group and 1/9 (11%) patients for the CO2 laser group. Resolution of VUR was observed in 11/14 (79%), and 9/9 (100%) of patients for the electrocautery group and the CO2 laser group, respectively. Two complications were identified in the electrocautery group of patients: ileus (Clavien 2), and transient bilateral ureteral obstruction requiring placement of ureteral stents (Clavien 3B). There were no complications in the CO2 laser group.Creation of the detrusor tunnel with a CO2 laser is safe and effective, and is associated with a lower rate of failure and complication in this cohort.

View details for DOI 10.1016/j.jpurol.2014.07.006

View details for Web of Science ID 000346364600057

View details for PubMedID 25168317

The promotion of functional urinary bladder regeneration using anti-inflammatory nanofibers BIOMATERIALS Bury, M. I., Fuller, N. J., Meisner, J. W., Hofer, M. D., Webber, M. J., Chow, L. W., Prasad, S., Thaker, H., Yue, X., Menon, V. S., Diaz, E. C., Stupp, S. I., Cheng, E. Y., Sharma, A. K. 2014; 35 (34): 9311-9321

Abstract

Current attempts at tissue regeneration utilizing synthetic and decellularized biologic-based materials have typically been met in part by innate immune responses in the form of a robust inflammatory reaction at the site of implantation or grafting. This can ultimately lead to tissue fibrosis with direct negative impact on tissue growth, development, and function. In order to temper the innate inflammatory response, anti-inflammatory signals were incorporated through display on self-assembling peptide nanofibers to promote tissue healing and subsequent graft compliance throughout the regenerative process. Utilizing an established urinary bladder augmentation model, the highly pro-inflammatory biologic scaffold (decellularized small intestinal submucosa) was treated with anti-inflammatory peptide amphiphiles (AIF-PAs) or control peptide amphiphiles and used for augmentation. Significant regenerative advantages of the AIF-PAs were observed including potent angiogenic responses, limited tissue collagen accumulation, and the modulation of macrophage and neutrophil responses in regenerated bladder tissue. Upon further characterization, a reduction in the levels of M2 macrophages was observed, but not in M1 macrophages in control groups, while treatment groups exhibited decreased levels of M1 macrophages and stabilized levels of M2 macrophages. Pro-inflammatory cytokine production was decreased while anti-inflammatory cytokines were up-regulated in treatment groups. This resulted in far fewer incidences of tissue granuloma and bladder stone formation. Finally, functional urinary bladder testing revealed greater bladder compliance and similar capacities in groups treated with AIF-PAs. Data demonstrate that AIF-PAs can alleviate galvanic innate immune responses and provide a highly conducive regenerative milieu that may be applicable in a variety of clinical settings.

View details for DOI 10.1016/j.biomaterials.2014.07.057

View details for Web of Science ID 000341901300007

View details for PubMedID 25145852

Laparoscopic-Assisted Vesicocalicostomy for Severe Pelvi-Ureteral Stricture Disease JSLS-JOURNAL OF THE SOCIETY OF LAPAROENDOSCOPIC SURGEONS Diaz, E. C., Susan, S., Patel, N. S., Lee, B. H., Cabelin, M., Aron, M., Stein, R. J. 2013; 17 (3): 468-470

Abstract

A 39-year-old female previously treated with shock wave lithotripsy developed extensive ureteral stricture disease. After 2 unsuccessful attempts at retrograde balloon dilatation, she was evaluated at our center for further management. Successful reconstruction was performed with laparoscopic-assisted vesicocalicostomy.

View details for DOI 10.4293/108680812X13291597716627

View details for Web of Science ID 000324517500022

View details for PubMedID 24018089

Identification of the variables associated with pain during transrectal ultrasonography-guided prostate biopsy in the era of periprostatic nerve block: the role of transrectal probe configuration BJU INTERNATIONAL Moussa, A. S., El-Shafei, A., Diaz, E., Gao, T., Zaytoun, O. M., Fareed, K., Ulchaker, J. C., Jones, J. S. 2013; 111 (8): 1281-1286

Abstract

To identify the different factors that are associated with pain perceived during transrectal ultrasonography (TRUS)-guided prostate biopsy (PBx), with special focus on the role of transrectal probe configuration.We analysed prospective data on 1114 patients undergoing TRUS-guided PBx at our institute from January 2007 to August 2010. Patients completed questionnaires based on a 10-point visual analogue pain scale related to the consecutive steps of PBx: probe insertion, application of periprostatic nerve block (PPNB) and the obtaining of PBx cores. The variables of interest were age, prostate volume, DRE findings, number of previous biopsies, probe type and the number of retrieved cores. All variables were correlated to pain scores using multivariate regression analysis.At the probe insertion step, end-fire probes were more painful than side-fire probes. The Siemens G50 with metal, short plastic and long plastic needle guides (Siemens, Munich, Germany) had higher pain scores than the B&K probe (Bruel & Kjaer Medical, Copenhagen, Denmark; P = 0.09, 0.008 and 0.003, respectively). For pain at the PPNB application step, all G50(TM) guide subtypes and the Sonoline Prima probe (Siemens) had higher pain scores than the B&K probe, but this only reached statistical significance for the G50(TM) probe with short plastic guide (P = 0.03). On obtaining PBx cores, all G50(TM) subtypes had higher pain scores when compared with the B&K probe (P = 0.59, 0.38 and 0.69, respectively).The probe design and needle guide affect pain during each step of TRUS-guided PBx. Both the B&K and Sonoline Prima probes caused less pain when compared with the G50(TM) probe, regardless of needle guide.

View details for DOI 10.1111/j.1464-410X.2012.11689.x

View details for Web of Science ID 000319520800029

View details for PubMedID 23465033