Research and Publications
Dr. Winoker maintains an active research program at the intersection of health and technology with the overarching goal of improving outcomes for patients afflicted by kidney stones. He leads several grant-funded biomedical engineering projects and is a regularly invited lecturer and contributor to the medical literature.
Primary research interests:
- Surgical innovation for kidney stones through the evaluation of novel technologies and techniques
- Opioid stewardship and non-narcotic adjuncts for pain relief in kidney stone patients
- Patient-centered care, including digital health tools to empower patients and improve outcomes
- Better understanding of the physiochemical factors driving the development of various stone types
- Radiographic clinical decision support tools for kidney stone diagnosis and treatment
- Surgical trainee education
Grants & Clinical Trials
Current Research Support:
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Barbara and Donald Zucker Research Grant (July 2022)
Integrated cone-beam CT for the detection of residual fragments following ureteroscopy.
Role: Principal Investigator
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NIH TL1 Postdoctoral Biodesign Training Program (2021-present)
A novel technique for improving the evaluation and diagnosis of upper tract urothelial carcinoma using untethered microgrippers.
Role: Principal Investigator
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Johns Hopkins University Provost Undergraduate Research Award (2021-present)
Development of a urinary tract remote pressure monitor.
Role: Principal Investigator
2021-present
Prior Research Support:
R01CA151395-08
PET-determined prostate brachytherapy dosing using intraoperative image-guidance
Role: Co-investigator, 5% Effort
NCT03471650
A Phase II Study to Evaluate the Performance of PSMA-targeted 18F-DCFPyL PET/CT for the Detection of Clinically Significant Prostate Cancer in Men with an Elevated PSA
Role: Co-investigator, 5% Effort
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Selected Publications
Patient Summary: In the face of an ongoing opioid epidemic, there is a collective push to improve opioid-prescribing stewardship, particularly after surgery. Percutaneous nephrolithotomy (PCNL), a procedure reserved for large and complex kidney stones, is one such urologic surgery that is associated with postoperative pain. This study found that regional anesthesia during surgery can reduce the amount of opioid medications required after surgery without compromising pain control.
Winoker JS, Koo K, Alam R, Matlaga B. Opioid-sparing analgesic effects of peripheral nerve blocks in percutaneous nephrolithotomy: a systematic review. J Endourol. 2022 Jan;36(1):38-46
Patient Summary: Opioids are frequently overprescribed after surgery. Organizational position statements advise using the lowest dose and potency to achieve pain control. However, the lack of guidelines contributes to wide variation in prescribing patterns. As part of a multidisciplinary expert panel, procedure-specific guidelines for postoperative opioid prescribing were designed to help reduce overprescribing in urologic surgery.
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Koo K, Winoker JS, Patel HD, et al. Evidence-Based Recommendations for Opioid Prescribing After Endourological and Minimally Invasive Urological Surgery. J Endourol. 2021 Dec;35(12):1838-1843.
Patient Summary: The presence of stones in the lower pole, or most dependent portion, of the kidney poses unique surgical challenges due to kidney anatomy. As a result, these stones can be more challenging to treat effectively in comparison to similarly-sized stones in other locations. This study provides surgeons with an overview of historical lessons learned and modern recommendations for managing these potentially challenging entities.
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Alam R, Matlaga BR, Alam A, Winoker JS. Contemporary considerations in the management and treatment of lower pole stones. Int Braz J Urol. 2021 Sep-Oct;47(5):957-968.
Patient Summary: The latency of kidney stone disease and potentially long time between symptomatic stone events are among the many factors that beget poor adherence to treatment and lifestyle recommendations. As with other chronic conditions, preventive strategies to reduce the risk of progression and recurrence rely on maintaining appropriate self-management behaviors. mHealth apps possess great potential to support long-term disease self-management, but the number of commercially available options can be overwhelming. This summary comprehensively evaluated patient-oriented mHealth apps available for the medical management of kidney stone disease and provided a standardized framework for evaluating app quality.
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Winoker JS, Koo K, Huang MM, et al. Systematic Evaluation of Smartphone Applications for the Medical Management of Nephrolithiasis. J Endourol. 2021 Jul;35(7):1058-1066.
Patient Summary: Accurate estimation of stone fragment size during ureteroscopy and laser lithotripsy for kidney stones is important for surgical efficiency and the safety of both intraoperative fragment extraction and postoperative passage of residual stone fragments. This study evaluated the use of a novel stone measurement software application during ureteroscopy.
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Koo K, Aro T, Becker REN, Lim S, Winoker JS, et al. Integrated Real-Time Digital Measurement During Ureteroscopic Procedures for Nephrolithiasis: A Workflow Feasibility Study. J Endourol. 2020 Sep;34(9):900-904.
