Profile

Margarett Shnorhavorian, MD, MPH

Margarett Shnorhavorian, MD, MPH

Urology, Disorders of Sex Development, Developmental Pediatrics

On staff since July 2006

Children's Title: Surgical Director, DSD Program; Director, Research Division of Urology

Academic Title: Associate Professor of Urology, University of Washington; Director, Clinical Research

Research Center: Center for Clinical and Translational Research

    • Michele Gillette, WY 06.22.16

      Dr. Shnorhavorian has been my daughters doctor since she was 1. We trust and love her. She has been a straight shooter and a wonderful comfort. My daughter feels comfortable with her and we will be coming back all the way from Wyoming for my daughters surgery. We will always trust Dr. S with our baby girl.

  • Award Name Award Description Awarded By Award Date
    Prize Abstract Session Prize Abstract Session presentation American Urological Association National Meeting, Society of Pediatric Urology, "Fertility Preservation among Adolescent and Young Adult Cancer Survivors in the AYA HOPE Study," San Diego, California American Urological Association National Meeting, Society of Pediatric Urology May 13, 2013
    First Place Clinical Research Award Section on Urology, National Conference & Exhibition American Academy of Pediatrics 2012
    Southwest Oncology Group Young Investigator Award 2010
    COG-AFLAC Young Investigator Award in Adolescent and Young Adult Oncology 2009
    Male Reproductive Health Research Award NIH K-award 2008 - 2013
    • Ritenour CW, Seidel KD, Leisenring W, Mertens AC, Wasilewski-Masker K, Shnorhavorian M, Sklar CA, Whitton JA, Stovall M, Constine LS, Armstrong GT, Robison LL, Meacham LR
      Erectile Dysfunction in Male Survivors of Childhood Cancer-A Report From the Childhood Cancer Survivor Study.
      27117527 The journal of sexual medicine , 2016 June - 2016 June : 13(6)945-54 PMCID: PMC4879056
    • Kieran K, Shnorhavorian M
      Current standards of care in bladder and prostate rhabdomyosarcoma.
      26776454 Urologic oncology , 2016 Jan. 8 - 2016 Jan. 8
    • Ellison JS, Shnorhavorian MS, Willihnganz-Lawson K, Grady RW, Merguerian PA.
      "A Critical Appraisal of Continence in Bladder Exstrophy: Long-Term Outcomes of the Complete Primary Repair
      Journal of Pediatric Urology , 2016
    • Ellison JS, Shnorhavorian MS, Grady RW, Merguerian PA.
      "Impact of Concomitant Hernia Repair at time of Complete Primary Repair of Bladder Exstrophy
      Journal of Pediatric Urology , 2016
    • Akhavan A, Richards M, Shnorhavorian M, Goldin A, Gow K, Merguerian PA
      Renal Cell Carcinoma in Children, Adolescents and Young Adults: A National Cancer Database Study
      25451825 J Urol , 2014 Nov. 4
    • Akhavan A, Shnorhavorian M, Garrison L, Merguerian PA
      Resource Utilization and Costs Associated with the Diagnostic Evaluation of Nonrefluxing, Primary Hydronephrosis in Infants
      24704116 J Urol , 2014 Apr,
    • Akhavan A, Merguerian PA, Larison C, Goldin A, Shnorhavorian M
      Trends in the Rates of Pediatric Pyeloplasty for Ureteropelvic Junction Obstruction Over 19 Years: A PHIS Database Study
      Advances in Urology , 2014 Apr,
    • Keegan TH, Tao L, Derouen MC, Wu XC, Prasad P, Lynch CF, Shnorhavorian M, Zebrack BJ, Chu R, Harlan LC, Smith AW, Parsons HM, AYA HOPE Study Collaborative Group
      Medical care in adolescents and young adult cancer survivors: what are the biggest access-related barriers?
      24408440 Journal of cancer survivorship : research and practice , 2014 Jan. 10
    • Akhavan A, Merguerian PA, Grady RW, Disandro M, Shnorhavorian M
      Digital photographic measurement in hypospadias: Validation and comparison to intraoperative measurement.
      24291248 Journal of pediatric urology , 2013 Nov. 7
    • Shnorhavorian M, Charlesworth-Attie S, Wilder-Smith A, Cress R, Hamilton A, Kato I, Keegan T, Lynch C, Prasad P, Wu X, Harlan L , Schwartz S
      Fertility Preservation Among Adolescent and Young Adult Cancer Survivors in the AYA HOPE Study
      American Urological Association National Meeting, Society of Pediatric Urology , 2013 May 3 : San Diego, California
    • Shnorhavorian M, Leisenring W, Goodman P, Friedman D, Stovall M, Meacham L, Chow E, Sklar C, Diller L, Ferrer F, Armstrong G, Neglia J, Robison L
      Long-Term Adverse Genito-Urinary (GU) Outcomes in Survivors of Childhood Cancer: A report from the Childhood Cancer Survivor Study (CCSS)
      American Urological Association National Meeting, Society of Pediatric Urology , 2013 May 3 : San Diego, California
    • Wilson CL, Ness KK, Neglia JP, Hammond S, Shnorhavorian M, Leisenring WL, Stovall M, Robison LL, Armstrong GT
      Renal carcinoma after childhood cancer: a report from the childhood cancer survivor study.
      23515901 Journal of the National Cancer Institute , 2013 Apr, 3 : 105(7)504-8 PMCID: PMC3691945
    • Su R, Adam M, Fechner P, Badaru A, Ramsdell L, Merguerian P, Shnorhavorian M
      External Masculinization Score (EMS) and the Success of Genetic Testing in a Cohort of 46, XY DSD Patients
      Podium, 1st Annual GME Research Day, Top Ten finalist research presentation , 2013 Apr,
    • Smith AW, Bellizzi KM, Keegan THM, Zebrack B, Chen VW, Neale AV, Hamilton A, Shnorhavorian M, Lynch CF, and the AYA HOPE Study Collaborative Group
      Health-related Quality of Life of Adolescent and Young Adult Cancer Patients in the United States: the AYA HOPE study
      J Clinical Oncology , 2013 Feb. 21
    • Fechner, PY, Shnorhavorian M
      Disorders of Sex Development
      In "Urological Emergencies: A Practical Approach, 2nd Edition." H Wessells (ed.) , 2013 : Springer, New York, New York
    • Wilson CL, Ness KK, Neglia JP, Hammond S, Shnorhavorian M, Leisenring WL, Stovall M, Robison LL, Armstrong GT
      Renal carcinoma following therapy for childhood cancer: A report from the Childhood Cancer Survivor Study
      J Natl Cancer Inst , 2012 Oct. 17
    • Su R, Merguerian P, Hidalgo J, Grady R, Lendvay T, Shnorhavorian M
      Long-term Lower Urinary Tract Outcomes in Boys After Early Treatment of Posterior Urethral Valves
      Poster, American Academy of Pediatrics, New Orleans, Louisiana , 2012 Oct.
    • Kenney LB, Cohen LE, Shnorhavorian M, Metzger M, Lockhart B, Hijiya N, Duffey-Lind E, Constine L, Green D, Meacham L
      Male Reproductive Health after Childhood, Adolsecent, and Young Adult Cancer: A Report from the Childrens Oncology Group
      J of Clinical Oncology , 2012 Sept. 20 : 30(27)3408-16
    • Shnorhavorian M, Kroon L, Jeffries H, Johnson R
      Creating a Standardized Process to Offer the Standard of Care: Continuous Process Improvement Methodology is Associated With Increased Rates of Sperm Cryopreservation Among Adolescent and Young Adult Males With Cancer
      J of Pediatr Hematol Oncol , 2012 Sept. 13
    • Belizzi, K, Smith A, Schmidt S, Keegan T, Zebrack B, Lynch C, Deapen D, Shnorhavorian M, Tompkins B, Simon M; and the Adolescent and Young Adult Health Outcomes and Patient Experience (AYA HOPE) Study Collaborative Group
      Positive and negative psychosocial impact of being diagnosed with cancer as an adolescent or young adult
      Cancer , 2012 Mar. 13 : doi: 0.1002/cncr.27512
    • Moshiri M, Chapman T, Fechner PY, Dubinsky T, Shnorhavorian M, Osman S, Bhargava P, Katz DS
      Evaluation and Management of Disorders of Sex Development: Multidisciplinary Approach to a Complex Diagnosis
      RadioGraphics , 2012 11 : 32(6)1599-618
    • Shnorhavorian M
      Transitioning patients with Disorders of Sex Development to Adult Care: The Role of The Pediatric Urologist
      J Urol , 2012 9 : 188(3)700-1
    • Shnorhavorian M, Hidalgo-Tamola J, Koyle MA, Wessells H, Larison C, Goldin A
      Unintentional and sexual abuse related pediatric female genital trauma: A multi-institutional study of free-standing pediatric hospitals in the United States
      Pediatric Urology , 2012 8 : 80(2)417-22
    • Shnorhavorian M, Jacobs, MA, Stearns G, Mingin G, Koyle MA
      Practice variation and clinical confusion regarding undescended testes and retractile testes among primary care respondents: A multi-regional survey study in the United States
      Pediatr Surg Intl , 2012 6 : 28(6)635-639
    • Adam JP, Fechner P, Ramsdell LA, Badaru A, Grady R, Pagon RA, McCauley E, Cheng EY, Parisi MA, Shnorhavorian M
      Ambiguous Genitalia: What Prenatal Genetic Testing is Practical?
      Am J of Med Genet A , 2012 6 : 158A(6)1337-43
    • Shnorhavorian M, Johnson R, Shear SB, Wilfond BS
      Responding to Adolescents with Cancer who Refuse Sperm Banking: When "No" Should Not Be the Last Word
      J of Adolescent and Young Adult Oncology , 2012 2 : 1(3)
    • Zamilpa I, Koyle MA, Grady RW, Joyner BD, Shnorhavorian M, Lendvay TS
      Can we Rely on the Presence of Dextranomer-Hyaluronic Acid Copolymer Mounds on Ultrasound to Predict Vesicoureteral Reflux Resolution After Injection Therapy?
      J of Urology , 2011 6 : 185(6 Suppl)2536-41
    • Margarett Shnorhavorian, MD, MPH, Goldsby R, Chen Y, Raber S, Li L, Diefenbach K, Shnorhavorian M, Kadan-Lottick N, Kastronos F, Yasui Y, Stovall M, Oeffinger K, Sklar C, Armstrong GT, Robison LL, Diller L
      Survivors of Childhood Cancer Have Increased Risk of Gastrointestinal Complications Later in Life
      Gastroenterology , 2011 5 : 140(5)1464-7
    • Shnorhavorian M, Song K, Zamilpa I, Wiater B, Mitchell MM, Grady RW
      Spica casting compared to Bryant's traction after complete primary repair of exstrophy: safe and effective in a longitudinal cohort study.
      20639033 The Journal of urology , 2010 Aug. : 669-73
    • Sorensen MD, Koyle MA, Cowan CA, Zamilpa I, Shnorhavorian M, Lendvay TS
      Injection volumes of dextranomer/hyaluronic acid are increasing in the endoscopic management of vesicoureteral reflux.
      20140734 Pediatric surgery international , 2010 May : 509-13
    • Shnorhavorian M
      Oncofertility: Ethical, Legal, Social, and Medical Perspectives edited by Teresa K. Woodruff, Laurie Zoloth, Lisa Campo-Engelstein, and Sarah Rodriguez
      Springer , 2010
    • Shnorhavorian M
      A rewarding experience for a pediatric urologist.
      20811860 Cancer treatment and research , 2010 : 485
    • Hidalgo-Tamola J, Shnorhavorian M, Koyle MA
      "Open" minimally invasive surgery in pediatric urology.
      19297251 Journal of pediatric urology , 2009 June : 221-7
    • Shnorhavorian M, Friedman DL, Koyle MA
      Genitourinary long-term outcomes for childhood cancer survivors.
      19239818 Current urology reports , 2009 Mar. : 134-7
    • Shnorhavorian M, Anderson KR
      Anatomic and physiologic considerations in ureteroscopy.
      15040397 The Urologic clinics of North America , 2004 Feb. : 15-20
    • Keegan T, Tao L, DeRouen M, Wu X, Prasad P, Lynch C, Shnorhavorian M, Zebrack B, Chu R, Harlan L, Smith A, Parsons H, and the AYA HOPE Study Collaborative Group
      Medical care in adolescents and young adult cancer survivors: what are the biggest access-related barriers?
      J Clinical Oncology : Submitted June 20, 2013
    • Potosky A, Harlan L, Cress R, Hamilton A, Kato I, Keegan T, Keel G, Schwartz S, Seibel, N, Shnorhavorian M, West M, Wu, X, and the AYA HOPE Study Collaborative Group
      Use of Appropriate Initial Treatment Among Adolescents and Young Adults with Cancer: A Population-Based Study
      J Clinical Oncology : Submitted May 13, 2013
    • Wasilewski-Masker K, Seidel KD, Leisenring W, Mertens AC, Shnorhavorian M, Ritenour CW, Stoval M, Green DM, Sklar CA, Armstrong GT, Robison LL, Meacham LR
      Male infertility in long-term survivors of pediatric neoplasms: A report from the Childhood Cancer Survivor Study
      Human Reproduction : Submitted February 2013
    • Su R, Merguerian P, Grady R, Shnorhavorian M
      Surgical Hypospadias After Exstrophy (SHAE): Management and Outcomes
      J of Urology : Submitted May 13, 2013
    • Shnorhavorian M
      Genitourinary long-term outcomes for childhood cancer survivors
      In: Pediatric Urology: Surgical Complications and Management, 2nd Edition (Wilcox D, Koyle M, Godbole P, eds.)

  • Presentations Title Event Location Date
    "National Trends in Resource Utilization for the Management of Antenatal Hydronephrosis". American Urological Association Annual Meeting 2016 San Diego,CA 2016
    "Variation in Consecutive 24-Hour Urine Studies in Pediatric Patients". American Urological Association Annual Meeting 2016 San Diego, CA 2016
    DSD Ethics of Genital Surgery Nationwide Childrens Hospital Thrive Conference Colombus, Ohio Nov. 7, 2015
    "A Critical Appraisal of Continence In Bladder Exstrophy: Long-Term Outcomes of the Complete Primary Repair". SPU Fall Congress Prague,CZ 2015
    "Impact of Concomitant Inguinal Hernia Repair at Time of Initial Exstrophy Repair". SPU Fall Congress Prague,CZ 2015
    Late Effects after Treatment of Childhood Malignancies American Urological Association 2014 Plenary Program State-of-the Art Lecture Orlando, FL May 18, 2014
    Moderator: Society of Pediatric Urology Panel on Legal and Ethical Issues in DSD American Urological Association Orlando, FL May 17, 2014
    Update from the DSD TRN Anatomy Workgroup " NIH DSD Translational Research Network and Advocacy Advisory Network Annual Meeting, American College of Surgeons Phoenix, AZ May 1, 2014 - May 4, 2014
    Whats in a name? Standardizing the Anatomic Evaluation of DSD NICHD Scientific Research Workshop, Diagnostic Factors Associated with Quality of Life Outcomes at Different Development Stages in DSD National Institute of Health (NIH), Bethesda, MD March 26, 2014
    Are genetic variants that influence testicular cancer risk also involved in hypospadias and undescended testes? A case-parent study Pediatric Urology Fall Congress Las Vegas, Nevada Sept. 20, 2013
    From Cancer to Wellness: Fertility Preservation Cancer Survivorship Symposium, Seattle Childrens Hospital Seattle, Washington Oct. 27, 2012
    Common urologic problems in girls and adolescents North American Society of Pediatric and Adolescent Gynecology National Meeting Miami, Florida April 2012
    Curbside consultation in urology North American Society of Pediatric and Adolescent Gynecology National Meeting Miami, FL April 2012
    Pediatric Urology for the primary care provider Providence Physician Group Mill Creek, Washington Jan. 31, 2012
    Ups and Downs of Testes: Evaluation and Management of Undescended Testes Clinicians Guide to Pediatric Urology: A Practical Update. Seattle Childrens Hospital, CME Level I Seattle, Washington Nov. 19, 2011
    Modern Surgical Management of Urogenital Sinus and Cloaca Pediatric Surgery Department Conference, Hue Central Hospital Hue, Vietnam Oct. 2011
    Seattle Childrens Hospital Center for Clinical and Translational Research External Review Research Presentation Seattle, Washington Sept. 19, 2011
    Outcomes in Reproduction in Childhood and Adolescent Survivors: ORCAS an update Male Reproductive Health Research Award Symposium, University of Washington Seattle, Washington April 6, 2011
    Disorders of Sex development: Consensus and Controversy Pediatric Urology Conference Seattle Children's Hospital Feb. 14, 2011
    Complex Hypospadias Reconstruction Modern Techniques Department of Urology Grand Rounds, Hue Central Hospital Hue, Vietnam 2011
    Evaluation and Surgical Management of Ambiguous Genitalia Department of Pediatric Surgery Grand Rounds, Hue Central Hospital Hue, Vietnam 2011
    DSD - Multidisciplinary Approach Department of Urology Conference University of Washington 2011
    Consensus and Controversies in the Surgical Management of Patients with DSD Seattle Childrens Hospital, CME Level I and North American Society of Androgen Insensitivity Syndrome Support Group-USA Seattle, Washington 2011
    Challenging DSD Cases Department of Urology Conference University of Washington 2011
    DSD Department of Urology Conference University of Washington 2011
    Moving Beyond Cancer to Wellness: Male Fertility Preservation Fertility Breakout Session, Lance Armstrong Foundation, Cancer Care Alliance Seattle, Washington Nov. 6, 2010
    Outcomes in Reproduction in Childhood and Adolescent Survivors Seattle Childrens Hospital Grand Rounds Seattle, Washington Sept. 30, 2010
    Patient Acquired Images in Pediatric Postoperative Care Results in Reduction of Unnecessary Emergency Department Visits American Academy of Pediatrics (AAP) National Conference and Exhibition Washington, DC Oct. 18, 2009
    Emerging guidelines from the Childrens Oncology Group (COG) Yale Surgical Society Grand Rounds, Division of Urology New Haven, CT June 5, 2009
    LH and FSH Are Significantly Elevated in Young Men After Treatment with Ifosfamide and Cyclophosphamide in Relation to the Total Dose of Chemotherapy American Academy of Pediatrics, Section on Urology Annual Meeting Washington, DC 2009
    Surgical management of intersexuality, cloacal malformation and anomalies of genitalia in girls Department of Urology Conference University of Washington 2009
  • Grant Title Grantor Amount Award Date
    Decision support for parents receiving genetic information about childs rare disease Patient Centered Outcomes Research Institute (PCORI) $1,373,164 Jan. 1, 2013 - Dec. 31, 2015
    Mens Reproductive Health Research at the University of Washington/K12 Training program NIH/NICHD 2012 - 2017
    Disorder of Sex Development: Platform for Basic and Translational Research NIH $4,000,000 Sept. 26, 2011 - June 30, 2016
    Translating the Science of Testicular Tissue Cryopreservation St. Baldricks Foundation $250,000 2011 - 2013
    Outcomes in Reproduction for Childhood and Adolescent Survivors Rally Foundation $5,000 May 1, 2010 - March 31, 2011
    Hypospadias, undescended testes, Testes tumors (HUT): A DNA banking study University of Washington/Seattle Childrens Hospital $40,000 2010
    Outcomes in Reproduction after Cisplatin in Adolescent Survivors (ORCAS) Childrens Oncology Group (COG) and AFLAC, National Childrens Cancer Foundation Fund $60,000 Jan. 1, 2010 - Dec. 31, 2011
    Genes Involved in Male Reproductive Tract Anomalies and the Risk of Testis Cancer: A Candidate Genetic Polymorphism Study. Seattle Childrens Center for Clinical and Translational Research $20,000 Sept. 1, 2009 - Aug. 31, 2010
    Outcomes in Reproduction for Childhood and Adolescent Survivors: A study of the effects of Ifosfamide Seattle Childrens Clinical and Translational Research Center $40,000 Sept. 1, 2008 - Aug. 31, 2010
    Health-related quality of Life: A pediatric clinical and research tool National Institute of Child Health and Human Development April 1, 2008 - March 31, 2011
    Quality of Life in Intersexuality: A Pediatric Clinical and Research Tool National Institute of Child Health and Human Development April 1, 2008 - March 31, 2011
    Feasibility of Expended Patterns of Care Study of AYA Cancers (AYA HOPE) NIH/NCI $25,000 2007 - 2010
    Childhood Cancer Survivor Study (CCSS) National Cancer Institute Sept. 1, 1993 - Nov. 30, 2010
    Testicular effects of modern chemotherapy regimens in osteosarcoma survivors National Cancer Institute (NCI) Scientific Review Group: Epidemiology of Cancer Study Section (EPIC) $3,934.654 /5 years

Overview

Board Certification(s)

Urology
Pediatric Urology

Medical/Professional School

University of California San Francisco School of Medicine, San Francisco
University of California Berkeley, Berkeley

Residency

Urology, Yale New Haven Hospital, New Haven

Fellowship

Pediatric Urology, University of Washington School of Medicine, Seattle

Clinical Interests

Crytorchidism; prenatal hydronephrosis; urogenital reconstruction

Research Description

Ifosfamide, an alkalating agent structurally related to cyclophosphamide, is a newer chemotherapeutic agent whose toxicity profile has not been well studied. The hypothesis is that ifosfamide impairs fertility.

The main study airs include:

a) determine the toxicity profile by identifying the doses which increase risk of infertility;

b) identifying protective germ cell line polymorphisms in patients exposed to ifosfamide;

c) potential intermediate biomarkers of infertility in this group.

I will gather questionnaire data (regarding erectile dysfunction and infertility), biochemical evaluation, DNA analysis, and semen samples.

Research Focus Area

Epidemiology, Cancer