Children's Hospital Colorado

Meet the New Chair of Pediatric Urology

2/3/2025 5 min. read

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Nicholas Cost, MD, the Ponzio Family Chair in Pediatric Urology, was recently announced as the new Chair of Pediatric Urology at Children’s Hospital Colorado. In his more than 10 years as a urologic oncology specialist at Children’s Colorado, Dr. Cost has made an immeasurable impact on kids, adolescents and young adults with kidney cancer, testicular cancer and a variety of other rare urologic cancers.

When he began this work, he hoped to create a program that put comprehensive, multidisciplinary care at the heart of its approach to treating urologic cancers — something that didn’t yet exist in the pediatric space. Having accomplished this goal at Children’s Colorado, he’s ready to help others achieve their own successes.

Q: What are your new goals for the program?

A: This role is a little different in the sense that it spans outside of urology in some ways. I will really be focused on all the other much more common parts of what pediatric urology is. There are nine of us that are MD providers and six advanced practice providers (APPs) that work in the department, and so it's really my goal to shine a light on the others to highlight the work they're doing and making sure that they have the resources they need. I think people do the best work possible when they're doing the work that's meaningful to them.

I also want to continue to support subspecialization and leadership development for each of our team members, where we give people a sense of ownership over a part of pediatric urology where they can really grow it and feel like they're responsible for it. When people are passionate about their work, ultimately the quality for the kids, which is what matters the most, ends up being better.

Q: What are some of the other things you're excited about seeing when it comes to how we're able to serve kids and families?

A: We're going to invest in discrete programs. As an example, in our Complex Urologic Reconstructive Surgery Program, we are putting resources behind skilled nursing, psychology support and research. We are building a collaborative clinical environment where we're going to bring in experts from nephrology and then augment that with research. That will allow us to take the best possible care of the kids that we see, and then we are combining that with advocacy and policy work, so we can hopefully positively impact the outcomes for kids outside of Colorado and our region.

Q: Can you share how you intend to build research into the rest of the work the team is doing and speak to the importance of research in the urology space?

A: We really view that as comprehensive in the sense that we're involved in all aspects of research. So, that includes translational work that's in the lab looking at how the urinary tract develops and functions. And then we have on the clinical side, anything from clinical trials where we're trying to provide better care and improve outcomes. And then, we have a uniquely large enterprise that's dedicated to qualitative research in this area, looking at patient-reported outcomes and how they're experiencing the care. I think there can be a bit of a divide, especially as a surgeon, between what you think is important and then how the patients perceive that. And I think that we would all be better if those things were in more alignment. Our group is really on the forefront of that and is putting a lot of resources into developing that patient-facing research.

Q: Are there any challenges in the healthcare landscape and the pediatrics landscape that you foresee needing to work through as the leader of our urology program?

A: As we've grown, we've taken on serving a quite large regional area, including Montana, Wyoming, the western parts of Kansas, the Dakotas, New Mexico and Nebraska. We have to think about how we can meet those patients where they are and not necessarily just that they have to come here to get care.

So how do we, in a thoughtful way through all the various modalities available, provide the best care we can in the safest way we can? It’s easy to say, “Just come here,” but that's not really focusing on what's best for the patient. Even within our own state, there’s more we could do.

Q: You've spoken so highly of your colleagues and the folks you're looking forward to supporting in your new role. Can you share a little bit about the work that you're excited to see them do?

A: Our Transitional Urology Program, led by Dan Wood, MD, is really great, and it's so unique. In general, pediatric-facing practices have viewed turning 18 as the end point, and so we have a big lack of visibility into what happens in patients’ outcomes later into adulthood. And I think we would all agree that we don't really believe our responsibility to them ends at that point. We have the ability with our group to continue to follow them.

Another thing is the congenital anomalies of the kidney and urinary tract work that is a collaborative effort among many of our urology providers — Jeff Campbell, MD, Vijaya Vemulakonda, MD, Kyle Rove, MD, Brian Caldwell, MD, Nina Mikkilineni, MD, Kelly Harris, MD, and all of our APPs. We're going to rebrand that and expand it to be more than just the congenital anomalies piece. Across the board, patients that we have need this multidisciplinary care between urology and nephrology and psychology. We're looking forward to, in the next year, relaunching that as a formal multidisciplinary clinic, and then augmenting that with qualitative research around that.

There's also been a recent hire, Heiko Yang, MD, PhD, who is focused on urologic stone disease. He will spend some of his time on pediatrics and some with adults. That's an issue that we're seeing more and more not just here, but across the country. I'm really excited to bring in somebody who has clinical and research expertise in that area, and that not only increases our clinical capacity, but also lab-based research trying to understand why people develop stones and how we can prevent them and treat them most effectively.

Q: What makes you feel proud to be leading this department?

A: Well, the people that I get to work with are just so outstanding. And that's top to bottom. I mean, literally all of them – ASCs, operations, finance, MAs, nursing, APPs, physicians. We have an environment where everyone feels like they're an integral part because they are, and that takes intention. So, what makes me excited is that there’s a huge amount of energy and potential power that we can put forward toward these goals. I just feel an enormous responsibility to pay back the opportunities that I had. The best way I can do that is to put some of the people that are just starting in their career in a position where they can thrive.