Open Access

EDITORIAL

Laurence H. Klotz
Canadian Journal of Urology, Vol.10, No.6, pp. 2032-2032, 2003
Abstract This article has no abstract. More >

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POINT-COUNTERPOINT DEBATE

Nancy A. Dawson
Canadian Journal of Urology, Vol.10, No.6, pp. 2036-2037, 2003
Abstract A multidisciplinary approach to prostate cancer has become the rule and not the exception. Involving the entire team, which includes a medical oncologist, from the time of initial diagnosis is optimal. This facilitates maximal patient education regarding treatment options and enhances informed decision making.
A coordinated approach also promotes enrollment on clinical trials, which are often, multimodality, especially in high-risk early stage prostate cancer. Integrated therapeutic strategies throughout the patient's disease course can improve both patient care and satisfaction. More >

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ARTICLE

Malcolm J. Moore
Canadian Journal of Urology, Vol.10, No.6, pp. 2038-2039, 2003
Abstract The benefits of chemotherapy in men with symptomatic HRPC include pain relief, better physical functioning and improved quality of life. These have been well established in randomized trials. A meaningful or statistically significant improvement in survival has yet to be demonstrated. In the absence of a survival benefit, there is concern that treating men when they are free of symptoms may have a negative impact upon quality of life due to drug related toxicity. It will also limit or eliminate any therapeutic options when symptoms eventually develop and therapy is needed most. More >

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ARTICLE

Alan So, S. Larry Goldenberg, Martin E. Gleave
Canadian Journal of Urology, Vol.10, No.6, pp. 2040-2050, 2003
Abstract Since its discovery in 1979, serum PSA has revolutionized how physicians manage men with prostate cancer. PSA screening, although currently under much debate, has been recommended by most North American medical bodies, including the Canadian Urological Association, to be performed as a shared-decision making process after discussing with patients the pros and cons of treatment. Although most commonly thought of as a screening tool, serum PSA has also been used to predict tumor volume, stage and prognosis in patients before and after treatment. In this review, we examine PSA testing and its effectiveness in the More >

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ARTICLE

Gordon A. McLorie³, Jeff Pugach³, Dov Pode², John Denstedt⁴, Darius Bagli³, Shimon Meretyk², R. John D’A Honey⁴, Paul A. Merguerian³, Amos Shapiro², Antoine E. Khoury³, Ezekiel H. Landau¹
Canadian Journal of Urology, Vol.10, No.6, pp. 2051-2055, 2003
Abstract Purpose: Extracorporeal shock wave lithotripsy (ESWL) in older children appears to have comparable results when compared to adults, no study has focused on its use in younger children. We reviewed our ESWL experience in children under age 3.5 years to evaluate its safety, and define optimal treatment parameters.
Methods: We retrospectively reviewed consecutive medical and diagnostic imaging records from three ESWL centers, pertaining to 34 children under 3.5 years of age (36 renal units-RU). The children were from two distinct populations served exclusively by the three centers. We analyzed patient presentation, etiology, age, weight, stone size, preoperative… More >

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ARTICLE

Alexander Agranovich¹, Piotr Czaykowski², David Hui³, Tom Pickles⁴, Winkle Kwan¹
Canadian Journal of Urology, Vol.10, No.6, pp. 2056-2061, 2003
Abstract Objective: To review retrospectively the outcome and toxicity of Radiotherapy (RT) in the cohort of elderly patients (EP) with muscle-invasive urinary bladder carcinoma (MIUBC).
Methods: Thirty-six EP were treated with RT with radical intent. The age of the cohort ranged from 71 to 89 years with a median of 79 years. Eighty percent of the patients had Eastern Cooperative Oncology Group (ECOG) 0 and 1 performance status. Conventional and accelerated fractionation RT regimen were utilized.
Results: With median follow up of 45.8 months, the median survival was 23.9 months. There was a trend toward better survival in patients More >

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ARTICLE

Darren T. Beiko, Kenneth A. Beasley, Pavin K. Koka, James D. Watterson, Linda Nott, John D. Denstedt, Hassan Razvi
Canadian Journal of Urology, Vol.10, No.6, pp. 2062-2067, 2003
Abstract Introduction/objective: Advances in ureteroscope design and refinements of ancillary instrumentation have resulted in an expanded role for ureteroscopy in the management of urinary calculi. Technological enhancements coupled with improved endourologic skills have also been associated with a reduction in procedural-related complications. Historically, postoperative imaging with ultrasound (U/S) or intravenous pyelogram (IVP) had been advocated to rule out persistent obstruction due to retained stone fragments or ureteral stricture. The purposes of this study were to evaluate the incidence of postoperative ureteral obstruction in a contemporary series of patients undergoing ureteroscopic holmium:YAG laser lithotripsy without basket extraction of… More >

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RESIDENT’S CORNER

Todd M. Webster, Ronald G. Gerridzen
Canadian Journal of Urology, Vol.10, No.6, pp. 2068-2069, 2003
Abstract Urethral erosion following pubovaginal sling is a rare occurrence. When synthetic sling materials are used urethral erosion often necessitates removal of the sling and urethral reconstruction. The literature is sparse with respect to the best approach to fascial sling erosion. We report a case of a 73 year-old woman who underwent a pubovaginal sling using autologous rectus fascia for treatment of stress urinary incontinence (SUI). She developed urethral erosion following 2 weeks of clean intermittent catheterization (CIC). Visual internal urethrotomy (VIU) was performed to incise the sling and the prolene sutures were removed to eliminate More >

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CASE REPORT

Peter T. K. Chan, Jamie Libman
Canadian Journal of Urology, Vol.10, No.6, pp. 2070-2073, 2003
Abstract For obstructive azoospermia, surgical sperm retrieval from the epididymis for IVF/ICSI is an established management. However, various recent studies have established that surgical reconstruction with vasovasostomy or vasoepididymostomy remains a more cost-effective treatment option than upfront assisted reproduction. After epididymal sperm retrieval, fibrosis and scarring of the punctured epididymal tubule can lead to complete epididymal obstruction. The feasibility of surgical reconstruction after surgical epididymal sperm retrieval has not been established. We describe two cases of bilateral microsurgical vasoepididymostomy, using a new 2-suture longitudinal intussusception technique we previously described, after previous successful bilateral percutaneous epididymal sperm More >

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CASE REPORT

John S. Lam¹, Alain C. Borczuk², John R. Franklin¹
Canadian Journal of Urology, Vol.10, No.6, pp. 2074-2076, 2003
Abstract Malignant Leydig cell tumor (LCT) of the testis are extremely rare and account for less than 0.2% of all testicular cancers. Testicular tumors of all histological types rarely occur in African American men. The authors describe a rare case of an advanced stage malignant LCT arising from the testicle of an African American man at the young age of 35, who presented with hemoptysis and a productive cough. Clinical features and treatment of Leydig cell tumor of the testis are discussed. More >

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