Open Access

EDITORIAL

Laurence H. Klotz
Canadian Journal of Urology, Vol.11, No.1, pp. 2108-2108, 2004
Abstract This article has no abstract. More >

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ARTICLE

Shabbir M. H. Alibhai¹, Laurence H. Klotz²
Canadian Journal of Urology, Vol.11, No.1, pp. 2110-2117, 2004
Abstract Introduction: Most treatment studies of localized prostate cancer are observational in nature. The recent publication of a large randomized trial of radical prostatectomy (RP) versus watchful waiting (WW) has focused increased attention on the treatment of localized prostate cancer. We reviewed all published randomized trials that compared different primary treatment modalities for localized prostate cancer.
Materials and methods: We performed a comprehensive Medline search from 1966 to March 2003 to identify all English-language randomized trials of RP, external-beam radiotherapy (EBRT), brachytherapy, watchful waiting, and primary androgen-deprivation therapy in localized prostate cancer.
Results: Nine publications dealing with four separate… More >

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ARTICLE

R. Choo¹, V. Do¹, L. Sugar², L. Klotz², E. Bahk¹, E. Hong¹, C. Danjoux¹, G. Morton¹, G. DeBoer¹
Canadian Journal of Urology, Vol.11, No.1, pp. 2118-2124, 2004
Abstract Objective: To examine the change of histologic grade of untreated, low to intermediate grade, clinically localized prostate cancer over time on repeat prostate biopsy.
Methods and materials: In a prospective single-arm cohort study, patients were managed with observation alone unless they met pre-defined criteria of disease progression (PSA, clinical or histologic progression). Sixty-seven (54%) of a total of 123 eligible patients underwent follow-up prostate biopsy. Median time to the follow-up biopsy was 22 months (range: 7-60).
Results: On the follow-up biopsy, Gleason score was unchanged in 20 patients (30%), upgraded in 19 (28%), and downgraded in 27 (40%).… More >

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ARTICLE

Ian Poon¹, Melania Pintilie², Mark Potvin³, Tom McGowan⁴
Canadian Journal of Urology, Vol.11, No.1, pp. 2125-2132, 2004
Abstract Purpose: Prostate cancer represents a large part of the workload for radiation oncology departments in Canada. Recent evidence suggests that conformal external beam radiotherapy improves results. The planning and treatment process for conformal patients requires a greater amount of resources that are in short supply in Ontario. An understanding of these differences is important to provide an accurate estimate of future radiation needs of the province. These differences can be quantified in a cost model that portrays the direct costs of delivering external beam radiotherapy in Ontario. With a developed cost model, a prospective direct cost… More >

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Open Access

CASE REPORT

Joshua D. Wiesenthal, Helen Ettler¹, Hassan Razvi²
Canadian Journal of Urology, Vol.11, No.1, pp. 2133-2135, 2004
Abstract Epidermoid cysts of the testicle are rare, benign lesions that are clinically indistinguishable from malignant germ cell tumors. A scrotal mass in a 27-year-old man was incidentally detected by his family physician, and confirmed to be intratesticular by ultrasound. Radical orchidectomy was performed revealing the pathologic diagnosis. The presentation, evaluation and management of epidermoid cysts are discussed. More >

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CASE REPORT

Uzair B. Chaudhary¹, David L. Milling¹, Nabil K. Bissada²
Canadian Journal of Urology, Vol.11, No.1, pp. 2136-2138, 2004
Abstract Hypercalcemia associated with transitional cell carcinoma (TCC) is rarely encountered. We report a case of TCC of bladder with documented production of parathyroid hormone related protein (PTHrP). Our patient had a rapidly progressive course and died 2 months after radical cystectomy. Literature suggests that these patients present with advanced stage and carry a poor prognosis. The histopathologic features, treatment and prognosis associated with this rare paraneoplastic syndrome are reviewed. More >

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CASE REPORT

Sean van Diepen, John Grantmyre
Canadian Journal of Urology, Vol.11, No.1, pp. 2139-2140, 2004
Abstract Double-J ureteral stents facilitating the drainage of urine from the kidney to the bladder are widely used. Stents designed for patient self-removal are commonplace. We report a case of urosepsis that lead to the incidental discovery of a failed self-removal of a double-J ureteral stent. The retrieval cord broke during self-removal and the patient mistook the string for the stent. Adequate patient education is essential to assure successful self-removal. More >

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Open Access

HOW I DO IT

David S. Wang¹, Vincent G. Bird², Christopher S. Cooper¹, J. Christopher Austin¹, Howard N. Winfield¹
Canadian Journal of Urology, Vol.11, No.1, pp. 2141-2145, 2004
Abstract Objectives: To determine the feasibility, clinical outcomes, and complications of laparoscopic upper pole heminephrectomy for ectopic ureter. The standard treatment for a duplex kidney with a poorly functioning upper pole moiety is an upper pole heminephrectomy. We review our technique and experience with laparoscopic upper pole heminephrectomy. A brief review of the literature is provided.
Methods: A retrospective review of clinical records from three patients who underwent laparoscopic upper pole heminephrectomy was performed. Two of the three patients presented with lifelong urinary incontinence and were diagnosed with an ectopic ureter associated with a poorly functioning upper pole… More >

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RESIDENT’S CORNER

A. Hazem Ismail, Waleed Altaweel, Simone Chevalier, Wassim Kassouf, Armen G. Aprikian
Canadian Journal of Urology, Vol.11, No.1, pp. 2146-2150, 2004
Abstract Introduction: Vascular endothelial growth factors (VEGF) figure among the most potent angiogenic factors identified. Local as well as serum VEGF-A over-expression has been correlated with metastasis in prostate cancer. However, little is known on VEGF-A expression in prostate cancer metastases themselves. Our objective was to assess VEGF-A expression in relation with angiogenesis in prostate cancer lymph node metastases.
Methods: Fifty-four lymph node metastatic specimens obtained from 32 patients were included in this study. All nodes were of prostate cancer origin as confirmed by positive PSA staining. Immunohistochemistry was performed to identify VEGF-A expressing cancer cells. Consecutive sections… More >

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RESIDENT’S CORNER

Michael L. Pianezza¹, Steven Rubin², Juan Bass², Shirley Chou², John G. Pike¹, Michael P. Leonard¹
Canadian Journal of Urology, Vol.11, No.1, pp. 2151-2156, 2004
Abstract Background: Wilms' Tumor is the most common malignant neoplasm of the urinary tract in children. Since 1969, the National Wilms' Tumor Study Group (NWTSG) has contributed to improving the clinical management and outcome of children affected by Wilms' Tumor. We have managed our patients according to NWTSG protocols and report our results herein.
Methods: Retrospective chart review of consecutive patients presenting at the Children's Hospital of Eastern Ontario (CHEO) with a diagnosis of Wilms' Tumor between April 1990 and March 2001.
Results: Forty patients with Wilms' Tumor (18 M/22 F) were diagnosed at CHEO during this interval. Mean… More >

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RESIDENT’S CORNER

Ethan D. Grober, John Tsihlias, Michael A. S. Jewett, Joan M. Sweet, Andrew J. Evans, John Trachtenberg, Mike Robinette, Robert K. Nam
Canadian Journal of Urology, Vol.11, No.1, pp. 2157-2162, 2004
Abstract Objectives: To correlate the primary Gleason pattern among patients with biopsy-derived Gleason 7 tumors with the radical prostatectomy specimen Gleason grading and other clinical and pathologic outcomes.
Methods and materials: Among 474 patients who underwent radical prostatectomy for clinically localized prostate cancer between 1997-2001, 205 (43%) had Gleason 7/10 tumors on pre-operative needle biopsy. Among these patients, 148 (72.2%) were assigned a primary Gleason 3 pattern (3+4=7) and 57 (27.8%) were assigned a primary Gleason 4 pattern (4+3=7). The two groups were compared with respect to age, serum PSA levels, Gleason grade in the radical prostatectomy specimen,… More >

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RESIDENT’S CORNER

Margarita Hollingsworth¹, Francisco Quiroz², Michael L. Guralnick¹
Canadian Journal of Urology, Vol.11, No.1, pp. 2163-2166, 2004
Abstract Objective: To review our experience in managing the uncommon problem of a retained Foley catheter secondary to an inability to deflate the catheter balloon.
Methods: A chart review of 13 patients in whom it was not possible to deflate their Foley catheter balloons was performed. We review the various techniques used to deflate their catheter balloons and present a modified algorithm.
Results: In 23% of our patients, passive aspiration with a syringe successfully deflated the balloon. In 31% of our patients, cutting the catheter with or without subsequent aspiration successfully deflated the balloon. In 15% of our patients, More >

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RESIDENT’S CORNER

Richard D. Sowery, Darren T. Beiko, Jeremy P. W. Heaton
Canadian Journal of Urology, Vol.11, No.1, pp. 2167-2168, 2004
Abstract A patient presented with a metal ring around the base of his penis. The ring had been placed 3 years prior to presentation. Intra-operative findings revealed a ventral erosion with complete transection of the urethra and massive fixed lymphedema of the penile skin distal to the ring. Treatment consisted of removal of the ring with metal shears and bolt cutters. Small reduction of the edema was seen 3 months following removal, and the patient refused further treatment. The most interesting part of the outcome was the preservation of penile urethral voiding although intromission was not More >

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