Open Access

ARTICLE

Anthony J. Bella¹, William O. Brant¹, Tom F. Lue¹, Gerald B. Brock²
Canadian Journal of Urology, Vol.13, No.5, pp. 3233-3238, 2006
Abstract Objective: To determine whether a causative relationship exists between non-arteritic anterior ischemic optic neuropathy (NAION) and the use of phosphodiesterase-5 (PDE-5) inhibitors for the treatment of erectile dysfunction.
Methods: A comprehensive review of the literature was performed to identify the contemporary understanding of NAION pathophysiology, epidemiology, and occurrence in men using the oral PDE-5 inhibitors sildenafil (Viagra, Pfizer), vardenafil (Levitra, Bayer AG), and tadalafil (Cialis, Lilly-ICOS LLC) for the treatment of erectile dysfunction.
Results: NAION is the second most common acquired optic neuropathy in men aged 50 years and older. Risk factors for NAION, cardiovascular disease, and… More >

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ARTICLE

Bertil F. M. Blok, Gilles Karsenty, Jacques Corcos
Canadian Journal of Urology, Vol.13, No.5, pp. 3239-3243, 2006
Abstract Objective: To determine current trends in management and surveillance of the neurogenic bladder population by Canadian urologists who routinely work with and provide care for these patients.
Methods: A questionnaire was mailed to members of the Canadian Urological Association. The assessment and follow-up of upper and lower urinary tract function in neurogenic bladder patients, their optimal frequency and management of related infections were the topics of inquiry.
Results: One hundred and five of 602 urologists responded, for a response rate of 18%. Twenty-three (22%) of the respondents did not treat neurogenic bladder patients. Four out of five… More >

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ARTICLE

R. Ashley McLellan¹, David G. Bell^1,2, Ricardo A. Rendon^1,2
Canadian Journal of Urology, Vol.13, No.5, pp. 3244-3249, 2006
Abstract Objectives: To assess the impact of a clinical pathway (CP) on length of stay (LOS), complications, readmission rates, and patient satisfaction for patients undergoing a radical retropubic prostatectomy (RRP).
Materials and methods: A standardized CP for all patients undergoing RRP was developed and implemented. Post-operatively, patients enrolled in the CP received oral ibuprofen and acetaminophen analgesia, with oral and subcutaneous narcotics available for breakthrough pain. Patients enrolled in the CP were compared to a pre-CP historical cohort. Patients were asked to complete a short, validated satisfaction questionnaire 10 days post-operatively.
Results: Sixty-eight consecutive patients underwent a RRP More >

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Open Access

ARTICLE

Allen F. Morey¹, L. Andrew Evans¹, R. Clayton McDonough III², Alyssa M. Park¹, Wade J. Sexton², Joseph W. Basler³, Richard A. Santucci⁴, Christopher L. Amling⁵, Keith J. O’Reilly⁶
Canadian Journal of Urology, Vol.13, No.5, pp. 3250-3254, 2006
Abstract Objectives: We performed the first prospective, randomized, multi-center comparison of overall quality and patient tolerability of polyethylene glycol (PEG) and sodium phosphate (NaP) solution for mechanical bowel preparation prior to urinary diversion surgery.
Methods: Between 2001 and 2003, 36 patients at six institutions underwent major urological reconstructive surgery incorporating small intestine (35 radical cystectomy with urinary diversion and 1 bladder augmentation). Patients were prospectively randomized to receive either oral polyethylene glycol (group 1, n=16) or sodium phosphate (group 2, n=20) for mechanical bowel preparation prior to surgery, according to our multi-institutional IRB-approved protocol. All patients completed… More >

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ARTICLE

François Meyer, Bernard Têtu, Isabelle Bairati, Louis Lacombe, Yves Fradet
Canadian Journal of Urology, Vol.13, No.5, pp. 3255-3260, 2006
Abstract Purpose: Prostatic intraepithelial neoplasia (PIN) is considered as a precursor lesion for adenocarcinoma of the prostate. Most data supporting this relationship comes from the short-term follow-up of patients with repeated biopsies. We report a study in which patients were followed-up for 11 years to assess the relationships between the presence of high grade PIN, low grade PIN, and atypical adenomatous hyperplasia (AAH) and the subsequent occurrence of prostate cancer.
Materials and methods: For 601 men treated by TURP in 1990-1993, prostate specimens were reviewed to assess the presence of high grade PIN, low grade PIN, and AAH.… More >

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ARTICLE

Prem A. Ramakrishnan, Younis H. Al-Bulushi, Mohammed Medhat, Priti Nair, Salma G. Mawali, Venkat P. Sampige
Canadian Journal of Urology, Vol.13, No.5, pp. 3261-3270, 2006
Abstract Introduction: Management of complete staghorn calculi represents a challenging problem for urologists. We describe our technique and clinical experience with modified anatrophic nephrolithotomy in patients harboring large, extensively branched staghorn calculi.
Materials and methods: From October 1996 to February 2005 twenty-six patients with complete staghorn calculi defined as filling the entire collecting system or at least 80% of it, were treated employing a modification of the classical anatrophic nephrolithotomy technique. The mean patient age was 46 (range 16-70) years and the mean stone size was 3150 (range 1375-4800) mm². Intra-operative data, complications and stone-free rates were recorded.… More >

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Open Access

HOW I DO IT

Jonathan M. Ng¹, Saleh Binsaleh², Britton Tisdale², Edward D. Matsumoto^1,2, Anil Kapoor^1,2
Canadian Journal of Urology, Vol.13, No.5, pp. 3271-3274, 2006
Abstract Ectopic pheochromocytomas (paragangliomas) are rare tumors that are traditionally treated with open surgery. We present our technique of such a tumor treated laparoscopically and review the safety, feasibility and advantages of this approach. More >

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CASE REPORT

Ahmed S. Safwat, Nabil K. Bissada
Canadian Journal of Urology, Vol.13, No.5, pp. 3275-3276, 2006
Abstract Urethral duplication is considered a rare congenital anomaly. The exact embryology is still controversial. A patient with subtotal urethral duplication is presented and the technique utilized to excise the anomalous structure is detailed. More >

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CASE REPORT

A. M. Kajbafzadeh¹, M. Baharnoori²
Canadian Journal of Urology, Vol.13, No.5, pp. 3277-3278, 2006
Abstract Fetus in fetu (FIF) is a very rare condition, with a reported incidence of one in 500,000 live births. It most likely represents a monozygotic diamniotic twin that implants itself and grows within the body of its normal, karyotypically identical sibling, which typically manifests as a fetiform abdominal mass in a newborn or infant.
The mass is located in the retroperitoneum in most cases, including our example, and is commonly surrounded by encapsulated fluid. However, FIF has been reported to occur in other locations, such as within the cranium, the scrotum, and the oral cavity. Usually… More >

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Open Access

CASE REPORT

A. AL-Sayyad, I. Cagiannos
Canadian Journal of Urology, Vol.13, No.5, pp. 3279-3280, 2006
Abstract We present a case of fibrous pseudotumor of the epididymis and tunica vaginalis which is one of the rarest paratesticular tumors. Fibrous pseudotumor presents as a solid scrotal mass with normal serum markers. Pathological examination is the only reliable way to make the diagnosis with these tumors exhibiting characteristic macroscopic and microscopic features. It is important to recognize this entity since local excision is the treatment of choice and orchiectomy is unnecessary. More >

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CASE REPORT

Ithaar H. Derweesh¹, Hazem R. Ismail¹, Cristina Magi-Galluzzi^1,2, Jonathan Hale³, David A. Goldfarb¹
Canadian Journal of Urology, Vol.13, No.5, pp. 3281-3282, 2006
Abstract Introduction: Renal metastasis by non-small cell lung cancer is uncommon and usually described at autopsy.
Case presentation: We report the rare case of a 77-year-old man with localized non-small cell lung carcinoma who underwent extirpative surgery and 2 years later presented with gross hematuria and was noted to have a large infiltrating renal mass on computed tomography.
Conclusions: In patients with a prior history of resected localized non-small cell lung carcinoma, presence of a renal lesion should prompt the clinician to consider the possibility of metastasis. Further evaluation should consider this scenario. More >

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RESIDENT’S CORNER

Yves Caumartin¹, Luc Lacoursière², Alain Naud¹
Canadian Journal of Urology, Vol.13, No.5, pp. 3283-3290, 2006
Abstract We describe the case of a 23 year-old man with highflow priapism following blunt perineal trauma. He was treated successfully with super-selective embolization with a resorbable material (gel foam). We will review the pathophysiology, etiology, and diagnosis and treatment approaches of highflow priapism based on a review of the medical literature. More >

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RESIDENT’S CORNER

Alvaro Lucioni, David E. Rapp, Edward M. Gong, Paula Fedunok, Gregory T. Bales
Canadian Journal of Urology, Vol.13, No.5, pp. 3291-3295, 2006
Abstract Objective: Botulinum toxin type A (BTX-A) has been successfully used in the treatment of patients with overactive bladder (OAB) symptoms refractory to anticholinergic therapy, with most studies performing trigone-sparing detrusor injections. Increasing evidence suggest that sensory nerve dysfunction contributes to the pathophysiology of OAB and, for this reason, targeting the afferent innervation of the bladder trigone during injection may provide clinical benefit.
Materials and methods: We conducted a pilot study to assess the benefit of trigonal-inclusion during BTX-A injection. A total of 40 patients with OAB refractory to anticholinergic treatment received trigone or trigone-sparing injection of BTX-A.… More >

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