Open Access

EDITORIAL

Gabriel P. Haas
Canadian Journal of Urology, Vol.13, No.6, pp. 3307-3307, 2006
Abstract This article has no abstract. More >

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ARTICLE

A. E. MacNeily, K. Afshar
Canadian Journal of Urology, Vol.13, No.6, pp. 3309-3316, 2006
Abstract Introduction: Many urologists endorse the concept of screening asymptomatic siblings of children known to have vesicoureteral reflux. Others oppose screening until there is better evidence to justify the cost and potential morbidity of adopting a widespread screening program.
Methods: A literature review of the following topics was carried out: 1) screening programs in general; 2) reflux in general; 3) familial reflux; and 4) screening for familial reflux.
Results: The evidence supporting our traditional surgical and medical management strategies for reflux is weak. The evidence supporting screening is lacking. Public Health organizations do not address the issue of screening… More >

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Open Access

ARTICLE

Oleg Shapiro¹, Karen Jones², Ching Wang¹, Steve Landas², Gabriel P. Haas¹
Canadian Journal of Urology, Vol.13, No.6, pp. 3317-3320, 2006
Abstract Bladder cancer is the fifth most common cancer in the Western world and is on the rise. Most patients present with superficial disease and are treated by transurethral resection of bladder tumor. More than half of these patients experience recurrence with about 20% progressing to muscle invasive disease. Intravesical chemotherapy has been shown to decrease the risk of recurrence of bladder cancer. Mitomycin C has emerged as a major agent for an immediate post-resection intravesical instillation. This article reviews the literature on the mode of action, rationale for immediate adjuvant treatment with mitomycin C and More >

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ARTICLE

Deb Feldman-Stewart^1,2, Michael D. Brundage^1,2,3, Rob Siemens⁴, David Skarsgard⁵
Canadian Journal of Urology, Vol.13, No.6, pp. 3321-3326, 2006
Abstract Purpose: To compare the helpfulness of two educational aids or booklets on early-stage prostate cancer.
Method: Participating consecutive patients and a family member, in three centres, received one of two booklets, one produced by AstraZeneca (AZ), the other produced by us (CCE); the patient and family shared a booklet but were separate study participants. The primary outcome was the Purpose-based Information Assessment completed after participants read their booklet; they rated the importance (4-point Likert scale) of six potential purposes for the information: to help organize their thoughts, understand their situations, decide on treatment, plan, provide emotional support… More >

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ARTICLE

Tracy Sexton^1,2, George Rodrigues^1,2,3, Ed Brecevic^1,2, Laura Boyce¹, Denise Parrack¹, Michael Lock^1,2, David D’Souza^1,2
Canadian Journal of Urology, Vol.13, No.6, pp. 3327-3334, 2006
Abstract Objective:To assess accuracy of recorded prostate cancer stage after implementation of a quality assurance staging improvement plan.
Methods and materials:Genitourinary multidisciplinary TNM staging guidelines were prospectively implemented. Educational programs for health records technicians (HRT) and clinicians preceded implementation of the new guidelines. Patient stage information was entered into the Oncology Patient Information System (OPIS) as part of the usual operations of the cancer center by an HRT. Physician and HRT auditors performed a subsequent quality assurance audit on 97 prostate cancer patients seen over a 2-month period. Assessment of staging accuracy and reasons for discrepancies between the… More >

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ARTICLE

Daniel Y. C. Heng, Kim N. Chi
Canadian Journal of Urology, Vol.13, No.6, pp. 3335-3339, 2006
Abstract Background: Patients with advanced prostate cancer eventually cease to respond to hormonal therapy and thus progress to hormone refractory prostate cancer (HRPC). Prednisone has been used in this setting; however, limited data is available for this monotherapy in the asymptomatic HRPC population.
Objective: To evaluate the PSA response rate to prednisone in asymptomatic patients with hormone refractory prostate cancer (HRPC). Secondary objectives were to determine toxicity, predictors of response, and to determine overall survival of this population.
Methods: Patients with asymptomatic HRPC that were treated with low dose prednisone from April 1998 to 2003 were identified from the… More >

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Open Access

HOW I DO IT

Saleh Binsaleh¹, Patrick P. Luke², Christopher Nguan², Anil Kapoor¹
Canadian Journal of Urology, Vol.13, No.6, pp. 3340-3345, 2006
Abstract Objectives: Autosomal dominant polycystic kidney disease an inherited systemic disorder is characterized by the development of multiple cysts in the kidneys and other organs. When nephrectomy is indicated, the laparoscopic approach is challenging due to the massive size of these kidneys. We present our technique and evaluate the surgical outcomes of laparoscopic versus open nephrectomy for patients with such condition.
Materials and methods: A retrospective review was done for six laparoscopic and six open nephrectomies performed by two laparoscopic surgeons in two university hospitals between January 2004 and December 2004. Preoperative, intraoperative, and postoperative data are presented.… More >

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Open Access

CASE REPORT

Aaron B. Grotas, Harris M. Nagler
Canadian Journal of Urology, Vol.13, No.6, pp. 3346-3347, 2006
Abstract The stimulatory role of testosterone in the production and release of prostate-specific antigen (PSA) has been well characterized. Testosterone production by the testes is dependent on a functional hypothalamic-pituitary-gonadal axis. High prolactin levels have been shown to disrupt this axis, resulting in decreases in gonadotropins and testosterone levels. We report a patient with prostate cancer and elevated PSA levels followed with “watchful waiting” for several years who experienced a precipitous decrease in PSA level over a 3 month period. The patient was found to have an asymptomatic prolactin-secreting pituitary macroadenoma. More >

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CASE REPORT

Canadian Journal of Urology, Vol.13, No.6, pp. 3348-3350, 2006
Abstract Aim: To describe a malignant cystic nephroma in an asymptomatic man.
Methods: Case report and review of the literature.
Results: A 60-year-old white male presented with an incidentally discovered right perirenal mass. An MRI demonstrated a large perinephric encapsulated mass with diffuse heterogeneity. Patient underwent a radical nephrectomy and retroperitoneal node dissection. Histopathological analyses of the resected specimen revealed malignant cystic nephroma.
Conclusion: This represents the first published report of this rare tumor in an adult patient. More >

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RESIDENT’S CORNER

M. C. Smaldone, G. M. Cannon Jr, R. M. Benoit
Canadian Journal of Urology, Vol.13, No.6, pp. 3351-3352, 2006
Abstract Currently, the prosthesis of choice for patients undergoing penile prosthesis surgery is a three piece inflatable device, as this provides optimal inflation and deflation when compared to a one or two piece prosthesis. However, prior pelvic surgery or radiation therapy can obliterate the retropubic space and make placement of the reservoir required for a three piece prosthesis difficult. We report a novel location for reservoir placement in a man who had undergone multiple pelvic surgeries after suffering a severe pelvic crush injury. More >

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RESIDENT’S CORNER

Marcelo A. Orvieto, Kevin C. Zorn, Ofer N. Gofrit, James Anderson, Gregory P. Zagaja, Charles B. Brendler
Canadian Journal of Urology, Vol.13, No.6, pp. 3353-3357, 2006
Abstract Purpose: We describe surgical modifications in radical retropubic prostatectomy (RRP) which have significantly reduced the incidence of bladder neck contractures (BNC).
Materials and methods: Between March 1994-July 2005, 977 men underwent a RRP by a single surgeon. Group I comprised 548 patients operated upon July 1994-December 1999, without the modifications described below. Group II comprised 429 men operated upon January 2000-December 2004, with the following surgical modifications: 1) reconstruction of the bladder neck (BN) to a diameter of 28 French; 2) placement of the posterior (6 o'clock) vesicourethral suture on mild traction before placing this suture into… More >

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RESIDENT’S CORNER

Christopher C. Hoag, William N. Taylor, Victor A. Rowley
Canadian Journal of Urology, Vol.13, No.6, pp. 3358-3363, 2006
Abstract Introduction: There is little documentation of the efficacy of the Doli-S lithotripter. This study investigated the outcome of ESWL with the Doli-S lithotripter on previously untreated renal calculi.
Methods: Over a 12-month period, 105 consecutive patients with renal stones, treated by a single urologist were enrolled in the study. None of the stones were previously treated. Data gathered included stone characteristics and treatment characteristics. Treatment was to an endpoint of either fluoroscopically successful fragmentation or to 2500 shockwaves. Patients were followed with KUBs, ultrasounds, or CT-KUBs to assess residual stone burden. Treatment success was defined as… More >

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