Open Access

EDITORIAL

Gabriel P. Haas
Canadian Journal of Urology, Vol.15, No.2, pp. 3950-3950, 2008
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LEGENDS IN UROLOGY

Alvaro Morales
Canadian Journal of Urology, Vol.15, No.2, pp. 3951-3953, 2008
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REVIEW

Uzma Athar, Teresa C. Gentile
Canadian Journal of Urology, Vol.15, No.2, pp. 3954-3966, 2008
Abstract Metastatic renal cell carcinoma (RCC) has a poor overall survival. Localized RCC remains a surgical disease. About 20%-30% patients who present with limited disease at the time of nephrectomy develop metastasis. The median time to relapse after nephrectomy is 15-18 months. The maximum numbers of relapses are within the first 3 years. In metastatic RCC, immunotherapy is effective in a relatively small percentage of patients but is very toxic. In recent years, there has been an improved understanding of the biology of RCC. This has lead to the development of various agents that target ligands More >

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REVIEW

Elijah O. Kehinde¹, May Al Maghrebi², Jehoram T. Anim³
Canadian Journal of Urology, Vol.15, No.2, pp. 3967-3974, 2008
Abstract Incidental prostate cancer (PCa) has been demonstrated at autopsy in about 80% of men aged 80 years and above and also in 10%-15% of younger men aged 30-50 years in the United States. These data imply a wide variation in aggressiveness of prostate cancer, from indolent tumors to aggressive cancers that kill the patients. The use of prostate specific antigen (PSA) in screening for PCa may detect even indolent disease for which radical prostatectomy may not be necessary. Currently available criteria such as histological grade, PSA level, stage of the disease do not always predict… More >

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ARTICLE

Alex G. Kavanagh, Jay C. Lee, Bryan Donnelly
Canadian Journal of Urology, Vol.15, No.2, pp. 3975-3979, 2008
Abstract Purpose: To determine the wait time between initial referral, biopsy, diagnosis and individual treatment modalities of prostate cancer treatment through the Calgary Prostate Institute rapid access clinic (RAC) and compare to historical data estimates in Alberta and to suggested standards. Biopsy rate, rate of confirmed prostate cancer and the distribution of treatment modality for patients seen through the RAC is included.
Materials and methods: A non-consented, retrospective chart review of 1103 patients from the Calgary Health Region referred to the RAC between September 2005 and August 2006 was completed.
Results: Patients experienced a median wait time of 21… More >

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ARTICLE

Jay D. Raman¹, James Thomas¹, Steven M. Lucas¹, Karim Bensalah¹, Yair Lotan¹, Clayton Trimmer², Jeffrey A. Cadeddu¹
Canadian Journal of Urology, Vol.15, No.2, pp. 3980-3985, 2008
Abstract Objective: The experience with radiofrequency ablation (RFA) in solitary kidneys is limited in numbers and follow-up. Therefore, we report our oncologic and renal function outcomes of RFA for T1a tumors in patients with a solitary kidney.
Methods: From April 2000 to August 2007, 242 patients were treated with RFA for renal cortical masses. Sixteen patients with localized tumors ≤ 4 cm in a solitary kidney were identified. Clinical and radiographic data were reviewed to assess indications, complications, disease recurrence, and renal function.
Results: Twenty-one renal masses were ablated in 16 patients with a solitary kidney. The mean patient… More >

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ARTICLE

Ali Fuat Atmaca, Ziya Akbulut, Serkan Altinova, Alper Çaglayan, Mehmet Tuzlali, M. Derya Balbay
Canadian Journal of Urology, Vol.15, No.2, pp. 3986-3989, 2008
Abstract Introduction: We wanted to determine whether routine postoperative chest radiography is needed after surgery with eleventh rib resection.
Materials and methods: Data on 80 patients who underwent radical or partial nephrectomy, nephroureterectomy or adrenalectomy through 82 flank incisions with eleventh rib resection were collected and analyzed retrospectively.
Results: Radical and partial nephrectomies, nephroureterectomies and adrenalectomies were done through 47, 20, 6 and 9 flank incisions in 80 patients, respectively. Among these, one patient underwent a partial nephrectomy and subsequent contralateral radical nephrectomy, and another patient underwent simultaneous bilateral adrenalectomies. The intrapleural space was entered accidentally in 16… More >

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ARTICLE

Gregory R. Hanson, Lester S. Borden, Jr., Doug D. Backous, Stephen W. Bayles, John M. Corman
Canadian Journal of Urology, Vol.15, No.2, pp. 3990-3993, 2008
Abstract Introduction: With nerve-sparing techniques, patients undergoing a radical prostatectomy may avoid the morbidity of erectile dysfunction. Certain patients who are not candidates for nerve-sparing procedures may be eligible for nerve interposition grafts. While bilateral cavernosal nerve grafting after radical prostatectomy has shown efficacy, the effect of unilateral nerve grafting following prostatectomy remains unclear. We evaluate a large group of patients who underwent a unilateral cavernosal nerve replacement.
Methods: Forty patients underwent unilateral nerve sparing surgery with concomitant contralateral cavernosal nerve replacement. Patients were selected for this procedure based upon preoperative nomogram risk assessment, endorectal MRI evidence… More >

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MINIMALLY INVASIVE AND ROBOTIC SURGERY

Edouard J. Trabulsi¹, Robert A. Linden¹, Leonard G. Gomella¹, Davis E. McGinnis², Stephen E. Strup³, Costas D. Lallas¹
Canadian Journal of Urology, Vol.15, No.2, pp. 3994-3999, 2008
Abstract Purpose: The addition of robotic assistance with the da Vinci surgical system for performing laparoscopic radical prostatectomy has been reported to improve surgical outcomes. In order to evaluate the benefit of robotic assistance to improve cancer control in a center with an established laparoscopic radical prostatectomy program, we evaluated the incidence of positive surgical margins in both transperitoneal laparoscopic (LRP) and robotically assisted laparoscopic radical prostatectomy (RALP).
Materials and methods: We performed an Institutional Review Board (IRB) approved, retrospective review of 247 men with clinically localized prostate cancer treated with either a LRP or a RALP from… More >

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HOW I DO IT

Khurshid A. Guru^1,2, Adam E. Perlmutter¹, Zubair M. Butt¹, James O. Peabody³
Canadian Journal of Urology, Vol.15, No.2, pp. 4000-4003, 2008
Abstract Introduction: To describe a technique that may facilitate neurovascular bundle preservation during robot-assisted radical prostatectomy.
Materials and methods: From December 2007 to January 2008, 10 patients underwent robot-assisted radical prostatectomy with bilateral nerve preservation. Hydrodissection of the neurovascular bundle was performed by injecting a 1:10000 epinephrine solution diluted in 0.9% normal saline into the lateral prostatic pedicle with an injection cannula needle (Wolf®). Operative time, blood loss and margin status were assessed when this new technique was utilized. Erectile function status will be analyzed in the future.
Results: Ten potent patients underwent bilateral nerve-sparing robot-assisted radical prostatectomy… More >

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HOW I DO IT

Alvaro Lucioni, David E. Rapp, Edward M. Gong, William S. Reynolds, Paula A. Fedunok, Gregory T. Bales
Canadian Journal of Urology, Vol.15, No.2, pp. 4004-4008, 2008
Abstract Introduction: The Gynecare Prolift pelvic floor repair system (GPS) comprises a synthetic mesh placed via a transvaginal, transobturator approach. We present our technique focusing on the safety and feasibility of the GPS.
Materials and methods: GPS candidates are evaluated in the office with a full history, physical examination, urinalysis and when appropriate, urodynamic evaluation. Patients were offered total vaginal vault prolapse repair or isolated anterior repair dependent of site of defect. Follow-up comprised a full history, physical examination, and global assessment of subjective satisfaction (2 and 6 weeks, 6 months postoperative). Concentration was placed on intraoperative and More >

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CASE REPORT

Apostolos P. Labanaris¹, Vahudin Zugor², Bernd Meyer¹, Sven Scheuering¹, Sami Takriti¹, Reinhard Kühn¹
Canadian Journal of Urology, Vol.15, No.2, pp. 4009-4011, 2008
Abstract Non-urothelial neoplasms of the bladder account for less than 5% of all bladder tumors. Sarcoma constitutes the most usual mesenchymal malignancy of the bladder, with leiomyosarcomas being the most common type of sarcoma in adults. A coexistence of this rare tumor with another malignancy has not been reported, to our knowledge. This report demonstrates a case of high-grade bladder leiomyosarcoma cancer with prostate cancer in a 72-yearold patient. The most striking features of this case include the rapid disease progression that confirms the highly aggressive nature of this uncommon disease. More >

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CASE REPORT

George R. Schade, Ofer N. Gofrit, Kevin C. Zorn
Canadian Journal of Urology, Vol.15, No.2, pp. 4012-4015, 2008
Abstract A 42-year-old woman with tuberous sclerosis (TS)presented with acute right-sided flank pain. Imaging studies demonstrated numerous bilateral renal angiomyolipomas (AML), the largest located within the right upper pole, extending into the venous system to the level of the infra-hepatic inferior vena cava (IVC).Intravascular extension of AML is quite rare, however,may potentially result in fatal complications if not appropriately treated. We present a case report and a description of the surgical management, and provide a review of the literature concerning this rare finding. More >

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CASE REPORT

Prashant Jani¹, Ahmed Lotfy Nasr², Dina El Demellawy¹
Canadian Journal of Urology, Vol.15, No.2, pp. 4016-4019, 2008
Abstract A case of synchronous adrenocortical carcinoma (ACC) and renal cell carcinoma (RCC) has not yet been described in the English medical literature, to our knowledge. We report a first such case of adrenocortical and renal cell carcinomas occurring simultaneously in a 53-year-old male. He presented with history of vague abdominal pain. Ultrasound followed by a computed tomography (CT) scan and a magnetic resonance imaging (MRI) examination revealed a 6.4 cm left adrenal mass and a 3.5 cm right renal mass. The patient had complaints of gastroparesis manifesting with constant nausea as well as intermittent abdominal More >

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RESIDENT’S CORNER

Anil A. Thomas¹, Ryan Hedgepeth¹, Timur P. Sarac², Sandip P. Vasavada¹
Canadian Journal of Urology, Vol.15, No.2, pp. 4020-4023, 2008
Abstract Scrotal hematoma is a rare and unusual complication of transfemoral cardiac catheterization. We describe the case of a 43-year-old man who presented with a delayed retroperitoneal hemorrhage and massive scrotal hematoma following cardiac catheterization. Emergent groin exploration was performed with ligation of the inferior epigastric artery and evacuation of the scrotal hematoma. Urological sequelae from transfemoral arterial access are rare. However, scrotal hematoma may occur if bleeding occurs between anatomic fascial planes. More >

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RESIDENT’S CORNER

Anil A. Thomas¹, Ryan Hedgepeth¹, Timur P. Sarac², Sandip P. Vasavada¹
Canadian Journal of Urology, Vol.15, No.2, pp. 4024-4026, 2008
Abstract Acquired bladder diverticula due to bladder outlet obstruction are not uncommon in the adult male population. Congenital diverticula originate adjacent to the trigone and are rarely diagnosed in adults. We report an unusual case of a diverticulum arising adjacent to an ectopic ureter located on the left lateral wall near the dome of the bladder. Although the diverticulum appeared to be congenital, its large size was likely a result of high pressure voiding. The patient underwent a transurethral resection of the prostate to reduce his bladder outlet obstruction, and subsequently underwent an open diverticulectomy. More >

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RESIDENT’S CORNER

Jean Wong, Gilbert J. Wise, Bradly Clark
Canadian Journal of Urology, Vol.15, No.2, pp. 4027-4029, 2008
Abstract Primary genitourinary melanoma accounts for less than 1% of all cases of melanoma. Melanoma of prostatic origin is extremely rare. These patients are difficult to diagnose and carry a very poor prognosis. Aggressive surgical resection is the current treatment standard. We report a case of primary malignant melanoma of the prostate found during transurethral resection of the prostate. More >

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CLINICAL TRIALS

Richard W. Casey¹, Jack Barkin²
Canadian Journal of Urology, Vol.15, No.2, pp. 4030-4033, 2008
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CLINICAL TRIALS

Mary J. Mackenzie, Eric Winquist, George Rodrigues
Canadian Journal of Urology, Vol.15, No.2, pp. 4034-4042, 2008
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