Open Access

EDITORIAL

Gabriel P. Haas
Canadian Journal of Urology, Vol.16, No.2, pp. 4532-4532, 2009
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LEGENDS IN UROLOGY

E. Darracott Vaughan, Jr.
Canadian Journal of Urology, Vol.16, No.2, pp. 4533-4535, 2009
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ARTICLE

Michael Cox¹, John J. Klutke², Carl G. Klutke¹
Canadian Journal of Urology, Vol.16, No.2, pp. 4536-4540, 2009
Abstract Introduction and objective: Hunner's ulcer subtype interstitial cystitis (IC) is characterized by the presence of circumscribed inflammatory ulcerations in the bladder wall identified during endoscopic examination of individuals with irritative voiding symptoms and pelvic pain. We present our experience with management of this subgroup with intralesional submucosal injection of corticosteroid.
Methods: Prospective analysis of patients presenting with Hunner's ulcer subtype IC was performed between November 2006 and April 2008. All patients underwent flexible cystoscopy and biopsy confirming the presence of Hunner's ulcer(s). Under general anesthesia, 10 ml of triamcinolone acetonide (40 mg/ml) was injected in 0.5 ml… More >

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ARTICLE

Howard Huaihan Pai^1,5, Brenna Eldridge², Darcy Bishop³, Abraham Alexander^1,5, Mary Lesperance⁴, Paul Blood^1,5, Jan Lim^1,5, Charles Ludgate^1,5
Canadian Journal of Urology, Vol.16, No.2, pp. 4541-4552, 2009
Abstract Purpose: To assess outcome and predictive factors in men with prostate cancer who receive post radical prostatectomy (RP) radiotherapy (RT) either in the adjuvant or salvage setting, with or without neoadjuvant androgen deprivation therapy (NADT).
Methods: A retrospective analysis was performed on 175 patients with clinically localized prostate cancer treated with RP who subsequently received RT (dose range 50 Gy-68 Gy). Twenty-two patients received adjuvant RT (ART), 57 received NADT + ART, 15 received salvage RT (SRT), and 81 received NADT + SRT. Outcome was assessed by biochemical disease-free survival (BDFS), prostate cancer specific survival and overall… More >

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ARTICLE

Manlio A. Goetzl¹, Ron Krebill², Tomas L. Griebling^1,3, J. Brantley Thrasher¹
Canadian Journal of Urology, Vol.16, No.2, pp. 4553-4557, 2009
Abstract Introduction/objective: Margin positivity has been a well described adverse prognostic factor in patients undergoing radical prostatectomy. Previous studies with regards to predictors of margin positivity after prostatectomy have primarily focused on the retropubic or robotic approach. We sought to examine the predictors of margin positivity in a contemporary series of men undergoing radical perineal prostatectomy (RPP).
Materials and methods: We reviewed the records of 103 patients who underwent RPP at our institution from July 1998 until May 2008. A positive surgical margin (PSM) was defined as the presence of cancer cells at the inked margin of the… More >

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ARTICLE

Nilgun Mutlu¹, Levent N. Türkeri², Faruk Yencilek³, Aslan Demir², Kaya Emerk⁴
Canadian Journal of Urology, Vol.16, No.2, pp. 4558-4567, 2009
Abstract Background: Data on utilizing complexed prostate specific antigen (cPSA) offering increased diagnostic performance over other available clinical parameters in diagnosis of prostate cancer is still controversial. Our objective was to determine diagnostic performance of cPSA compared to total prostate specific antigen (tPSA) and corresponding ratios for possible routine application.
Methods: In a prospective study including overall 315 consecutive men, 177 patients with suspicious digital rectal examination, and/or tPSA value ≥ 2.5 ng/ml underwent prostate biopsy. Serum samples for tPSA, cPSA and free PSA were analyzed using automated chemiluminometric technology.
Results: Area under the curve (AUC) for cPSA, although… More >

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ARTICLE

Mayank Mohan Agarwal¹, Shrawan K. Singh¹, Darshan Kumar Sharma¹, Priyadarshi Ranjan¹, Santosh Kumar¹, Vaddi Chandramohan², Nitin Gupta¹, Naveen C. Acharya¹, Vidur Bhalla³, Ravimohan Mavuduru¹, Arup K. Mandal¹
Canadian Journal of Urology, Vol.16, No.2, pp. 4568-4575, 2009
Abstract Introduction: Fracture of the penis is rare and needs a surgeon's attention for appropriate management. The exact role of diagnostic investigations has not been established. We studied the role of these investigations and the results of surgery.
Case series: Seventeen patients with median age of 36 years (range, 27-72 years) presented to us between 2002 and 2007 with suspected fracture of the penis. The mode of injury was sexual intercourse (15 patients), masturbation (1 patient), and rolling over in bed (1 patient). The median time from injury to presentation was 10 hours (range, 1-144 hours). Clinical evaluation… More >

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ARTICLE

Gaurang Shah¹, Luay Susan¹, Jean Furcroy²
Canadian Journal of Urology, Vol.16, No.2, pp. 4576-4579, 2009
Abstract Female circumcision — a procedure where the parts of the female genitals are removed, which is also known as female genital cutting (FGC) or female genital mutilation (FGM) — continues to be practiced in more than 28 African countries. It is estimated that 80-100 million women have been circumcised. We performed a review of the literature to examine the history of female circumcision, its medical and psychological consequences, and government and non-government educational initiatives that are currently being taken to eradicate this practice. More >

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MINIMALLY INVASIVE AND ROBOTIC SURGERY

George L. Martin, Rafael N. Nunez, Aaron D. Martin, Paul E. Andrews, Erik P. Castle
Canadian Journal of Urology, Vol.16, No.2, pp. 4580-4583, 2009
Abstract Introduction: Flank positioning with the patient's ipsilateral arm elevated over the head on an arm board is often used during laparoscopic kidney surgery. There have been reports of brachial plexus neuropraxia, rhabdomyolysis and other complications related to this positioning. Herein we describe our modified positioning technique for laparoscopic renal surgery.
Method: Beginning in November 2003, all patients undergoing laparoscopic renal surgery have been positioned in the 30 degree modified flank position. The ipsilateral arm is not elevated on an arm board but lies in an ergonomic "sling" position with the elbow flexed slightly greater than 90 degrees.… More >

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HISTORY OF UROLOGY

Jennifer Gordetsky, Ronald Rabinowitz, Jeanne O’Brien
Canadian Journal of Urology, Vol.16, No.2, pp. 4584-4588, 2009
Abstract Objective: Catherine de Medici, queen consort of King Henry II of France, was a powerful woman at a time when power for her sex was determined by fecundity. A decade-long history of infertility might have placed her at risk for condemnation, but her husband's known urologic abnormalities played in her favor. This presentation will address the penile deformity of her husband, Henry II, and how this likely played a crucial role in her eventual rise to power, the interventions undertaken with regard to her purported infertility, and the historical ramifications when Catherine de Medici went on… More >

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CASE REPORT

Nathan Hoag¹, Peter J. Pommerville¹, Pamela C. Kibsey², Douglas J. Cavers³, Richard J. Eddy⁴
Canadian Journal of Urology, Vol.16, No.2, pp. 4589-4591, 2009
Abstract Intravesical Bacillus Calmette-Guérin (BCG) is widely used as an adjuvant therapy in the treatment of superfi cial bladder cancer. BCG is administered as a live, attenuated form of Mycobacterium bovis, and acts as an immunomodulary agent to delay tumor progression. BCG is generally well tolerated, though localized and systemic infectious complications may occur. A literature search revealed that tuberculous epididymitis is a rarely reported complication of intravesical BCG therapy. We report the case of an 82-year-old male who developed tuberculous epididymitis while undergoing intravesical BCG treatment for transitional cell carcinoma of the bladder. Right orchiectomy More >

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CASE REPORT

Santosh Kumar¹, Kim Vaiphei², Benu Panigrahy¹, Naveen Acharya¹, Saurav Pandya¹
Canadian Journal of Urology, Vol.16, No.2, pp. 4592-4595, 2009
Abstract Epithelioid hemangioendothelioma (EH) is a very rare vascular tumor of intermediate biological behavior. It can arise from various sites including bone, liver, spleen, pleura, lung, skin, or soft tissue. We report a case of a 24-year-old man who presented with a history of acute urinary retention and a palpable lump in the lower abdomen. Imaging showed a large pelvic mass displaying heterogeneous texture with solid and cystic components compressing and displacing adjacent structures. The patient underwent exploratory laparotomy with excision of the pelvic mass. Histopathological examination confi rmed the diagnosis of EH. Pelvic soft tissue More >

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CASE REPORT

John G. Pattaras¹, Ross Milner²
Canadian Journal of Urology, Vol.16, No.2, pp. 4596-4598, 2009
Abstract Introduction: Laparoscopic radical nephrectomy has become an international standard of care for medium to large renal tumors. Endovascular aneurysm repair (EVAR) has been accepted as a reasonable alternative to open abdominal aortic aneurysm (AAA) repair. We report a case of minimally invasive management of two potentially lethal diseases in a single hospitalization.
Patient and methods: The patient is a 76-year-old male who was found to have an incidental finding of an AAA and an enhancing 9 cm left central renal mass. He was deemed to be an appropriate candidate for endovascular AAA repair and laparoscopic nephrectomy based… More >

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CASE REPORT

Daniel Taussky¹, Denis Soulières²
Canadian Journal of Urology, Vol.16, No.2, pp. 4599-4600, 2009
Abstract We present a case of a patient with metastatic renal cell cancer (RCC) treated with hypofractionated radiotherapy while being treated with sunitinib. He received a single dose of 8 Gy of external beam radiation to a metastatic mass of several centimeters diameter in the right lateral ribs, followed by a second identical dose. Clinically, the patient achieved a nearly complete disappearance of the mass. We discuss the possible synergy between tyrosine kinase receptor inhibitors (TKRIs) and radiotherapy and the importance of dose fractionation. More >

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RESIDENT’S CORNER

Sujeet S. Acharya, Mohan S. Gundeti, Gregory P. Zagaja, Arieh L. Shalhav, Kevin C. Zorn
Canadian Journal of Urology, Vol.16, No.2, pp. 4601-4606, 2009
Abstract Background: Although malformations of the genitourinary tract are typically identified during childhood, they can remain silent until incidental detection in evaluation and treatment of other pathologies during adulthood. The advent of the minimally invasive era in urologic surgery has given rise to unique challenges in the surgical management of anomalies of the genitourinary tract.
Objective: This article reviews the embryology of anomalies of Wolffian duct (WD) derivatives with specific attention to the seminal vesicles, vas deferens, ureter, and kidneys. This is followed by a discussion of the history of the laparoscopic approach to WD derivative anomalies. Finally,… More >

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RESIDENT’S CORNER

Sapan N. Ambani¹, Bruce L. Jacobs¹, Aleksandr M. Perepletchikov², Ronald L. Hrebinko, Jr.¹
Canadian Journal of Urology, Vol.16, No.2, pp. 4607-4610, 2009
Abstract The presentation of a synchronous renal cell carcinoma (RCC) and germ cell tumor (GCT) is rare. We report the case of a 57 year-old male who presented with a right renal mass and retroperitoneal lymphadenopathy. He underwent a successful right partial nephrectomy and retroperitoneal lymph node dissection, and the subsequent pathology revealed a stage I clear cell RCC and a retroperitoneal teratoma with a component of benign prostatic tissue. We briefl y discuss the rarity of this occurrence, the pathological features that helped support this diagnosis, and the likely etiologies of these synchronous lesions. More >

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RESIDENT’S CORNER

W. A. Mayer¹, M. J. Resnick¹, D. Canter¹, P. Ramchandani², A. Kutikov¹, J. F. Harryhill¹, V. L. Carpiniello¹, T. J. Guzzo³
Canadian Journal of Urology, Vol.16, No.2, pp. 4611-4614, 2009
Abstract Synchronous metastasis of renal cell carcinoma (RCC) to the ureter or the bladder represents an extremely rare event. We report one case of synchronous metastasis of RCC to the ipsilateral ureter and one case of solitary synchronous metastasis of RCC to the urinary bladder. We review the literature and discuss possible mechanisms of dissemination. We discuss the surgical management of metastases from RCC as well as the surgical options in the treatment of these rare occurrences. More >

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CLINICAL TRIALS

Richard W. Casey¹, Jack Barkin²
Canadian Journal of Urology, Vol.16, No.2, pp. 4615-4616, 2009
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CLINICAL TRIALS

Eric Winquist, Mary J. Mackenzie, George Rodrigues
Canadian Journal of Urology, Vol.16, No.2, pp. 4617-4623, 2009
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