Open Access

EDITORIAL

Gabriel P. Haas
Canadian Journal of Urology, Vol.16, No.3, pp. 4624-4624, 2009
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LEGENDS IN UROLOGY

Catherine R. deVries
Canadian Journal of Urology, Vol.16, No.3, pp. 4625-4626, 2009
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REVIEW

Andrew C. Kramer
Canadian Journal of Urology, Vol.16, No.3, pp. 4627-4631, 2009
Abstract Objective: Requests for sperm extraction in terminally ill or recently deceased patients have been increasing with the gained acceptance and success of assisted reproductive techniques such as in vitro fertilization and intracytoplasmic sperm injection. This review aims to outline the many challenges associated with these requests.
Materials and methods: The medical literature surrounding ethical and legal issues of posthumous sperm extraction was examined.
Results: Several issues within the field of sperm extraction in the terminally ill patient and the postmortem patient still arouse a significant amount of debate and controversy. One controversial factor surrounds the issue of consent… More >

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ARTICLE

Karim Bensalah¹, Jay D. Raman^1,3, Ilia S. Zeltser¹, Aditya Bagrodia¹, Steven M. Lucas¹, Wareef Kabbani², Jeffrey A. Cadeddu¹
Canadian Journal of Urology, Vol.16, No.3, pp. 4632-4638, 2009
Abstract Objective: To compare kidney oxygenation profiles between partial and complete renal artery clamping during nephron sparing surgery (NSS) in a porcine model.
Materials and methods: Twelve female farm pigs underwent a laparoscopic nephrectomy. Subsequently, an open partial nephrectomy was performed on the remaining kidney using either total (n = 6, TC) or partial (n = 6, PC) clamping of the renal artery. Real time renal partial oxygen pressure (rPO2) was monitored using a Licox probe (Integra, San Diego, CA). Creatinine levels were measured prior to open partial nephrectomy and on POD #3 and #7. The remaining kidney… More >

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ARTICLE

James Renaud¹, Slav Yartsev^1,3, A. Rashid Dar^2,3, Jake Van Dyk^1,3
Canadian Journal of Urology, Vol.16, No.3, pp. 4639-4647, 2009
Abstract Purpose: To describe a clinical pilot case of renal lymphoma successfully treated using helical tomotherapy, and to evaluate alternative hypofractionated treatment schedules and their potential applicability to future cases of renal cell carcinoma (RCC).
Patients and methods: An 82-year-old female patient with a large right perinephric mass encircling the lower pole of the right kidney was treated on the Hi-ART unit (TomoTherapy Inc., Madison, WI, USA) with daily pretreatment megavoltage CT imaging. Gross tumor volumes (GTVs) were outlined on every MVCT study. The Planned Adaptive software was used for calculation of dosimetric parameters for both the target… More >

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ARTICLE

J. Kellogg Parsons^1-3, Vicky A. Newman², James L. Mohler⁴, John P. Pierce², Shirley Flatt², Karen Messer², James Marshall⁴
Canadian Journal of Urology, Vol.16, No.3, pp. 4648-4654, 2009
Abstract Introduction: Diet has been linked to prostate cancer risk. Dietary modification may inhibit prostate cancer progression.
Materials and methods: As part of a randomized trial, we analyzed the effect of a diet based intervention on 25 prostate cancer patients who had previously undergone surgery or radiation.
Results and conclusions: In the intervention arm, vegetable intake increased (p < 0.05), fat intake decreased (p < 0.05), and mean plasma levels of ß-carotene and total carotenoids increased (p < 0.05). In the control arm, there were no significant changes in diet or blood carotenoids. These data support the feasibility of studying More >

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ARTICLE

Angelish Kumar, Guilherme Godoy, Samir S. Taneja
Canadian Journal of Urology, Vol.16, No.3, pp. 4655-4659, 2009
Abstract Objective: To determine if adjustment of prostate-specific antigen velocity (PSAV) for variation improves prediction of cancer in men with previous negative prostate biopsy.
Patients and methods: Records of men undergoing prostate biopsy between 1999 and 2004 by a single urologist were reviewed to identify men with at least three follow up PSA measurements. Patients with atypia, high grade prostatic intraepithelial neoplasia or cancer on baseline biopsy were excluded. Men were rebiopsied if perceived to have rising PSA. Men with cancer, no cancer, or no repeat biopsy were compared for PSAV and a new parameter, PSAV%/Variation. PSAV was… More >

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EDITORIAL COMMENT

Amar Singh
Canadian Journal of Urology, Vol.16, No.3, pp. 4659-4659, 2009
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ARTICLE

Stanton M. Regan, Stephen D. W. Beck, Richard Bihrle, Richard S. Foster¹
Canadian Journal of Urology, Vol.16, No.3, pp. 4660-4663, 2009
Abstract Objective: To examine the usefulness of routine stentograms in patient management following urinary diversion.
Materials and methods: A retrospective review of all patients undergoing urinary diversion from February 2004 to February 2007 was performed. Three hundred twenty-six patients were identified. One hundred fifty patients were excluded: 101 patients had no stentogram and 49 patients had incomplete records or follow up.
Results: Of the 176 patients, ureteral anastomotic leak was detected in three of 344 ureters (0.9%). The ureteral stents were left in situ until the leaks resolved. None of the three developed a ureteral stricture. Ten (3.0%) ureters… More >

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MINIMALLY INVASIVE AND ROBOTIC SURGERY

Daniel J. Lee, Michael B. Rothberg, James M. McKiernan, Mitchell C. Benson, Ketan K. Badani
Canadian Journal of Urology, Vol.16, No.3, pp. 4664-4670, 2009
Abstract Objective: To evaluate the safety and feasibility of robotic-assisted radical cystoprostatectomy (RRCP) in a salvage setting for patients with a history of radiation and chemotherapy treatment, complex pelvic anatomy, and significant comorbidities.
Materials and methods: Over a 5-month period, six patients who met these criteria underwent RRCP for urothelial carcinoma. Two of the patients had major cardiovascular disease and were previously denied an open procedure subsequently underwent chemotherapy with external beam radiation protocol. One patient had brachytherapy for prior prostate cancer, and three additional patients had neoadjuvant chemotherapy with large diverticula, measuring up to 12 cm in… More >

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EDITORIAL COMMENT

Khurshid A Guru
Canadian Journal of Urology, Vol.16, No.3, pp. 4670-4670, 2009
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MINIMALLY INVASIVE AND ROBOTIC SURGERY

Iqbal Singh, Karim Kader, Ashok K. Hemal
Canadian Journal of Urology, Vol.16, No.3, pp. 4671-4676, 2009
Abstract Aim: To present the point of technique of robotic distal ureterectomy under cystoscopic guidance with pelvic lymphadenectomy (PLND), ureteral reconstruction with and without a psoas hitch in patients with distal ureteral urothelial cancer (DUCC) and to review the current literature.
Methods: The various steps of operative technique of robotic PLND, distal ureterectomy under cystoscopic guidance, ureteral reconstruction with and without a psoas hitch in patients of DUCC are described. Several tricks have been highlighted to undertake such procedure. The published English literature was also searched using the key words; robot, laparoscopy, ureteral reimplantation, distal ureterectomy, psoas hitch,… More >

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LETTER

Iqbal Singh, Karim Kader, Ashok K. Hemal
Canadian Journal of Urology, Vol.16, No.3, pp. 4676-4676, 2009
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EDITORIAL COMMENT

Ali Moinzadeh
Canadian Journal of Urology, Vol.16, No.3, pp. 4676-4676, 2009
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HOW I DO IT

Abdullah Erdem Canda, Ali Fuat Atmaca, Ahmet Tunc Ozdemir, Ziya Akbulut, M. Derya Balbay
Canadian Journal of Urology, Vol.16, No.3, pp. 4677-4681, 2009
Abstract Objective: We present our experience in performing testis sparing surgery (TSS) to treat sequential bilateral testicular tumors.
Material and methods: We performed TSS on two patients with bilateral sequential testicular tumors.
Results: A 43-year-old patient (Case 1) and a 33-year-old patient (Case 2) had previous inguinal orchiectomy for seminoma. The patients were diagnosed with secondary testicular tumors in the contralateral testes on follow-up. They were treated with TSS after frozen section analysis of the peritumoral testicular tissue. Pathologic evaluation of the removed tumors revealed immature teratoma and Leydig cell tumor. Both patients are disease-free without local recurrence and More >

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CASE REPORT

Anthony T. Corcoran¹, Ryan P. Smith², Ronald M. Benoit¹
Canadian Journal of Urology, Vol.16, No.3, pp. 4682-4683, 2009
Abstract Prostate brachytherapy is a minimally invasive option in treating prostate cancer, usually with little risk of surgical morbidity. This reports a case of signifi cant bleeding associated with the procedure of prostate brachytherapy. More >

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CASE REPORT

Alym Nizar Abdulla¹, Alan Arthur Covert², John E. Grantmyre³
Canadian Journal of Urology, Vol.16, No.3, pp. 4684-4686, 2009
Abstract Syringocystadenoma papilliferum (SCAP) is a benign rare adnexal skin neoplasm, which in a third of cases arises from an nevus sebaceus and is most commonly found on the head and neck and in very rare instances found on the genitalia. We report on a 59-year-old man with SCAP on the scrotum. The clinical scenario and histopathological findings are outlined. Following excision and histological confirmation of a noninfiltrative process, the patient remains asymptomatic. To our knowledge, only three other cases of such a lesion on the scrotum have been reported in the literature. More >

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CASE REPORT

Steven Weissbart, Justin Han, Ojas Shah
Canadian Journal of Urology, Vol.16, No.3, pp. 4687-4689, 2009
Abstract Renal artery pseudoaneurysms (RAPs) are vascular lesions that have most commonly been reported secondary to penetrating renal trauma and iatrogenic injury. We present the fi rst case of a RAP that developed as a result of an isolated deceleration injury. The patient presented 3 years after his injury with symptoms of gross hematuria, right fl ank pain, and syncope. Diagnosis of his RAP was made by magnetic resonance imaging (MRI) and angiography. He was successfully treated with angioembolization. More >

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RESIDENT’S CORNER

Michael C. Large, Hikmat Al-Ahmadie, Arieh L. Shalhav, Kevin C. Zorn
Canadian Journal of Urology, Vol.16, No.3, pp. 4690-4693, 2009
Abstract A 25-year-old female presented with worsening right fl ank pain and a 9 year history of a slow growing 4 centimeter calcifi ed renal mass. The lesion was resected by laparoscopic partial nephrectomy revealing a mixed epithelial and stromal tumor (MEST). This tumor has unusual features including the extensive amount of dystrophic calcifi cation and the young age at presentation. Herein, we present a focused review of the literature regarding MESTs, as well as a discussion of calcifi ed renal mass management. We conclude that laparoscopy may be utilized to safely perform nephron sparing surgery More >

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RESIDENT’S CORNER

Andrew E. Bourne¹, Stephen W. Bell², Robert O. Wayment¹, Bradley F. Schwartz¹
Canadian Journal of Urology, Vol.16, No.3, pp. 4694-4696, 2009
Abstract Adrenal “incidentalomas” are commonly found on body imaging, and treatment of these lesions 4 cm-6 cm in size is controversial. Most of these lesions are benign adrenal cortical adenomas. Lymphoma is a rare disease manifestation in the adrenal gland, and the overwhelming majority are metastatic lesions. Hodgkin lymphoma has never been reported as a primary adrenal lesion. We present a very unique case report of a 5 cm adrenal “incidentaloma” that represents the fi rst reported case of primary Hodgkin lymphoma in the adrenal gland. More >

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RESIDENT’S CORNER

Bruce L. Jacobs, Derek J. Matoka, Jodi K. Maranchie
Canadian Journal of Urology, Vol.16, No.3, pp. 4697-4700, 2009
Abstract We present the first report to our knowledge of progressive renal failure secondary to a retained intravesical foreign body. The urologic management of intravesical foreign bodies is challenging and is often complicated by a delay in presentation. Introduction into the bladder may be through a variety of means, including self insertion such as in this case. Extraction should be tailored according to the nature of the foreign body and should minimize bladder and urethral trauma. We report an unusual case of a 10 year delay in presentation after the insertion of two large intravesical foreign More >

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RESIDENT’S CORNER

Krishna Amuluru, Bradley A. Erickson, Onisura Okotie, Robert B. Nadler
Canadian Journal of Urology, Vol.16, No.3, pp. 4701-4703, 2009
Abstract We report a case of a patient who developed bilateral hydroureteronephrosis from papillary necrosis secondary to ingestion of commercial toilet bowl cleaner. Eight days after her ingestion, acute renal failure prompted a renal ultrasound that showed bilateral hydroureteronephrosis. Emergent bilateral percutaneous nephrostomy tubes were placed and subsequent ureteroscopy revealed a large amount of obstructing necrotic material consistent with papillary necrosis. Ureteroscopic removal of the material and bilateral ureteral stents improved renal function. The etiology of this patient’s papillary necrosis was likely due to a combination of hypovolemia, systemic acidosis from the ingestion, and direct toxicity More >

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CLINICAL TRIALS

Richard W. Casey¹, Jack Barkin²
Canadian Journal of Urology, Vol.16, No.3, pp. 4704-4705, 2009
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CLINICAL TRIALS

Mary J. Mackenzie, George Rodrigues, Eric Winquist
Canadian Journal of Urology, Vol.16, No.3, pp. 4706-4711, 2009
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