Open Access

EDITORIAL

Ching Y. Wang
Canadian Journal of Urology, Vol.16, No.4, pp. 4713-4713, 2009
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LEGENDS IN UROLOGY

A. Barry Belman
Canadian Journal of Urology, Vol.16, No.4, pp. 4714-4715, 2009
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ARTICLE

Paul Toren¹, Salima Ladak², Clement Ma^{3, Stuart McCluskey2, Neil Fleshner1
Canadian Journal of Urology, Vol.16, No.4, pp. 4716-4720, 2009
Abstract Objective: Postoperative analgesia is an important factor influencing surgical outcomes. We aimed to evaluate the role of patient controlled epidural analgesia (PCEA) versus intravenous (IV) patient controlled analgesia (PCA) in patients undergoing radical cystectomy.
Methods: We reviewed data from consecutive patients who had a radical cystectomy at our institution between 2003 and 2007 to evaluate the effect of either PCEA or IV PCA on the patients' postoperative pain--the primary outcome--as well as secondary outcomes including time to begin eating solid food, time to ambulation, and length of hospital stay. The patients received either hydromorphone or morphine via… More >}

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ARTICLE

Nasheer Sachedina, Rosely De Los Santos, Murugesan Manoharan, Mark S. Soloway
Canadian Journal of Urology, Vol.16, No.4, pp. 4721-4725, 2009
Abstract Objectives: Routine placement of a pelvic drain may be avoided after total prostatectomy, traditionally known as "radical retropubic prostatectomy", with lymph node dissection (TP/LND). From our experience with 846 patients, we contend that patient safety and efficacy is not compromised by selectively omitting a pelvic drain.
Materials and methods: TP/LND was performed in 846 patients with clinically localized prostate adenocarcinoma. Patient demographics, clinical and pathological data were recorded and relevant data was analyzed. After the prostate was removed and the anastomotic sutures tied, saline was instilled into the bladder through the urethral catheter. If there was no… More >

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ARTICLE

Amalia A. Vartanian, Eugenia V. Stepanova, Sergey L. Gutorov, Elico Sh. Solomko, Irina N. Grigorieva, Irina N. Sokolova, Anatoly Yu. Baryshnikov, Mikhail R. Lichinitser
Canadian Journal of Urology, Vol.16, No.4, pp. 4726-4732, 2009
Abstract Background: The ability of aggressive tumors to form nonendothelial tumor cell-lined microvascular channels is known as "vasculogenic mimicry" (VM). VM channels are revealed as periodic acid-Schiff (PAS)-positive patterns, and in some tumors their presence predicts clinical outcomes.
Objective: We aimed to study VM channels in clear cell renal cell carcinoma (cRCC) tumors and explore their prognostic significance and relationship to other suggested prognostic factors such as thymidine phosphorylase (TP) and vascular endothelial growth factor (VEGF) expression.
Methods: We retrospectively studied 45 patients who had undergone radical nephrectomy for clinically confined cRCC (stage T2-T3N0M0) at the Russian Cancer Research… More >

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ARTICLE

Katherine C. Hubert¹, Mandeep Singh^1,*, Esther H. Zhou², Grace Delos Santos¹, Mark D. Stovsky¹
Canadian Journal of Urology, Vol.16, No.4, pp. 4733-4735, 2009
Abstract Introduction/objective: We examined the potential correlation between Charlson comorbidity index (CCI) and stone free rate after extracorporeal shock wave lithotripsy (ESWL).
Materials and methods: Two hundred twenty-six adult patients were treated with 241 ESWL procedures for a renal or ureteral stone(s) over a 3 year period. Age, race, comorbidities, CCI, stone size and location, number of shocks and power level were determined. Treatment efficacies were evaluated at a mean of 56.1 days after each ESWL with computed tomography, abdominal x-ray, intravenous pyleography and/or renal ultrasound. Multivariate logistic regression analysis was performed.
Results: There was no correlation between CCI… More >

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MINIMALLY INVASIVE AND ROBOTIC SURGERY

Khurshid A. Guru^1,2, Abid Hussain², Rameela Chandrasekhar², Pamela Piacente², Marlene Bienko², Mark Glasgow⁴, Willie Underwood^1,2, Gregory Wilding³, James L. Mohler^1,2, Mani Menon⁵, James O. Peabody⁵
Canadian Journal of Urology, Vol.16, No.4, pp. 4736-4741, 2009
Abstract Purpose: The surgical robot is becoming an important tool for performance of minimally invasive surgical procedures around the world. We surveyed opinions about and utilization of robot-assisted surgery among urologic surgeons from 44 countries.
Material and methods: A total of 297 surveys were completed from September to November 2008 by participating urologic surgeons polled at various national and international urologic meetings. The survey evaluated surgeon background, personal experience with minimally invasive surgery, institutional status regarding robotic surgery surgeons' attitudes towards robot-assisted surgery, in general, and prostate, bladder and kidney oncologic procedures, specifically.
Results: Two hundred ninety-seven participants completed… More >

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EDITORIAL COMMENT

Michael Large, Kevin C. Zorn
Canadian Journal of Urology, Vol.16, No.4, pp. 4741-4741, 2009
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MINIMALLY INVASIVE AND ROBOTIC SURGERY

Kevin C. Zorn, Mark A. Wille, Alan E. Thong, Mark H. Katz, Sergey A. Shikanov, Aria Razmaria, Ofer N. Gofrit, Gregory P. Zagaja, Arieh L. Shalhav
Canadian Journal of Urology, Vol.16, No.4, pp. 4742-4749, 2009
Abstract Background: Several robot-assisted radical prostatectomy (RARP) series have reviewed the impact of the initial learning curve on perioperative outcomes. However, little is known about the impact of experience on urinary and sexual outcomes. Herein, we review the perioperative, pathological and functional outcomes of our initial 700 consecutive procedures with at least 1 year follow up.
Methods: From 2003-2006, 700 consecutive men underwent RARP at a single, academic institution. Perioperative data and pathologic outcomes were prospectively collected. Validated, UCLA-PCI-SF36v2 quality-of-life questionnaires were also obtained at 1, 3, 6 and 12 months following surgery. Outcomes between groups (cases 1-300,… More >

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EDITORIAL COMMENT

David Canes
Canadian Journal of Urology, Vol.16, No.4, pp. 4749-4749, 2009
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CASE REPORT

Danielle D. Sweeney, Matthew H. Hayn, Daniel Ricchiuti, Stephen V. Jackman
Canadian Journal of Urology, Vol.16, No.4, pp. 4750-4752, 2009
Abstract We present the fi rst reported complication of the Silhouette, (Applied Medical, Santa Margarita, CA) 4 Fr. soft, nitinol coil-reinforced double-J ureteral stent, that is specifi cally related to its unique construct and design. These novel ureteral stents were placed in a medically unstable patient with bilateral partially obstructing proximal ureteral calculi. At the time of ureteroscopy, it was noted that a mild to moderate amount of encrustation was present on the distal curl of the ureteral stent. Upon removal of the stent, resistance was encountered and disintegration and fragmentation of the stent was noted. More >

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EDITORIAL COMMENT

Jay D. Raman
Canadian Journal of Urology, Vol.16, No.4, pp. 4752-4752, 2009
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CASE REPORT

Dina El Demellawy¹, Ahmed Nasr², Salem Alowami³, Nicholas Escott¹
Canadian Journal of Urology, Vol.16, No.4, pp. 4753-4756, 2009
Abstract Urachal pathology is rare. The most frequently reported lesion is urachal adenocarcinoma. The pathogenesis of urachal adenocarcinoma is unknown. We report a case of a 55-year-old man who presented with microscopic hematuria. Clinical work up showed a tumor involving the urinary bladder with extravesical extension. Masses or tumors involving other organs were excluded. Partial cystectomy revealed a distended bladder wall with the formation of a cystically dilated mass fi lled with mucoid material. Microscopic examination showed enteric type adenocarcinoma with abundant mucin formation. The neoplastic urachal epithelium showed features of colonic differentiation as evidenced by More >

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CASE REPORT

J. C. Forde, R. G. Casey, R. Grainger
Canadian Journal of Urology, Vol.16, No.4, pp. 4757-4759, 2009
Abstract We report the case of a 57-year-old male who attended the emergency department after inserting a ballpoint pen into his urethra 24 hours earlier during a sexual encounter. Rigid cystoscopy was performed and confirmed the foreign body to have caused a partial rupture of the posterior urethra. It was subsequently removed using a combination of graspers and stone retrieval baskets. Self insertion of foreign bodies into the urethra is often as a result of psychiatric disturbance, alcohol intoxication or as a means of sexual gratification. Posterior urethral injuries are more commonly associated with pelvic trauma More >

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RESIDENT’S CORNER

Bilal Chughtai¹, David Samadi², Khurshid A. Guru³, Zelik Frischer⁴, Jamil Rehman⁴
Canadian Journal of Urology, Vol.16, No.4, pp. 4760-4761, 2009
Abstract We report a case of primary granulocytic sarcoma (GS) of the left adrenal gland, with no evidence of hematologic involvement. To our knowledge, this is the fi rst case of granulocytic sarcoma of the adrenal gland. More >

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RESIDENT’S CORNER

Susan E. Saunders, Jacob Matthew Conjeski, Stanley Zaslau, Jim Williams, Stanley J. Kandzari
Canadian Journal of Urology, Vol.16, No.4, pp. 4762-4764, 2009
Abstract A case of leiomyoma of the urinary bladder, a rare benign tumor, in a 56-year-old female fi rst seen with bilateral fl ank pain radiating to both groins, is reported. Examination showed a well developed female with obesity (260 pounds) and elevated blood pressure (132/90 mmHg). Evaluation with ultrasound, cystoscopy, urodynamics, and cytology contributed to the diagnosis of urinary bladder leiomyoma. Ultrasound detected a mass in the urinary bladder, and it was confi rmed by cystoscopy to be a 5 cm to 6 cm bladder mass on the anterior bladder wall. The mass was prolapsing More >

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RESIDENT’S CORNER

Louis-Olivier Gagnon¹, Yves Ponsot¹, Andrew Benko², Le Mai Tu¹
Canadian Journal of Urology, Vol.16, No.4, pp. 4765-4769, 2009
Abstract Introduction: Nutcracker syndrome (NCS) is a rare condition characterized by the entrapment of the left renal vein (LRV) between the superior mesenteric artery (SMA) and the aorta. It was first described in 1950 and the term nutcracker was attributed by de Schepper in 1972.
Clinical case: A 20-year-old female patient was admitted to the urology department with a history of hematuria and left flank pain. Basic hematuria investigation was inconclusive. Further investigation revealed a nutcracker syndrome on retrograde phlebography. Surveillance was the option first chosen. Three years later and after several symptomatic episodes, an intravascular stenting procedure… More >

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EDITORIAL COMMENT

Stanley Zaslau
Canadian Journal of Urology, Vol.16, No.4, pp. 4769-4769, 2009
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RESIDENT’S CORNER

Matthew H. Hayn, Timothy D. Averch, Stephen V. Jackman
Canadian Journal of Urology, Vol.16, No.4, pp. 4770-4773, 2009
Abstract Introduction: Surgical stress in patients with liver disease is associated with hepatorenal syndrome, coagulopathy, encephalopathy, sepsis, ARDS, and abnormalities of volume and electrolytes. These risks as well as the surgical difficulties associated with portal hypertension, varices, ascites, and thrombocytopenia limit the treatment options available to cirrhotic patients with renal masses. The decreased stress of laparoscopy may benefit patients with significant liver disease.
Methods: We performed a retrospective chart review of three patients with cirrhosis and renal masses who underwent laparoscopic renal surgery.
Results: The mean patient age was 56 years old. Two patients had Child-Pugh class B cirrhosis… More >

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ABSTRACT

Canadian Journal of Urology, Vol.16, No.4, pp. 4774-4792, 2009
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CLINICAL TRIALS

Richard W. Casey¹, Jack Barkin²
Canadian Journal of Urology, Vol.16, No.4, pp. 4793-4794, 2009
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CLINICAL TRIALS

George Rodrigues, Eric Winquist, Mary J. Mackenzie
Canadian Journal of Urology, Vol.16, No.4, pp. 4795-4800, 2009
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