Open Access

EDITORIAL

Gabriel P. Haas
Canadian Journal of Urology, Vol.16, No.6, pp. 4882-4882, 2009
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LEGENDS IN UROLOGY

Richard Turner-Warwick
Canadian Journal of Urology, Vol.16, No.6, pp. 4883-4886, 2009
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REVIEW

Anthony J. Polcari, Cory M. Hugen, Thomas M. Turk
Canadian Journal of Urology, Vol.16, No.6, pp. 4887-4894, 2009
Abstract While radical nephroureterectomy remains the gold standard of treatment for patients with upper tract urothelial tumors, technological advances have made endoscopic management possible. The careful selection of patients for such an approach is dependent upon an accurate diagnosis and an understanding of the natural history of the disease. High grade tumors behave aggressively and warrant radical extirpation unless an absolute contraindication exists. Motivated patients with low grade tumors and relative contraindications to nephroureterectomy can be managed with percutaneous or retrograde ureteroscopic techniques. High recurrence rates in the ipsilateral upper tract and bladder mandate close surveillance More >

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ARTICLE

Sameer M. Malhotra, Robert V. Rouse, Raymond Azzi, Jeffrey Reese
Canadian Journal of Urology, Vol.16, No.6, pp. 4895-4900, 2009
Abstract Objective: In patients with penile squamous cell carcinomas (SCCs), lymphadenectomy can be curative and should be considered in cases deemed high risk for metastatic spread to regional lymph nodes. Management of patients without palpable lymphadenopathy remains controversial. Current guidelines for T1 penile SCCs based on previous studies have suggested that moderately differentiated tumors are at low risk for metastatic disease; however given our experience with such patients we sought to examine whether such tumors were truly observable or should be treated more aggressively.
Materials and methods: A retrospective chart review of penile cancer cases at three institutions… More >

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EDITORIAL COMMENT

Curtis A. Pettaway
Canadian Journal of Urology, Vol.16, No.6, pp. 4899-4899, 2009
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LETTER

Sameer M. Malhotra, Robert V. Rouse, Raymond Azzi, Jeffrey Reese
Canadian Journal of Urology, Vol.16, No.6, pp. 4900-4900, 2009
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ARTICLE

Jana Jass¹, Gregor Reid²
Canadian Journal of Urology, Vol.16, No.6, pp. 4901-4907, 2009
Abstract Introduction/objective: Cranberries have been shown to produce urinary metabolites that influence uropathogen adhesion and prevent urinary tract infections. This study was designed to determine if consuming reconstituted, unsweetened cranberry drink from extract retained its bioactive properties by reducing uropathogen adhesion without adversely affecting urinary calcium, magnesium and the vaginal microflora.
Materials and methods: A randomized crossover study was undertaken in 12 healthy women consuming reconstituted unsweetened cranberry drink, CranActin or water. The urine was collected at 4 hours and 1 week of consumption and evaluated for antiadhesive properties and urinary pH, calcium and magnesium. Vaginal swabs were… More >

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ARTICLE

Yiu-Keung Lau^1,2, C. Ellen Lee³, Heather J. Prior⁴, Lisa M. Lix⁵, Colleen J. Metge⁶, William D. Leslie⁷
Canadian Journal of Urology, Vol.16, No.6, pp. 4908-4914, 2009
Abstract Introduction: Prostate cancer is the most common noncutaneous malignancy diagnosed in men. The use of androgen deprivation therapy (ADT) is the mainstay of treatment for metastatic disease. The use of ADT has been reported to increase the risk of osteoporosis in men with prostate cancer, with higher risk of fracture than age matched controls. We sought to confirm the higher fracture risk of men with prostate cancer on ADT in the Canadian population.
Methods: We used the Population Health Research Data Repository housed at Manitoba Centre for Health Policy to identify all cases of fractures of the… More >

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ARTICLE

Jeffery C. Wheat, William W. Roberts, J. Stuart Wolf Jr
Canadian Journal of Urology, Vol.16, No.6, pp. 4915-4920, 2009
Abstract Objectives: To establish the safety and efficacy of planned multi-session retrograde endoscopic lithotripsy (REL) for the treatment of large renal calculi in the morbidly obese.
Methods: We retrospectively reviewed charts of patients who underwent multi-session REL procedures from 2003 to 2008. Inclusion criteria included body mass index > 35, total linear stone diameter > 2.0 cm, and patients with a preoperative plan to perform multi-session ureteroscopy. A total of nine patients (six with staghorn calculi) underwent 21 separate procedures. Stone size was measured on preoperative imaging and was defined as length in greatest diameter. Stone free was… More >

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EDITORIAL COMMENT

Vernon M Pais Jr
Canadian Journal of Urology, Vol.16, No.6, pp. 4920-4920, 2009
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ARTICLE

Behrooz Azizi^1,2, Thomas Whelan^2,3, Michael Morse^2,3
Canadian Journal of Urology, Vol.16, No.6, pp. 4921-4923, 2009
Abstract Purpose: To determine the incidence of malignancy in resected renal tumors in a subpopulation of Canadian patients and the significance of tumor size, patient's demographics, and whether the tumor was an incidental finding.
Methods: Medical records of 168 consecutive nephrectomies performed between March 2003 and June 2008 at our institution were reviewed retrospectively.
Results: Average age of the patients was 61 years old (SD 11, range 28-89) and male to female ratio was 1.3:1. Total of 180 masses were resected in 168 nephrectomies (128 radical, 40 partial) during the study period. Of the 180 masses, 20 (11%) were… More >

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ARTICLE

Jeffrey S. Palmer
Canadian Journal of Urology, Vol.16, No.6, pp. 4924-4926, 2009
Abstract Purpose: Ungated extracorporeal shock wave lithotripsy (SWL) is unsynchronized to the patient's electrocardiogram. Although ungated extracorporeal shock wave lithotripsy (SWL) is associated with cardiac arrhythmias in adults, the incidence of arrhythmias in children has not been established. We report on the safety and efficacy of ungated SWL of renal calculi in children.
Materials and methods: We evaluated all children less than 18 years of age undergoing ungated SWL for renal calculi. Lithotripsy with gradual incremental energy increase was used to treat the stones. Patients were monitored for arrhythmias and other standard monitoring intraoperatively and postoperatively.
Results: Twenty-four consecutive… More >

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ARTICLE

Jennifer M. Pugliese, Richard N. Greene, Andrew C. Peterson
Canadian Journal of Urology, Vol.16, No.6, pp. 4927-4931, 2009
Abstract Purpose: We examined patterns of intravesical therapy use in nonmuscle invasive bladder cancer over the last 10 years at our institution where there is equal access to healthcare. We further examined any affect that the introduction of national guidelines may have had on the utilization of intravesical therapy in these patients.
Materials and methods: An Institutional Review Board (IRB) approved retrospective chart review was performed between the years 1997 and 2007. Only those with premalignant or malignant pathology, as identified using intradepartmental surgical logs and pathology reports, were included.
Results: Four hundred seventeen procedures, representing 228 patients, were… More >

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MINIMALLY INVASIVE AND ROBOTIC SURGERY

Kyle A. Richards, Iqbal Singh, Ashok K. Hemal
Canadian Journal of Urology, Vol.16, No.6, pp. 4932-4935, 2009
Abstract Ureteropelvic junction obstruction is a fairly common diagnosis in urology. With the emergence of robotic surgery in urology, complex ureteral reconstruction of the proximal, mid, and distal ureter is being undertaken with robotic assistance with excellent results. We present the case of a 61-year-old male who presented with an atypical partial ureteropelvic junction obstruction. The etiology was suspected to be from external compression of the proximal ureter by a calcifi ed periureteral mass. The mass was theorized to be secondary to occult ureteral perforation and extraluminal migration of a renal calculus during repeat percutaneous nephrolithotomy More >

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MINIMALLY INVASIVE AND ROBOTIC SURGERY

David S. Bargnesi¹, Ronney Abaza², Steven H. Selman¹
Canadian Journal of Urology, Vol.16, No.6, pp. 4936-4938, 2009
Abstract Fibroepthelial polyps are uniformly benign tumors of the collecting system which may cause obstruction of an affected renal unit. We present a unique case of a 34-yearold male with a solitary functioning kidney who presented with fl ank pain and renal insuffi ciency. Radiographic and ureteroscopic evaluation revealed ureteral obstruction due to extensive polyps. After ureteral stenting and normalization of renal function, successful polyp excisions were performed laparoscopically through a ureterotomy. The pathology revealed benign fi broepithelial polyps. The patient remained asymptomatic until 3 years later when ureteroscopy performed for a calculus revealed a widely More >

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MINIMALLY INVASIVE AND ROBOTIC SURGERY

Simon D. Wu, Ricardo R. Rios, Joshua J. Meeks, Robert B. Nadler
Canadian Journal of Urology, Vol.16, No.6, pp. 4939-4940, 2009
Abstract Introduction: Weck Hem-o-Lok clip migration into the bladder has been reported after robot-assisted laparoscopic radical prostatectomy (RALP). We report a case of Weck clip migration into the rectum presenting as a mass on colonoscopy.
Methods: A 61-year-old male with a prostate specific antigen level of 4.84 ng/ml underwent transrectal ultrasound guided biopsy of the prostate revealing a Gleason's 3 + 3 adenocarcinoma of the prostate involving 20% of the sampled tissue for the left apex. He was subsequently treated with a transperitoneal robot-assisted laparoscopic radical prostatectomy and bilateral pelvic lymphadenectomy. Weck Hem-o-Lok clips were used to ligate… More >

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CASE REPORT

O. A. Raheem¹, R. G. Casey¹, C. Attah¹, L. Clarke², A. McGrath³, E. Gaffney², D. Hollywood⁴, T. E. D. McDermott¹, T. H. Lynch¹
Canadian Journal of Urology, Vol.16, No.6, pp. 4941-4945, 2009
Abstract Squamous cell carcinoma of the prostate gland is very rare, constituting 0.5%-1% of all prostatic malignancies. Though it has a similar clinical presentation to prostate cancer, the tumor is more aggressive, spreading to bone, liver and lung. The median survival time is approximately 14 months. Diagnosis is exclusively by histology. Therapeutic options may include radical surgery, radiotherapy, chemotherapy, hormonal therapy or a combination of these treatments. We present a case of locally advanced squamous cell carcinoma of the prostate and comment on its management and subsequent disease related complication. More >

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CASE REPORT

Brandan A. Kramer¹, James G. Minnis², Bradley F. Schwartz¹
Canadian Journal of Urology, Vol.16, No.6, pp. 4946-4947, 2009
Abstract We present the case of a 76-year-old man with a large bladder diverticulum presenting as an inguinal hernia with small bowel incarceration. Bladder herniation is extremely rare and when clinically suspected, computed tomography can be an important adjunct to diagnosis. More >

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CASE REPORT

Brooke Edwards¹, Sarah Goodrich¹, Chandru P. Sundaram²
Canadian Journal of Urology, Vol.16, No.6, pp. 4948-4949, 2009
Abstract Schwannomas, a soft-tissue tumor of a Schwann cell, involving the kidney are rare, with few cases available in the literature. Herein, we report a case of a rare variant, an ancient schwannoma of the renal hilum. More >

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RESIDENT’S CORNER

Andrew G. Winer, Elias S. Hyams, Ojas Shah
Canadian Journal of Urology, Vol.16, No.6, pp. 4950-4952, 2009
Abstract Direct small bowel injury is an exceedingly rare complication of percutaneous nephrostomy tube placement. In this report, we present a case of inadvertent injury to the small bowel during percutaneous nephrostomy tube placement with subsequent development of small bowel obstruction. We reviewed the literature to determine the risk factors and appropriate management of small bowel injuries as a result of such a procedure. More >

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RESIDENT’S CORNER

Lei Chu, Timothy D. Averch, Stephen V. Jackman
Canadian Journal of Urology, Vol.16, No.6, pp. 4953-4954, 2009
Abstract Background: Testicular atrophy and necrosis as a result of ischemic orchitis is a well-established complication after inguinal hernia repair. We reviewed four patients with a recent history of inguinal hernia repair and subsequently developed ischemic orchitis to evaluate management options to provide symptomatic relief and prevent testicular atrophy.
Case series: The first patient underwent loosening of inguinal hernia mesh for scrotal pain and decreased arterial testicular flow 8 hours after inguinal hernia repair. The second patient developed ischemic orchitis 20 hours after inguinal herniorrphaphy and required removal of mesh. Neither patient had testicular atrophy at their follow More >

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RESIDENT’S CORNER

Adam Luchey, Aimee Rogers, Susan E. Saunders, H. James Williams, Henry J. Fooks, Stanley Zaslau
Canadian Journal of Urology, Vol.16, No.6, pp. 4955-4957, 2009
Abstract It is extremely rare that a documented case of blunt trauma results in rupture of a testicular tumor. We present the case of a 24-year-old man who was crushed by a tree who developed spontaneous testicular rupture. At surgical exploration, he was found to ultimately have a mixed germ cell tumor of the testicle. This case illustrates the importance of physical examination, patient clinical history, and scrotal ultrasound in the management of scrotal trauma. In this instance, the testicular mass ruptured and lead to signifi cant testicular hemorrhage. More >

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RESIDENT’S CORNER

Anthony T. Corcoran¹, Matthew H. Hayn¹, Debra L. Zynger², P. Dafe Ogagan³, Forozan Navid³, Benjamin D. Davies¹
Canadian Journal of Urology, Vol.16, No.6, pp. 4958-4961, 2009
Abstract Renal cell carcinoma with inferior vena cava (IVC) tumor thrombus is a well described clinical entity. We report a case of 64-year-old man that developed an aggressive renal pelvic squamous cell carcinoma (SCC) with extensive IVC and bilateral iliac vein tumor thrombus. To our knowledge this is the fi fth reported case of renal pelvic SCC with IVC tumor thrombus and the fi rst involving the iliac veins. We review the current therapeutic options for treatment of SCC with IVC involvement. More >

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CLINICAL TRIALS

Richard W. Casey¹, Jack Barkin²
Canadian Journal of Urology, Vol.16, No.6, pp. 4962-4963, 2009
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CLINICAL TRIALS

George Rodrigues, Mary J. Mackenzie, Eric Winquist
Canadian Journal of Urology, Vol.16, No.6, pp. 4964-4970, 2009
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