Open Access

EDITORIAL

Leonard G. Gomella
Canadian Journal of Urology, Vol.17, No.2, pp. 5057-5057, 2010
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LEGENDS IN UROLOGY

Emil A. Tanagho
Canadian Journal of Urology, Vol.17, No.2, pp. 5058-5062, 2010
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REVIEW

Peter J. Pommerville¹, Johan G. de Boer²
Canadian Journal of Urology, Vol.17, No.2, pp. 5063-5070, 2010
Abstract Analogues of the gonadotropin releasing hormone (GnRH) inhibit the hypothalamic-pituitary-gonadal axis. This has provided treatment modalities for advanced and metastatic prostate cancer. The latest group of analogues, the GnRH antagonists, make promising treatments available that avoid the transient surge in testosterone that occurs with the use of GnRH agonists. Such surges may stimulate tumor growth, causing patients to experience new or worsening cancer symptoms and potential serious adverse effects, including increased bone pain, urinary retention, and spinal cord compression and consequently delay the therapeutic benefi ts of agonist therapy. Degarelix, an antagonist, recently approved in More >

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ARTICLE

Simon Brewster¹, Levent Türkeri², Maurizio Brausi³, Vincent Ravery⁴, Bob Djavan⁵
Canadian Journal of Urology, Vol.17, No.2, pp. 5071-5076, 2010
Abstract Background: Needle biopsy of the prostate is a common outpatient procedure. In March 2009, the European Association of Urology (EAU) published an updated, evidence-based "Guidelines on Prostate Cancer," including recommendations for this procedure.
Objective: To survey onco-urology specialists attending the 6th European Section of Oncological Urology (ESOU) meeting in Istanbul, Turkey in January 2009, to assess their biopsy practices and compare them with March 2009 EAU guidelines.
Design, setting and participants: The authors designed a questionnaire and distributed it to 606 conference delegates. It was completed by 298 delegates, of whom 156 were experienced onco-urological specialists.
Measurements: The survey… More >

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ARTICLE

Abhishek Karnwal¹, Rose Venegas², Brian Shuch^1,3, Jeffrey Bassett^1,3, Jacob Rajfer^1,3, Richard Reznichek^1,3
Canadian Journal of Urology, Vol.17, No.2, pp. 5077-5081, 2010
Abstract Objective: To compare the sensitivity and specificity of UroVysion fluorescence in situ hybridization assay (FISH) with cystoscopy and urine cytology in the surveillance of patients with documented non-muscle invasive bladder cancer (CIS, pTa and pT1).
Methods: This retrospective study was done on a consecutive series of patients undergoing surveillance for non-muscle invasive bladder cancer. The results of FISH were analyzed with concurrent cystoscopy and urine cytology.
Results: In all, 94 follow up visits from 59 patients were evaluated. The mean follow up was 52 months. FISH detected 30/48 recurrences of bladder cancer, as compared to 20/48 for cytology… More >

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ARTICLE

Abhishek Karnwal¹, Rose Venegas², Brian Shuch^1,3, Jeffrey Bassett^1,3, Jacob Rajfer^1,3, Richard Reznichek^1,3
Canadian Journal of Urology, Vol.17, No.2, pp. 5082-5086, 2010
Abstract Objective: Lower pole percutaneous nephrostomy is performed frequently for percutaneous nephrolithotomy (PCNL), using a variety of imaging modalities such as fluoroscopic, computed tomography (CT) or ultrasound guidance. This study was performed to estimate the potential risk of colonic injury during lower pole percutaneous nephrostomy for PCNL.
Methods: We observed the position of the colon relative to the kidney in 134 patients who underwent CT kidney, ureter, bladder (KUB) examinations in the prone position.
Results: We found the prevalence of colon lying posterior to the kidney (i.e. retrorenal) in males to be 13.6% on the right, and 11.9% on More >

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MINIMALLY INVASIVE AND ROBOTIC SURGERY

Eugene K. Lee, Janet Baack, David A. Duchene
Canadian Journal of Urology, Vol.17, No.2, pp. 5084-5098, 2010
Abstract Purpose: The robotic assisted radical prostatectomy (RARP) has become the most common operative choice for localized prostate cancer. At our institution, we have also seen a substantial increase in the proportion of RARP. Possible patient factors may include marketing, increased Internet usage by patients, and patient-to-patient communication. We surveyed urologists from the central United States to determine possible surgeon factors for the popularity of the RARP.
Materials and methods: We mailed a survey to all urologists in the South Central Section of the American Urological Association. After demographic information was obtained, participants were asked to choose an… More >

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ARTICLE

Mark Oremus¹, Jean-Eric Tarride²
Canadian Journal of Urology, Vol.17, No.2, pp. 5087-5093, 2010
Abstract Objective: To use data from a randomized controlled trial and update an earlier economic evaluation of surgery versus collagen injection for the treatment of female stress urinary incontinence (SUI).
Materials and methods: A decision tree model was developed using probabilities of success and complications from a randomized controlled trial. Resource use and cost data were taken from the earlier economic evaluation. The primary outcome was treatment success, which was defined as a negative 24 hour PAD test given 1 year post-treatment. The evaluation was conducted from the 'healthcare system' perspective and separate analyses were undertaken for Ontario… More >

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MINIMALLY INVASIVE AND ROBOTIC SURGERY

Iqbal Singh¹, Ashok K. Hemal²
Canadian Journal of Urology, Vol.17, No.2, pp. 5099-5108, 2010
Abstract Aim: To review the global select data on the current technique, perioperative outcome and literature on the robot-assisted pyeloplasty (RAP).
Methods: The published English literature (PubMed) was extensively searched using the key words; robot, robot-assisted pyeloplasty, laparoscopy, laparoscopic pyeloplasty and ureteropelvic junction obstruction. The selected studies were then reviewed, tracked and analyzed in order to determine the current role, outcome and status of robot-assisted laparoscopic pyeloplasty.
Results: The search yielded about 25 published series on RAP comprising about 740 cases with a mean operative time, estimated blood loss, crossing vessel prevalence, hospital stay, perioperative complication rate and follow More >

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MINIMALLY INVASIVE AND ROBOTIC SURGERY

Satya Allaparthi, Robert D. Blute, Jr.
Canadian Journal of Urology, Vol.17, No.2, pp. 5109-5113, 2010
Abstract Seminal vesicle cysts combined with ipsilateral renal agenesis, ectopic ureter and giant right ampullary cyst of vas deferens represent a rare urological anomaly, Zinner's syndrome. In symptomatic patients, seminal vesiculectomy along with en bloc excision of the ipsilateral ampullary cyst, ectopic ureter and dysplastic renal tissue is the preferred treatment option. We report robotic assisted removal of a large seminal vesicle cyst with ipsilateral renal agenesis, ectopic ureter and a giant right ampullary cyst of vas deferens in a 34-year-old male. We reviewed the literature about this rare urological anomaly and novel usage of da More >

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HOW I DO IT

Mohamed H. Kamel¹, Nabil K. Bissada¹, Nizar Bou Diab¹, Anthony T. Kaczmarek²
Canadian Journal of Urology, Vol.17, No.2, pp. 5114-5116, 2010
Abstract Objectives: Radical perineal prostatectomy (RPP) has an important place as a management option for prostate cancer. Herein we describe an adaptation that we found to significantly help the exposure during this procedure.
Methods: After opening the urethra, the long Lowsley tractor is changed to the short tractor. Caudal traction facilitates the dissection up to the bladder neck, which is opened. Classically, at this point an umbilical tape or Penrose drain substitutes the short tractor. Because of the limitation in the amount of traction that can be applied without fracturing through the tissue, we have utilized traction sutures More >

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CASE REPORT

Michael S. Ingber, Farzeen Firoozi, Howard B. Goldman, Courtenay K. Moore, Sandip P. Vasavada, Raymond R. Rackley
Canadian Journal of Urology, Vol.17, No.2, pp. 5117-5119, 2010
Abstract Introduction: Peritoneovaginal fistula is an extremely rare cause of persistent vaginal leakage following a hysterectomy. Likewise, fallopian tube prolapse is an uncommon but known complication of hysterectomy. Fallopian tube prolapse resulting in peritoneal leakage has yet to be reported in the literature.
Clinical case: A 27-year-old female presented with a two year history of continuous leakage per vagina. The leakage started shortly after an abdominal hysterectomy. Examination noted clear fluid emanating from a vaginal lesion located at the level of the vaginal cuff. An extensive workup ruled out vesicovaginal and ureterovaginal fistula. Surgical exploration noted that the More >

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CASE REPORT

Ben Tran, Joe McKendrick
Canadian Journal of Urology, Vol.17, No.2, pp. 5120-5123, 2010
Abstract Metastatic urachal cancer is a rare disease and subsequently, does not have a defi ned systemic treatment. Although urachal cancer is most commonly adenocarcinoma and histologically similar to colon cancer, treatment selection is usually based upon location (the proximity of the urachus to the bladder) with bladder cancer regimens the most commonly prescribed. We report a case of metastatic urachal cancer where the immunohistochemical profi le’s similarities to colon cancer led to treatment with colon cancer specifi c chemotherapy. Our case is the fi rst to report urachal cancer treated with and responding to modifi More >

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CASE REPORT

Chukwudi O. Okorie¹, Louis L. Pisters²
Canadian Journal of Urology, Vol.17, No.2, pp. 5124-5126, 2010
Abstract Complex vesicovaginal fistula (VVF) can result in severe destruction of urinary and anal sphincters. We present two cases of patients who underwent retubularized ileal stoma (Monti reconstruction) applied to an augmented bladder for continent urinary diversion. This reconstruction provides another option for a diversion technique in patients with irreparable urethra and bladder damage and a severely damaged anal sphincter. To the best of our knowledge, there have been no published studies of Monti reconstruction in patients with complex VVF. More >

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RESIDENT’S CORNER

Carlos H. F. Chan, Assaad El-Hakim, Sero Andonian
Canadian Journal of Urology, Vol.17, No.2, pp. 5127-5130, 2010
Abstract Introduction: Matrix stones are rare types of urinary calculi composed of mucoproteins and mucopolysaccharides. Since isolated flank pain may be the only presenting symptom and routine radiographic studies are usually non-informative, diagnosis of such urinary calculi represents a clinical challenge. Traditionally, these matrix stones have been managed by either open pyelolithotomy or percutaneous nephrolithotomy (PCNL). Ureteroscopic management of a patient with matrix renal stones and review of literature is presented.
Case report: A 34-year-old woman presented with chronic right flank pain. Abdominal ultrasound found a 5.3 cm heterogeneous right renal pelvic mass with 9.7 mm stone. CT… More >

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RESIDENT’S CORNER

Bert S. Ivey, Karthik Devarajan, Chandru P. Sundaram
Canadian Journal of Urology, Vol.17, No.2, pp. 5131-5134, 2010
Abstract Introduction: Renal oncocytoma represents a diagnostic challenge to urologists. We present three patients with bilateral renal oncocytomas.
Cases: All three patients presented with bilateral renal masses and through surgical means, were diagnosed with oncocytoma. Renal biopsies were used to diagnose oncocytoma in the contralateral kidney.
Discussion: Considering oncocytoma represents up to 16% of renal masses, there is overtreatment of benign disease due the difficulty in distinguishing between histologies on radiographs. Even when the diagnosis of oncocytoma is made, concurrent renal cell carcinoma can be found in a small subset of patients. The value of renal biopsy in these… More >

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RESIDENT’S CORNER

William H. Carlson, David G. Bell, Joseph G. Lawen, Ricardo A. Rendon
Canadian Journal of Urology, Vol.17, No.2, pp. 5135-5137, 2010
Abstract Three male physicians underwent transrectal ultrasound guided prostate biopsies for elevated prostate-specific antigen levels or irregular digital rectal exam fi ndings. All three of these patients developed urosepsis secondary to multi-drug resistant organisms despite antibiotic prophylaxis. There are increasing reports of infectious complications following prostate biopsy caused by multi-drug resistant organisms. These cases highlight the potentially lethal risks to healthcare workers who are more likely to harbor multi-drug resistant organisms than the general population. Further research into preoperative assessment and appropriate antibiotic prophylaxis in all potentially high risk patients is warranted. More >

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CLINICAL TRIALS

Richard W. Casey¹, Jack Barkin²
Canadian Journal of Urology, Vol.17, No.2, pp. 5138-5140, 2010
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CLINICAL TRIALS

Eric Winquist, George Rodrigues, Mary J. Mackenzie
Canadian Journal of Urology, Vol.17, No.2, pp. 5141-5147, 2010
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