Open Access

EDITORIAL

Leonard G. Gomella
Canadian Journal of Urology, Vol.17, No.3, pp. 5148-5148, 2010
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LEGENDS IN UROLOGY

Brendan M. Fox
Canadian Journal of Urology, Vol.17, No.3, pp. 5149-5150, 2010
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REVIEW

Daniel P. Casella, Marc C. Smaldone, Timothy D. Averch
Canadian Journal of Urology, Vol.17, No.3, pp. 5151-5161, 2010
Abstract Natural orifi ce transluminal endoscopic surgery (NOTES) has attracted considerable recent attention for its potential to allow traditional abdominal procedures to be performed without a transabdominal incision. With considerable experience in the development and application of minimally invasive techniques, urologists have played a signifi cant role in early experimental NOTES efforts and have contributed to early investigations in human subjects accordingly. However, adoption of these techniques has been limited due to cumbersome endoscopic equipment and concerns regarding peritonitis from failed viscerotomy closure. Experience with use of NOTES in human subjects is limited, and studies comparing More >

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ARTICLE

Jennifer A. Locke, Nicholas Bruchovsky
Canadian Journal of Urology, Vol.17, No.3, pp. 5162-5169, 2010
Abstract Objectives: Finasteride has been shown to prolong the time off-treatment in men with prostate cancer during intermittent androgen suppression therapy, but it is not clear whether this results from an increase in prostate-specific antigen (PSA) doubling time or a delay in PSA responsiveness to regained testicular function. In the following study, we distinguish between these two possibilities and consider how the effectiveness of finasteride might be altered if androgens are synthesized within the malignant cell rather than the testis.
Subjects and methods: Six patients were followed on intermittent androgen suppression for intervals ranging from 7 to 10… More >

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EDITORIAL COMMENT

Levent Türkeri
Canadian Journal of Urology, Vol.17, No.3, pp. 5169-5169, 2010
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ARTICLE

Richard Casey¹, Zsuzsanna Gesztesi¹, Joseph Rochford²
Canadian Journal of Urology, Vol.17, No.3, pp. 5170-5177, 2010
Abstract Objectives: To evaluate the effect of zoledronic acid on androgen deprivation therapy in patients with hormone-sensitive prostate cancer by measuring the percentage change in lumbar-spine bone mineral density (BMD) at 12 and 24 months.
Materials and methods: An open-label, multicenter, randomized, two-phase study was conducted in patients with hormone-sensitive prostate cancer (N = 200) receiving 10.8 mg goserelin acetate with or without zoledronic acid (4 mg intravenously) every 3 months. In phase I, patients were randomized to goserelin acetate alone or goserelin acetate plus zoledronic acid for 12 months. In phase II, patients receiving goserelin acetate plus… More >

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ARTICLE

Taha A. Abdel-Meguid^1,2, Abdulmalik Tayib¹, Ahmad Al-Sayyad¹
Canadian Journal of Urology, Vol.17, No.3, pp. 5178-5183, 2010
Abstract Purpose: To evaluate efficacy and outcome of tamsulosin therapy for 4 mm-10 mm uncomplicated distal ureteral stones.
Materials and methods: A total of 150 patients (adults with newly diagnosed single unilateral distal ureteral 4 mm-10 mm stones) were double blindly randomized into GA or GB. All patients received traditional treatment of hydration and analgesia as needed. Additionally, patients received either placebo (GA) or 0.4 mg tamsulosin (GB) oral tablets once daily. Treatment and follow up were continued for up to 4 weeks. Endpoints were spontaneous stone passage rates (SPR) and passage time for different stone sizes within… More >

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ARTICLE

M. Adam Childs¹, Christopher G. Wood¹, Philippe E. Spiess¹, Labib G. Debiane¹, Mike Hernandez², Surena F. Matin¹, Randall E. Millikan³, Arlene Siefker-Radtkie³, Shellie M. Scott¹, Louis L. Pisters
Canadian Journal of Urology, Vol.17, No.3, pp. 5184-5189, 2010
Abstract Purpose: Retroperitoneal lymph nodes are a recognized site of relapse in patients undergoing nephroureterectomy (NU) for high grade upper tract urothelial carcinoma (UC). Retrospective studies suggest that retroperitoneal lymph node dissection (RPLND) may be curative at the time of NU for high grade upper tract UC. We hypothesized that chemotherapy followed by RPLND may successfully salvage select patients with isolated retroperitoneal relapse of upper tract UC following prior NU.
Materials and methods: We identified four patients with metastatic UC isolated to the subdiaphragmatic retroperitoneal lymph nodes after NU for upper tract UC. These patients had either a… More >

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ARTICLE

Brian T. Helfand, Ankur M. Manvar, Gregory B. Auffenberg, Robert Blackwell, Robert J. Hartman, Kevin T. McVary
Canadian Journal of Urology, Vol.17, No.3, pp. 5190-5194, 2010
Abstract Objectives: To report the initial clinical experience using a hybrid technique combining holmium laser ablation of the prostate (HoLAP) and holmium laser enucleation of the prostate (HoLEP) for the treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH).
Methods: A total of 18 patients with documented moderate to severe LUTS underwent the hybrid technique. Baseline characteristics were documented for all patients. Operative and resection times, as well as intra and perioperative complications, were recorded. Additionally, changes in American Urological Association symptom index (AUA-SI) and quality of life (QoL) scores and serum prostate-specific antigen… More >

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ARTICLE

Sharon E. Straus¹, Jayna Holroyd-Leduc², Michael Scott Orr³
Canadian Journal of Urology, Vol.17, No.3, pp. 5195-5199, 2010
Abstract Objective: To investigate whether there is any significant difference between the electronic and the paper-based version of Urogenital Distress Inventory-6 questionnaire (UDI-6) and the Incontinence Impact Questionnaire-7 questionnaire (IIQ-7).
Materials and methods: An electronic questionnaire and clinical tool was developed using a combination of open source questionnaire software and custom programming that closely replicated the paper version of the UDI-6 and IIQ-7 questionnaires. Ethics were reviewed and approved by the University Health Network of Toronto. The study randomized participants from the Urinary Incontinence Clinic to either complete the paper-and-pen version of the questionnaires or the electronic version… More >

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MINIMALLY INVASIVE AND ROBOTIC SURGERY

Daniel J. Lee, Philippa Cheetham, Ketan K. Badani
Canadian Journal of Urology, Vol.17, No.3, pp. 5200-5206, 2010
Abstract Objective: We sought to identify predictors of early urinary continence after robot-assisted prostatectomy (RARP) in men who underwent a posterior rhabdosphincter reconstruction.
Materials and methods: A prospective analysis was performed in 107 consecutive men who underwent RARP by a single surgeon in an academic center. Men were excluded if they received adjuvant radiation therapy (7 men), were lost to follow up (4), or did not have a posterior rhabdosphincter reconstruction (8 men). Eighty-eight men received a posterior rhabdosphincter reconstruction and were followed in this study. Patient demographic and postoperative urinary control was recorded at interval follow up… More >

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EDITORIAL COMMENT

Kevin C. Zorn
Canadian Journal of Urology, Vol.17, No.3, pp. 5205-5205, 2010
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MINIMALLY INVASIVE AND ROBOTIC SURGERY

Jessica M. DeLong¹, Oleg Shapiro², Alireza Moinzadeh¹
Canadian Journal of Urology, Vol.17, No.3, pp. 5207-5212, 2010
Abstract Introduction/objective: Partial nephrectomy is an effective surgical treatment for small renal masses. We compare a single surgeon’s experience with consecutive laparoscopic and robotic partial nephrectomy to assess potential perioperative outcomes. A review of the literature is provided.
Materials and methods: A retrospective review was performed comparing 15 consecutive patients undergoing laparoscopic partial nephrectomy to the subsequent consecutive 13 patients undergoing robotic assisted partial nephrectomy for small renal tumors. All patients had normal contralateral kidney appearance on cross sectional imaging. A similar transperitoneal technique was employed for both cohorts. A 4-arm technique was used for the robotic cases… More >

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HOW I DO IT

Miriam Hadj-Moussa, James A. Brown
Canadian Journal of Urology, Vol.17, No.3, pp. 5213-5215, 2010
Abstract Objective: We describe a technique of surgical clip placement, which prevents slippage when ligating the folded vas deferens during vasectomy.
Methods: We utilized this technique in 25 consecutive vasectomy procedures. After isolating the vas, two mosquito clamps are placed approximately 2 cm-3 cm apart and a small 5 mm-10 mm section of full thickness vas is removed. The lumen of each cut end is cauterized. Surgical clips (Ethicon Ligaclip Extra LS-200, Medium) are placed at approximately 2 mm, 3 mm and 15 mm (on the opposite side of the hemostat) from each cut end. By rotating the More >

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EDITORIAL COMMENT

J.C. Trussell
Canadian Journal of Urology, Vol.17, No.3, pp. 5215-5215, 2010
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CASE REPORT

Kevin J. Via, Kitty M. Burns, Donald L. Lamm
Canadian Journal of Urology, Vol.17, No.3, pp. 5216-5218, 2010
Abstract Early cystectomy has become an increasingly popular option for the treatment of high grade, stage T1 bladder cancer and has the advantage of removing sites that are often inaccessible to intravesical therapy. The following case report illustrates a possible lethal pitfall in cystectomy that leads us to suggest simple and inexpensive measures to prevent spillage of urine and the possible implantation of urothelial carcinoma during cystectomy. More >

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CASE REPORT

Hala Faragalla^1,2, Sahar Al-Haddad^1,2, Robert Stewart³, George M Yousef^1,2
Canadian Journal of Urology, Vol.17, No.3, pp. 5219-5222, 2010
Abstract Background: Renal cell carcinoma (RCC) with multinucleated giant cells has been reported in the literature. Different types of multinucleated giant cells have been described, including the osteoclast-like giant cells, rhabdoid cells, syncytial giant cells and tumor multinucleated giant cells.
Results: We describe a unique case of a clear cell RCC with extensive giant cell component. Tumor giant cells were arranged in an alveolar pattern and formed more than 50% of the tumor. The rest of the tumor was a classic clear cell renal cell carcinoma. A rhabdoid component was also focally seen. The immunohistochemical profile of the… More >

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CASE REPORT

Jorge Caso¹, Jose Correa¹, Dahui Qin², Wade J. Sexton¹
Canadian Journal of Urology, Vol.17, No.3, pp. 5223-5225, 2010
Abstract We present a patient who developed severe lower urinary tract symptoms following resection of a Ta low grade bladder urothelial carcinoma with immediate post-resection instillation of mitomycin-C. Urine cultures were negative. Radiographic imaging demonstrated a bladder mass. On biopsy she was found to have eosinophilic cystitis. We report the clinical scenario and discuss treatment options. A review of reported cases in the English literature is provided. More >

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RESIDENT’S CORNER

David Stoddard, Jonah Marshall, Guan Wu, Hani Rashid
Canadian Journal of Urology, Vol.17, No.3, pp. 5226-5228, 2010
Abstract Umbilical laparoendoscopic single-site surgery (U-LESS) is a relatively new technique for minimally invasive surgery being implemented in patients with urological complaints. We report the case of an incontinent 8-year-old girl who successfully underwent U-LESS for nephrectomy of a minimally functioning kidney with ectopic ureteral insertion into the vagina. More >

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RESIDENT’S CORNER

Meng Guan, Sero Andonian
Canadian Journal of Urology, Vol.17, No.3, pp. 5229-5231, 2010
Abstract Introduction: Laparoscopic renal cyst decortication has become the standard of care for management of large symptomatic simple renal cysts. The aim of the present case report is to present such a case in an ambulatory setting.
Case report: A 41-year-old woman presented with a 3 year history of a painful 9 cm x 7.3 cm right lower pole simple renal cyst. Laparoscopic renal cyst decortication was performed through three 5 mm trocars. The operating time was 145 minutes. There were no intraoperative or postoperative complications. The wounds were infiltrated with a total of 20 cc of 0.25%… More >

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RESIDENT’S CORNER

Franklin Lee, David S. Aaronson, Sarah Blaschko, Phil Barbosa, Alex K. Wu, Michael Eisenberg, Bradley A. Erickson, Jack W. McAninch
Canadian Journal of Urology, Vol.17, No.3, pp. 5232-5235, 2010
Abstract Objectives: To report two cases of secondary pulmonary hypertension resulting from microsphere extravasation following selective arterial embolization of renal angiomyolipoma, its diagnosis, and management.
Methods: We reviewed the cases of two patients at the University of California, San Francisco, treated with selective arterial embolization for management of their angiomyolipoma (AML) using Tris-Acryl Gelatin Microspheres.
Results: Both patients were women, ages 51 and 77. Indications for treatment were the following: Patient 1 was treated for a large asymptomatic AML. Patient 2 was treated for a symptomatic, bleeding AML. Both patients developed progressive hypoxia following selective arterial embolization using Tris-Acryl More >

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CLINICAL TRIALS

Richard W. Casey¹, Jack Barkin²
Canadian Journal of Urology, Vol.17, No.3, pp. 5236-5238, 2010
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CLINICAL TRIALS

Eric Winquist, George Rodrigues
Canadian Journal of Urology, Vol.17, No.3, pp. 5239-5244, 2010
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