Open Access

EDITORIAL

Leonard G. Gomella
Canadian Journal of Urology, Vol.17, No.5, pp. 5343-5343, 2010
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LEGENDS IN UROLOGY

Toichi Takenaka
Canadian Journal of Urology, Vol.17, No.5, pp. 5344-5345, 2010
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ARTICLE

Willie Underwood III^1,2, Heather Orom², Michael Poch¹, Brady T. West³, Paula M. Lantz⁴, Sam S. Chang⁵, Jay H. Fowke⁶
Canadian Journal of Urology, Vol.17, No.5, pp. 5346-5354, 2010
Abstract Objective: Patients turn to their physicians for information and guidance when making a prostate cancer treatment decision. The objectives of this study were to determine the likelihood of men consulting with and receiving treatment recommendations from different providers (urologists, radiation oncologists, and primary care physicians), the content of these recommendations, the perceived influence of recommendations and which recommendations, if any, were associated with prostate cancer treatment decisions.
Methods: One hundred and fifty-eight participants with localized prostate cancer completed a survey regarding their treatment decision-making process. Associations between treatment choice and urologist recommendations, consultations with radiation oncologists and More >

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ARTICLE

Wayne S. Kendal¹, Kien T. Mai²
Canadian Journal of Urology, Vol.17, No.5, pp. 5355-5359, 2010
Abstract Introduction: Variant histological subtypes of prostatic cancer occur uncommonly and are associated with poor survival, as has been ascertained through limited series and case reports. Here a population-based analysis of prostatic cancer is provided, to better analyze the survival behavior of these subtypes.
Materials and methods: The American SEER registry was used to review prostatic cancer diagnosed from 1988 to 2003, classified according to the International Classification of Diseases for Oncology. Kaplan-Meier and proportional hazards analyses were performed on adenocarcinomas and five infrequent variant subtypes to determine their overall survival behavior, allowing corrections for follow up inequity,… More >

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ARTICLE

Jeffrey J. Tomaszewski, Marc C. Smaldone, Sami Makaroun, Ryan P. Smith, Sushil Beriwal, Ronald M. Benoit
Canadian Journal of Urology, Vol.17, No.5, pp. 5360-5364, 2010
Abstract Introduction: Given the shorter half-life of cesium-131 (Cs-131) compared to iodine-125 (I-125), we hypothesized that initial PSA outcomes may differ. We compare initial PSA outcomes in men undergoing Cs-131 prostate brachytherapy to men treated with I-125.
Patients and methods: The first post-treatment PSA (obtained 3-6 months after the procedure) was compared in patients undergoing I-125 prostate brachytherapy to that of patients undergoing Cs-131 prostate brachytherapy at the same institution. Comparisons included the total cohort as well as low and intermediate risk patients.
Results: Mean pre-treatment PSA was 6.9 ng/mL in the I-125 cohort, and 6.9 ng/mL in the… More >

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ARTICLE

Daniel Canter¹, Richard E. Greenberg¹, Eric M. Horwitz², Alexander Kutikov¹, Jinsheng Li², Christopher Long¹, Mark Buyyounouski², Stephen A. Boorjian¹
Canadian Journal of Urology, Vol.17, No.5, pp. 5365-5369, 2010
Abstract Introduction: Radiation therapy (RT) after radical prostatectomy (RP) has been associated with a survival benefit in both the adjuvant and salvage setting. Nevertheless, optimal targeting of the prostate bed following surgery remains challenging. The Calypso 4D Localization System (Calypso Medical Technologies, Seattle, WA, USA) is a target positioning device that continuously monitors the location of three implantable electromagnetic transponders. We describe our technique of ultrasound-guided placement of these transponders into the prostate bed for adjuvant and salvage RT.
Methods: Seventeen patients presenting to Fox Chase Cancer Center for postoperative RT underwent transrectal ultrasound-guided placement of Calypso beacons.… More >

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ARTICLE

Josep M. Gaya¹, Joan Palou¹, Ferran Algaba², Jacobo Arce¹, Oscar Rodríguez-Faba¹, Humberto Villavicencio¹
Canadian Journal of Urology, Vol.17, No.5, pp. 5370-5376, 2010
Abstract Introduction: Micropapillary carcinoma is a rare pathologic variant of urothelial cell carcinoma. Intravesical bacillus Calmette-Guérin (BCG) has been reported to be ineffective and to entail an increased risk of development of non-organ-confined, metastatic disease.
We assess the treatment response and disease progression in patients with micropapillary carcinoma of the bladder.
Materials and methods: The study comprised 18 patients with micropapillary carcinoma of the bladder who underwent transurethral resection of a bladder tumor and multiple random biopsies between 1997 and 2003. We retrospectively analyzed treatment response and clinical and pathological cancer evolution related to cancer stage and the percentage… More >

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MINIMALLY INVASIVE AND ROBOTIC SURGERY

Stephen Lukasewycz¹, Matt Holman², Paul Kozlowski¹, Christopher R. Porter¹, Erin Odom¹, Chris Bernards², Nancy Neil³, John M. Corman¹
Canadian Journal of Urology, Vol.17, No.5, pp. 5377-5382, 2010
Abstract Introduction: Robotic assisted laparoscopic radical prostatectomy (RALP) is a common treatment for localized prostate cancer. Despite a primary advantage of improved postoperative pain, patients undergoing RALP still experience discomfort. Belladonna, containing the muscarinic receptor antagonists atropine and scopolamine, in combination with opium as a rectal suppository (B & O) may improve post-RALP pain. This study evaluates whether a single preoperative B & O results in decreased postoperative patient-reported pain and analgesic requirements.
Materials and methods: Patients undergoing RALP at Virginia Mason Medical Center between November 2008 and July 2009 were offered the opportunity to enter a randomized,… More >

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MINIMALLY INVASIVE AND ROBOTIC SURGERY

Satya B. Allaparthi, Thomas Hoang, Nadeem N. Dhanani, Ingolf A. Tuerk
Canadian Journal of Urology, Vol.17, No.5, pp. 5383-5389, 2010
Abstract Introduction: To determine the significance of prostate weight (PW) on clinical and pathological outcomes in patients undergoing da Vinci robot assisted laparoscopic extraperitoneal radical prostatectomy (EP-RARP).
Methods: From November 2008 to January 2010, 295 men underwent EP-RARP at our institution. We retrospectively reviewed our database and stratified patients into four groups based on pathologic PW: Group 1, less than 30 g; Group 2, 30 g to less than 50 g; Group 3, 50 g to less than 80 g; and Group 4, 80 g or larger. We prospectively compared these groups with respect to patient age, body… More >

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EDITORIAL COMMENT

Kevin C. Zorn
Canadian Journal of Urology, Vol.17, No.5, pp. 5389-5389, 2010
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MINIMALLY INVASIVE AND ROBOTIC SURGERY

Ted B. Manny, Ilya Gorbachinsky, Ashok K. Hemal
Canadian Journal of Urology, Vol.17, No.5, pp. 5390-5393, 2010
Abstract Introduction: To describe the incidence and outcomes of lower extremity neuropathies in a series of robot assisted laparoscopic radical prostatectomy (RALRP) and robot assisted laparoscopic radical cystectomy (RALRC) patients with 9 months follow up. Additionally, we compare this cohort to other published series of lithotomy based surgery and describe strategies for minimizing risk.
Materials and methods: We performed a retrospective analysis of 179 consecutive patients who underwent either RALRP or RALRC at a single institution during a 17 month period. We included all patients who experienced bothersome lower extremity pain, weakness, or numbness at any time during… More >

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HOW I DO IT

Alexander Tsivian, Matvey Tsivian, A. Ami Sidi
Canadian Journal of Urology, Vol.17, No.5, pp. 5394-5396, 2010
Abstract Introduction: Injuries of the upper (lumbar) portion of the ureter are rare; however, their reconstruction may pose considerable challenges. We describe a novel technique of surgical reconstruction in case of a long upper ureteral obliteration that may be a viable treatment option in select patients.
Materials and methods: Reconstruction of a iatrogenic 5 cm injury to the upper ureter, consisting of 2 cm obliteration and 1.5 cm stenotic segments on its sides, unsuitable for an end-to-end reanastomosis, was performed using a novel technique of augmented pelvic flap anastomotic ureteroplasty. The injured ureteral segment was excised, the ureteral… More >

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EDITORIAL COMMENT

Kristofer R. Wagner
Canadian Journal of Urology, Vol.17, No.5, pp. 5396-5396, 2010
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HOW I DO IT

James C. Forde¹, Kevin M. O’Connor¹, Deirdre M. Fanning¹, Michael J. Guiney², Thomas H. Lynch¹
Canadian Journal of Urology, Vol.17, No.5, pp. 5397-5400, 2010
Abstract The ileal conduit continues to be the most common form of urinary diversion performed worldwide. As a result of improved surgical technique the perioperative mortality and morbidity for patients undergoing ileal conduit urinary diversion has reduced remarkably. However, one early complication that may occur is that of urinary leak at the ileo-ureteric anastomosis. Urinary anastomotic leaks may be associated with signifi cant morbidity and mortality. Although a small initial leakage postoperatively is common, the problem arises in cases of continued urinary leakage from the ileo-ureteric anastomosis. We report the management of a persistent ileo-ureteric anastomotic More >

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CASE REPORT

Timothy V. Johnson¹, Ninetta Bond², Viraj A. Master¹
Canadian Journal of Urology, Vol.17, No.5, pp. 5401-5402, 2010
Abstract We present what we believe is, to the best of our knowledge, the fi rst report of open radical nephrectomy performed under epidural-only anesthesia. Our patient had localized renal cell carcinoma requiring open nephrectomy, but he also had comorbid emphysema that precluded general anesthesia. Epidural anesthesia, which bypassed the pulmonary system, allowed us to perform the surgery. More >

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CASE REPORT

Adam Stewart, David Hill
Canadian Journal of Urology, Vol.17, No.5, pp. 5403-5404, 2010
Abstract We present the case of a 6-month-old boy with an intra-abdominal testicle that spontaneously descended into the scrotum after the first stage of a planned 2 stage laparoscopic Fowler-Stephens orchidopexy. To our knowledge this has not been reported. More >

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CASE REPORT

Idir Ouzaid¹, Jean-François Hermieu¹, Sébastien Dominique¹, Pedro Fernandez², Laurence Choudat³, Vincent Ravery¹
Canadian Journal of Urology, Vol.17, No.5, pp. 5405-5407, 2010
Abstract Introduction: We present a case of a differentiated adenocarcinoma of the female urethra, which caused dysuria and voiding dysfunction.
Materials and methods: A 54-year-old female presented with dysuria and the sensation of incomplete voiding.
Results: An ultrasound-guided biopsy showed a urethral carcinoma. A magnetic resonance imaging (MRI) scan showed a high-stage tumor. The patient had a pelvic exenteration. The patient was free of disease after 2 years of follow up.
Conclusion: Urethral carcinoma is a rare malignancy. A biopsy is necessary to make a diagnosis. MRI is the best imaging for tumor staging. Small tumors are treated with a More >

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RESIDENT’S CORNER

Gavin M. Langille, Richard W. Norman
Canadian Journal of Urology, Vol.17, No.5, pp. 5408-5410, 2010
Abstract This case illustrates a rare complication of an impacted ureteric stone which eroded through the wall of the ureter leading to formation of a psoas abscess. Ureteric stent placement and percutaneous drainage of the abscess were insuffi cient to resolve the problem. Renal scan revealed poor function and the left kidney was removed. It showed evidence of acute supporative pyelonephritis with nephrolithiasis. More >

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RESIDENT’S CORNER

Bruce L. Jacobs¹, Todd M. Blodgett², Sara E. Monaco³, Ronald L. Hrebinko Jr¹, Samuel A. Jacobs⁴
Canadian Journal of Urology, Vol.17, No.5, pp. 5411-5414, 2010
Abstract Lymphomatous involvement of an adrenal gland during the course of a lymphoma is common, but a primary presentation of adrenal insufficiency in a patient with lymphoma involving both adrenal glands is rare. We describe a 36-year-old man with non-Hodgkin lymphoma (NHL) who presented with adrenal insufficiency. His evaluation consisted of several imaging modalities, including positron emission tomography-computed tomography (PET-CT) scans, which were helpful in defining the extent of disease prior to treatment and in monitoring the patient’s response to treatment. Our case illustrates the importance of preoperative evaluation to exclude a lymphoma, particularly in patients More >

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EDITORIAL COMMENT

Nabil K. Bissada
Canadian Journal of Urology, Vol.17, No.5, pp. 5414-5414, 2010
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CLINICAL TRIALS

Richard W. Casey¹, Jack Barkin²
Canadian Journal of Urology, Vol.17, No.5, pp. 5415-5418, 2010
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CLINICAL TRIALS

Eric Winquist, George Rodrigues
Canadian Journal of Urology, Vol.17, No.5, pp. 5419-5423, 2010
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