Open Access

EDITORIAL

Leonard G. Gomella
Canadian Journal of Urology, Vol.18, No.3, pp. 5666-5666, 2011
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LEGENDS IN UROLOGY

Michael Marberger
Canadian Journal of Urology, Vol.18, No.3, pp. 5667-5669, 2011
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BOOK REVIEW

John P. Mulhall
Canadian Journal of Urology, Vol.18, No.3, pp. 5670-5670, 2011
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REVIEW

Prashant Malhotra, Bruce F. Farber
Canadian Journal of Urology, Vol.18, No.3, pp. 5671-5675, 2011
Abstract Bacillus Calmette Guerin (BCG) immunotherapy is widely used for treatment of superfi cial bladder transitional cell carcinoma. Infectious complications while rare can be serious and severe disseminated infections as well as sepsis has been reported. There are no standard guidelines to direct therapy of these complications. Isoniazid is a commonly and widely used component of the various treatment regimens. Various strains of BCG are used for treatment of bladder cancer as well as vaccinations. These strains have evolved because of repeated subcultures in various laboratories in the world and have been shown to exhibit phenotypic… More >

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REVIEW

Ammar Hameed, Aza Mohammed, Sharjeel Nasir, Michael Plamer
Canadian Journal of Urology, Vol.18, No.3, pp. 5676-5682, 2011
Abstract Male urethral stricture disease is one of the common conditions encountered in the day-to-day urological practice. It can present at any age and has a wide range of etiological factors including infection, trauma and instrumentation. It usually manifests itself as lower urinary tract symptoms or urinary tract infections with signifi cant impairment in the quality of life. There are several treatment options for this condition and these mainly depend on the site, length, the underlying cause and previous treatment. The management of bulbar urethral strictures has greatly evolved over the last few decades with more More >

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MEETING REVIEW

Amir Kazzazi, Shabnam Momtahen, Aron Bruhn, Micah Hemani, Krishna Ramaswamy, Bob Djavan
Canadian Journal of Urology, Vol.18, No.3, pp. 5683-5688, 2011
Abstract The 2011 American Urological Association (AUA) annual meeting took place in Washington, DC, USA, on May 14-19. It is the largest gathering of urologists in the world, providing unparalleled access to groundbreaking research, new guidelines and the latest advances in urologic medicine. The opportunity to exchange knowledge among urologists on a worldwide level was providedbyparticipationofmorethan80countriesinthis scientific meeting. As one of the most important subjects, there were more than 500 presented studies in prostate cancer.Inthisreviewwewillhighlightsomeofthefindings and the clinical significance of a few of these abstracts concerning prostate cancer staging and markers. More >

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ARTICLE

Katarina Zvarova¹, Michal Ursiny¹, Timothy Giebink¹, Kathleen Liang², Jerry G. Blaivas³, Peter Zvara¹
Canadian Journal of Urology, Vol.18, No.3, pp. 5689-5694, 2011
Abstract Introduction: To assess the accuracy of sonouroflow (SUF), an at-home, wireless-based acoustic system for recording lower urinary tract symptoms (LUTS) and urinary flow rate, and to compare test-to-test variability in flow parameters recorded using this new portable method with those obtained by conventional uroflowmetry.
Materials and methods: An initial pilot study evaluated the technical feasibility of the SUF system. Subsequently, test-to-test variability was compared between sonourograms (SUFm) and standard uroflowmetry recordings. Uroflowmetry tests were performed at the urology office at pre-set times. SUF tests were performed at home on a schedule in keeping with the subjects' normal habits.
… More >

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ARTICLE

Tala Al Afraa, Lysanne Campeau, Wally Mahfouz, Jacques Corcos
Canadian Journal of Urology, Vol.18, No.3, pp. 5695-5698, 2011
Abstract Introduction: Urodynamic assessment is strongly recommended before artificial urinary sphincter (AUS) implantation. Detrusor overactivity (DO) and/or hypersensitivity and/or mild loss of compliance are frequently demonstrated in post prostatectomy incontinence. The aim of this study was to evaluate urodynamic parameter changes before and after AUS implantation in patients with urinary incontinence post-radical prostatectomy (RP) and concomitant urodynamic bladder abnormalities.
Materials and methods: We performed a retrospective review of charts pre- and post-AUS implantation. Sixteen out of a cohort of 52 patients met our inclusion criteria: stress urinary incontinence (SUI) due to RP and bladder dysfunction (early bladder sensation… More >

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ARTICLE

Dean E. Leocadio¹, Allen R. Kunselman², Timothy Cooper³, Jairo H. Barrantes⁴, J.C. Trussell¹
Canadian Journal of Urology, Vol.18, No.3, pp. 5699-5704, 2011
Abstract Introduction: Several animal models have been used for in vitro experimentation and surgical training exercises involving the vas deferens. The canine model is currently considered the standard for both in vivo and ex vivo studies. However, due to increasing costs associated with canine experimentation and in accordance with the principles of refine, reduce, and replace, a novel model that is cost-effective and easily obtainable is desired. We compared the morphology of the bull vas deferens with that of the human and canine vas deferens.
Materials and methods: Bilateral vas deferens tissue from human (n = 6), canine… More >

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ARTICLE

Busara Sirivanasandha, Pamela H. Lennox, Himat Vaghadia
Canadian Journal of Urology, Vol.18, No.3, pp. 5705-5709, 2011
Abstract Introduction: Spinal anesthesia for ambulatory transurethral resection of the prostate (TURP) is a well-established technique. This study reviews data collected over a 5-year period at a major Canadian tertiary academic center. The purpose of the study was to evaluate our experience and complications associated with spinal anesthesia using a combination of low-dose local anesthetic and narcotic in ambulatory TURP procedures.
Methods: Medical records were retrospectively reviewed for all ambulatory TURP patients treated between January 2000 and September 2005 at our Surgical Day Care Center. All spinal anesthetics were reviewed and classified based on dosage into: low-dose bupivacaine… More >

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EDITORIAL COMMENT

Stanley Zaslau
Canadian Journal of Urology, Vol.18, No.3, pp. 5709-5709, 2011
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ARTICLE

Attila Szendroi¹, Gabor Speer², Adam Tabak^2,3, Janos P. Kosa², Peter Nyírády¹, Attila Majoros¹, Imre Romics¹, Peter Lakatos²
Canadian Journal of Urology, Vol.18, No.3, pp. 5710-5716, 2011
Abstract Introduction: Prostate cancer is the second leading cause of cancer death among men in developed countries. Estrogen receptor-alpha (ER-α), vitamin D receptor (VDR), and the calcium-sensing receptor (CaSR), partly through their effects on calcium levels are implicated in the proliferation and carcinogenesis in the prostate gland. VDR, ER-α and CaSR genes show polymorphisms in humans that appear to have clinical significance in many pathological conditions, such as prostate cancer. Our aim was to evaluate the role of ER-α (PvuII, XbaI), VDR (BsmI) and CaSR (A986S) gene polymorphisms and serum calcium levels in the pathogenesis of prostate… More >

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ARTICLE

John-Paul McCarthy, Thomas A. A. Skinner, Richard W. Norman
Canadian Journal of Urology, Vol.18, No.3, pp. 5717-5720, 2011
Abstract Objectives: Urolithiasis is an increasing problem among patients aged 80 years and older. Our objective was to compare patients aged ≥ 80 years with a younger cohort in terms of presentation and management of urolithiasis.
Methods: Patients referred to a tertiary care stone clinic for the management of urolithiasis over a 5-year period were reviewed. Clinical data from patients aged ≥ 80 years were compared with a random sample of those under 80 years.
Results: There were 26 patients aged ≥ 80 years and 102 patients in the younger cohort; mean ages were 83.5 ± 0.6 and 50.1… More >

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ARTICLE

Jason Douglas Engel
Canadian Journal of Urology, Vol.18, No.3, pp. 5721-5725, 2011
Abstract Introduction: Erectile dysfunction (ED) is a common complication following bilateral nerve-sparing robotic prostatectomy (BNSRP). Early intervention with tadalafil plus a vacuum erection device (VED) may enhance the recovery of sexual function compared to tadalafil alone.
Materials and methods: Men who underwent BNSRP for prostate cancer were randomized into two groups: one received tadalafil 20 mg three times weekly, and the other received the same dose of tadalafil plus daily use of a VED for at least 10 minutes unbanded per day, five days per week. Treatment began one month post-surgery. Clinic visits occurred at 1, 3, 6,… More >

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HOW I DO IT

Joseph E. Jamal, Jason D. Engel
Canadian Journal of Urology, Vol.18, No.3, pp. 5726-5730, 2011
Abstract The management of post-prostatectomy erectile function has been debated since the nerve sparing radical prostatectomy was fi rst introduced. A number of penile rehabilitation protocols have been proposed with varying degrees of success and patient satisfaction. My management of post-prostatectomy erectile dysfunction has evolved based on an honest and critical appraisal of the literature and my own experience and research. A review of major studies published on the topic of post-prostatectomy penile rehabilitation is included here, in addition to a critical evaluation of my own clinical practice. After evaluating the effi cacy of these various More >

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RESIDENT’S CORNER

Joshua M. Liao, Wesley A. Mayer, Moses M. Kim, Richard E. Link
Canadian Journal of Urology, Vol.18, No.3, pp. 5731-5734, 2011
Abstract A 61-year-old male presented with long standing urinary frequency and the sensation of incomplete emptying. Computed tomography (CT) revealed a 9.5 cm x 7.9 cm x 6.9 cm pelvic mass behind the bladder and abutting the rectum. The mass was excised using a robotic-assisted laparoscopic approach. Pathologic examination of the mass demonstrated an extragastrointestinal stromal tumor (EGIST), an extremely rare entity. To the best of our knowledge, this is the fi rst EGIST to be found in the rectovesicular pouch of a male and the fi rst to be resected robotically. Our case adds to More >

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RESIDENT’S CORNER

Jeffrey Gahan¹, Samir P. Shirodkar¹, Michael A. Gorin¹, Tomas A. Salerno², Gaetano Ciancio^1,3
Canadian Journal of Urology, Vol.18, No.3, pp. 5735-5738, 2011
Abstract Adrenocortical carcinoma with tumor thrombus and concomitant testosterone production is a rare entity. We describe a case of a 53-year-old woman with a testosterone producing left-sided adrenocortical carcinoma with tumor extending to the right atrium and tumor embolus to the right pulmonary artery. To our knowledge, there exist no such reported cases in the medical literature. We describe our use of techniques derived from transplant surgery for the removal of this mass. Critical components for successful resection included early renal artery ligation, hepatic mobilization off the inferior vena cava, and minimization of cardiopulmonary bypass time More >

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RESIDENT’S CORNER

Natasha Khursigara¹, Barry B. McGuire¹, Hugh Flood¹
Canadian Journal of Urology, Vol.18, No.3, pp. 5739-5741, 2011
Abstract Late presenting posterior urethral valves are very rare and often present ambiguously. The consequence of late detection can be profoundly detrimental, resulting in persistent voiding dysfunction and/or renal failure. We present an unusual case of a patient with posterior urethral valves who presented at the age of 28 years. We review the literature and discuss the clinical features, diagnosis, and treatment of this condition. More >

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RESIDENT’S CORNER

Marc R. Walker, Alexander J. Ernest Jr, Leah P. McMann
Canadian Journal of Urology, Vol.18, No.3, pp. 5742-5744, 2011
Abstract Herein is a case of a 55-year-old man who presented with epididymitis. He subsequently failed medical management for the suspected infection and progressed to develop an acute scrotum and sonographic fi ndings consistent with a pyocele. Concurrent computed tomography (CT), obtained for persistent abdominal pain, revealed a large enhancing upper pole renal mass suspicious for malignancy. He was taken for emergent scrotal exploration to drain the presumptive pyocele. However, during scrotal exploration, no purulence or evidence of infection was seen. Although, seemingly unrelated to the renal mass, the thickened hydrocele sac was excised and sent More >

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MINIMALLY INVASIVE AND ROBOTIC SURGERY

Hiten D. Patel, Jeffrey K. Mullins, Phillip M. Pierorazio, Elias S. Hyams, Mohamad E. Allaf
Canadian Journal of Urology, Vol.18, No.3, pp. 5745-5750, 2011
Abstract Introduction: Laparoendoscopic single-site surgery (LESS) has emerged as a natural progression from standard laparoscopy toward minimization of surgical morbidity. We present our initial experience with LESS renal surgery in order to assess safety, feasibility, and early postoperative outcomes.
Materials and methods: Patients undergoing LESS renal surgery by a single surgeon from November 2008 to June 2010 were retrospectively identified. Safety, feasibility, and early outcomes were analyzed. Pain parameters were assessed using morphine equivalents used and visual analog pain scores (VAPS).
Results: LESS procedures included 13 radical nephrectomy (1 bilateral), 5 simple nephrectomy (1 bilateral), 2 partial nephrectomy, 2… More >

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CLINICAL TRIALS

George Rodrigues, Eric Winquist
Canadian Journal of Urology, Vol.18, No.3, pp. 5751-5756, 2011
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CASE REPORT

Kanmin Xue¹, Simon Pridgeon¹, Rebecca Gillibrand², Jose Sanchez de Crespo³, Hirsch Godbole¹, George Fowlis¹
Canadian Journal of Urology, Vol.18, No.3, pp. 5757-5762, 2011
Abstract Urinary schistosomiasis is a prevalent parasitic infection in certain areas of Africa and the Middle East. It could present with common as well as unusual urological symptoms, which poses a considerable diagnostic challenge in countries where there is relative low incidence of the disease. We describe three unusual cases of urinary schistosomiasis identifi ed in patients presenting to a London hospital. One patient was found to have schistosomiasis in the seminal vesicles following surgery for prostatic adenocarcinoma. Another was found to have schistosoma-related granulomatous infl ammation within a urachal cyst. Thirdly a patient was found More >

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