Open Access

EDITORIAL

Bob Djavan
Canadian Journal of Urology, Vol.18, No.4, pp. 5763-5763, 2011
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LEGENDS IN UROLOGY

Lawrence H. Einhorn
Canadian Journal of Urology, Vol.18, No.4, pp. 5764-5765, 2011
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BOOK REVIEW

Gerald Chodak
Canadian Journal of Urology, Vol.18, No.4, pp. 5766-5766, 2011
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REVIEW

Leonard G. Gomella, Francisco Gelpi, William Kevin Kelly
Canadian Journal of Urology, Vol.18, No.4, pp. 5767-5777, 2011
Abstract Introduction: Castrate-resistant prostate cancer (CRPC) is the most clinically advanced form of prostate cancer. Prior to 2004, treatment options for patients with CRPC were limited to palliative care with mitoxantrone. However, two phase III trials in 2004 showed improved survival with docetaxel compared with mitoxantrone in patients with metastatic CRPC. Docetaxel remains the current standard chemotherapy for CRPC.
Materials and methods: A literature review was conducted to ascertain agents recently approved or in development for CRPC as well as several treatment algorithms being developed in this patient population.
Results: Recently, the US Food and Drug Administration (FDA) approved… More >

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REVIEW

Nazila Yavari¹, Stefan Andersson-Engels², Ulrika Segersten¹, Per-Uno Malmstrom¹
Canadian Journal of Urology, Vol.18, No.4, pp. 5778-5786, 2011
Abstract Photodynamic therapy (PDT) is one of the most interesting methods of photo treatment. In general, PDT is a modality for the treatment of non-muscle invasive tumors. PDT is very well suited in managing bladder cancer, as the bladder is accessible by endoscopy and the tumors are most often limited to the mucosa or sub-mucosa. PDT is likely more useful for patients with recurrent tumors after conventional therapies, as well as for patients with diffuse non-muscle invasive bladder carcinomas that are refractory to standard treatments before the commitment to radical extirpative surgery, particularly in patients at More >

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REVIEW

Wally Mahfouz¹, Gilles Karsenty², Jacques Corcos¹
Canadian Journal of Urology, Vol.18, No.4, pp. 5787-5795, 2011
Abstract Introduction: The first application of botulinum toxin type A (BoNT-A) in urology was its injection into the urinary sphincter to treat neurogenic detrusor-sphincter dyssynergia (DSD) in quadriplegic men. Since that first report by Dyskatra et al in 1988, the results of focal BTA injections into the sphincter, the bladder wall and lately into the prostate have raised the interest of the urology community in this promising new therapeutic modality. This is an evidence-based review of the current indications, techniques and outcomes of BTA injections into the urethral sphincter.
Materials and methods: The Medline database was searched for… More >

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ARTICLE

Ashley King¹, David E. Rapp^1,2
Canadian Journal of Urology, Vol.18, No.4, pp. 5796-5801, 2011
Abstract Introduction: Research suggests that midurethral sling placement may have a beneficial effect on urgency (U) and urge incontinence (UUI). This study examined short term U/UUI outcomes in patients undergoing TVT-O placement.
Methods: One hundred patients undergoing TVT-O placement were prospectively assessed using 3 day bladder diary, combined with multiple validated incontinence questionnaires focusing on UUI, U and QoL.
Results: At 6 week assessment, improvements in daily pad use (2.6 to 0.9) and incontinence episodes (3.6 to 0.7) were seen (p < 0.05, both comparisons). Eighty-two patients reported cure of stress incontinence. Focused outcome scores for UUI improved from… More >

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ARTICLE

George Rodrigues^1,2, Glenn Bauman¹, Varagur Venkatesan¹, Belal Ahmad¹, Michael Lock¹, Tracy Sexton¹, David D’Souza¹, Larry Stitt², Somaya Eid^1,2
Canadian Journal of Urology, Vol.18, No.4, pp. 5802-5810, 2011
Abstract Introduction: A 29-item prostate cancer radiotherapy (PCRT) questionnaire with genitourinary (GU), gastrointestinal (GI), and sexual (S) domains has been previously validated for the assessment of late toxicity health-related quality of life (HRQoL) effects. The study objective was to cross-validate the PCRT domains versus the expanded prostate cancer index composite (EPIC) questionnaire urinary (U), bowel (B), hormonal (H), and S subscales.
Methods and materials: A single-institution cross-sectional PCRT patient cohort was surveyed. Descriptive and intra- and inter-class correlation coefficient statistics for the various EPIC and PCRT HRQoL domain scores were generated. Univariable and multivariable Cox and logistic regressions… More >

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ARTICLE

Franklin E. Kuehhas¹, Ralph Naegele¹, Elisabeth Eckersberger², Markus Margreiter¹, Ralf Herwig¹, Amir Kazzazi², Bob Djavan²
Canadian Journal of Urology, Vol.18, No.4, pp. 5811-5818, 2011
Abstract Introduction: To compare the commonly used 0-1 pad definition of urinary continence for postoperative functional outcome after radical prostatectomy and the correlation with self-reported urinary continence and to determine whether a patient questionnaire can deliver more accurate continence status rates.
Material and methods: We evaluated a cohort of 873 men who underwent radical prostatectomy (RP) at the General Hospital in Vienna between 1998 and 2006. Patients were surveyed with a questionnaire regarding their postoperative outcome and postoperative urinary incontinence. Baseline and pathological factors were examined to determine whether or not they had an impact on the continence status.
… More >

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ARTICLE

Daniel Canter, Alexander Kutikov, Konstantin Golovine, Petr Makhov, Jay Simhan, Robert G. Uzzo, Vladimir M. Kolenko
Canadian Journal of Urology, Vol.18, No.4, pp. 5819-5825, 2011
Abstract Objectives: We examined the in vitro cellular effects of the multi-targeted receptor tyrosine kinase inhibitors (TKIs) sunitinib and pazopanib on a series of human renal cell carcinoma (RCC) cell lines.
Methods: The human RCC cell lines 769-P, 786-O, HRC-24, HRC-31, HRC-45, HRC-78, SK-26B, and SK-45 were treated with varying concentrations of sunitinib and pazopanib. Cellular proliferation and cell death were assessed using the CellTiter-Blue Cell Viability Assay and the TUNEL assay, respectively. Effective doses (ED) for inhibition of cellular proliferation or induction of apoptosis were calculated for both sunitinib and pazopanib in each RCC cell line.
Results: Both… More >

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ARTICLE

Leonard B. Weinstock^1,2, Bob Geng³, Steven B. Brandes⁴
Canadian Journal of Urology, Vol.18, No.4, pp. 5826-5830, 2011
Abstract Introduction: This pilot study determined the efficacy of rifaximin, a gut-directed antibiotic, in reducing chronic prostatitis (CP) and gastrointestinal (GI) symptoms in patients with CP type III. The prevalence of small intestinal bacterial overgrowth (SIBO) and irritable bowel syndrome (IBS) in patients with CP was also evaluated.
Materials and methods: Chronic prostatitis patients were recruited and screened for SIBO and IBS using the lactulose breath test (LBT) and Rome II criteria, respectively. Patients with a positive LBT result and Chronic Prostatitis Symptom Index (CPSI) score ≥ 15 received rifaximin 550 mg three times daily for 10 days.… More >

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ARTICLE

Wayland Hsiao¹, Adam B. Shrewsberry¹, Kelvin A. Moses¹, Mathew Malek-Jones, Deborah Baumgarten², Viraj A. Master^1,3, Kenneth Ogan¹
Canadian Journal of Urology, Vol.18, No.4, pp. 5831-5835, 2011
Abstract Introduction: Increased use of nephron-sparing surgery has revealed a small but significant percentage of benign tumors. Improved imaging techniques have aided in diagnosis, but are still unable to differentiate benign from malignant tumors. We sought to evaluate whether the intra-tumor Doppler flow pattern could predict the presence of renal cell cancer (RCC).
Materials and Methods: Standard grayscale ultrasound (US) and Power Doppler ultrasound (PDUS) were performed on 40 patients referred to our clinic for suspicious renal masses diagnosed by CT or MRI from December 2007 to May 2010. PDUS findings were used to classify tumors according to… More >

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RESIDENT’S CORNER

Nitya E. Abraham¹, Ronald Simon², Ojas Shah¹
Canadian Journal of Urology, Vol.18, No.4, pp. 5836-5838, 2011
Abstract Risk of thermal injury to the bowel when utilizing electrocautery at the bladder dome has been reported anecdotally. This is a case report of a 64-year-old man with urothelial carcinoma in situ of the bladder who underwent transurethral resection of bladder tumor at the posterior bladder wall near the dome without evidence of perforation. The postoperative course was complicated by delayed small bowel perforation likely secondary to transmission of thermal energy during fulguration of the resection bed. This injury highlights the need for particular prudence when resecting and fulgurating bladder tumors using monopolar electrocautery, specifi More >

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RESIDENT’S CORNER

Andrea Lo¹, Robert K. Nam², D. Andrew Loblaw^3,4
Canadian Journal of Urology, Vol.18, No.4, pp. 5839-5843, 2011
Abstract There is debate about the optimal management of high risk localized prostate cancer. Initial options include surgery or radiation combined with androgen deprivation therapy. We describe a case of a patient with contraindications to radiotherapywhowasmanagedwithhighdoserate(HDR) brachytherapy as his sole treatment.
A medically operable patient presented with a T2c N0 M0 Gleason9adenocarcinomawithaninitialPSAof19.9ng/mL. Previously, he had severe ulcerative colitis managed with pancolectomy and a neorectum fashioned from ileum anastomosedbehindhisprostate.Afteranegativeextended lymph node dissection, a HDR brachytherapy implant of 35Gyin5fractionsover3dayswasdelivered.Noandrogen deprivationtherapywasused.Thetreatmentwasextremely welltoleratedintheshortandlongtermwithnosignificant bowel or bladder side effects observed in follow up. After 7 years, his PSA was 0.04 ng/mL.
The More >

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HOW I DO IT

Daniel Canter¹, Alexander Kutikov¹, Eric M. Horwitz², Richard E. Greenberg¹
Canadian Journal of Urology, Vol.18, No.4, pp. 5844-5848, 2011
Abstract Surgical treatment for men with localized prostate cancer —open, laparoscopic, or robotically-assisted-- remains one of the therapeutic mainstays for this group of patients. Despite the stage migration witnessed in patients with prostate cancer since the introduction of prostate-specific antigen (PSA) screening, detection of extraprostatic disease at the time of surgery and biochemical recurrence following prostatectomy pose signifi cant therapeutic challenges. Radiation therapy (RT) after radical prostatectomy (RP) has been associated with a survival benefi t in both the adjuvant and salvage setting. Nevertheless, optimal targeting of the prostate bed following surgery remains challenging. The Calypso… More >

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CLINICAL TRIALS

Eric Winquist, George Rodrigues
Canadian Journal of Urology, Vol.18, No.4, pp. 5849-5855, 2011
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CASE REPORT

Andrew C. Strine¹, David J. Grignon², Chandru P. Sundaram³
Canadian Journal of Urology, Vol.18, No.4, pp. 5856-5859, 2011
Abstract Ablative therapy has recently emerged as an option for the treatment of small renal masses (SRMs). Benign tumors and indolent renal cell carcinoma (RCC) represent a majority of these masses, although an additional but often unappreciated consideration is upper tract urothelial carcinoma (UC). We report the case of a 74-year-old man with upper tract UC presenting as a SRM without any apparent involvement of the pelvicalyceal system, leading to its inadvertent cryoablation. We also discuss the role of renal biopsy in the management of SRMs undergoing an ablative procedure. More >

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