Open Access

EDITORIAL

Leonard G. Gomella
Canadian Journal of Urology, Vol.18, No.6, pp. 5987-5987, 2011
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LEGENDS IN UROLOGY

Donald G. Skinner
Canadian Journal of Urology, Vol.18, No.6, pp. 5988-5990, 2011
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Open Access

REVIEW

Gokhan Koc¹, Xu Wang², Yi Luo³
Canadian Journal of Urology, Vol.18, No.6, pp. 5991-5997, 2011
Abstract Introduction: Renal cell carcinoma (RCC) is the most common type of kidney cancer in adults, responsible for approximately 90% of all kidney cancers. Prior to 2005, treatment options for patients with locally advanced and metastatic disease were limited. After the approval of sorafenib by the US Food and Drug Administration (FDA), other tyrosine kinase inhibitors (TKI) have been successively used for treating patients with advanced RCC. Pazopanib is the newest, orally bioavailable, and multi-targeted TKI, and is considered a first-line treatment option for certain patients. This review summarizes updated clinical studies, mechanism of action, and pharmacokinetics… More >

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Open Access

REVIEW

Deb Feldman-Stewart^1,2, Michael D. Brundage^1,2,3, Christine Tong¹
Canadian Journal of Urology, Vol.18, No.6, pp. 5998-6006, 2011
Abstract Introduction: We conducted a systematic review of primary evidence to clarify what information influences treatment selection by patients with early stage prostate cancer.
Materials and methods: We conducted a systematic review of the Web of Knowledge, using the ALL DATABASES option. Papers were then triaged out on the basis of the title and/or abstract, leaving 120 papers. Reviewing the full papers resulted in a final corpus of 21 papers.
Results: The data suggest that patients typically balance potential benefits against potential side effects but in a complex way with large variation across patients. For some patients, potential benefits… More >

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Open Access

ARTICLE

Nicolas B. Delongchamps¹, Grégoire Robert², Alexandre de la Taille³, Olivier Haillot⁴, Charles Ballereau⁵, Christian Saussine⁶, François Kleinclauss⁷, Abdel-Rahmène Azzouzi⁸, Bertrand Lukacs⁹, Olivier Dumonceau¹⁰, Marc Fourmarier¹¹, Marian Devonec¹², Aurélien Descazeaud¹³
Canadian Journal of Urology, Vol.18, No.6, pp. 6007-6012, 2011
Abstract Introduction: To compare postoperative outcomes of patients on oral anticoagulation (OA) treated with transurethral plasma vaporization of the prostate in saline water (TUVis) and transurethral resection of the prostate (TURP).
Materials and methods: Between January and December 2009, 111 patients on OA therapy were treated with either TURP or TUVis in eight centers. Types of OA and perioperative management were collected. Postoperative outcomes were statistically compared between the two groups.
Results: A total of 57 (51%) and 54 (49%) patients were treated with TURP and TUVis, respectively. Types of OA were not significantly different between the two groups,… More >

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ARTICLE

Jack M. Zuckerman, Britton Tisdale, Kurt McCammon
Canadian Journal of Urology, Vol.18, No.6, pp. 6013-6017, 2011
Abstract Introduction: This study aims to evaluate the complication rate and efficacy of the AdVance sling (American Medical Systems, Minnetonka, MN, USA) in patients with stress urinary incontinence (SUI) and a history of pelvic radiation.
Materials and methods: A retrospective chart review was conducted of all men at our institution with a history of prostate cancer and subsequent radiation therapy who were treated with an AdVance sling for SUI.
Results: Between 2007 and 2009, the AdVance sling procedure was performed in 27 patients with prior pelvic radiation therapy. The mean patient age was 73.2 years. At an average follow-up… More >

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ARTICLE

Pim J. van Leeuwen, Roderick C. N. van den Bergh, Tineke Wolters, Xiaoye Zhu, Meelan Bul, Fritz H. Schröder, Chris H. Bangma, Monique J. Roobol
Canadian Journal of Urology, Vol.18, No.6, pp. 6018-6024, 2011
Abstract Introduction: The value of characteristics assessed prior to diagnosis in predicting aggressive prostate cancer, metastases, and mortality in men participating in a screening study were identified.
Materials and methods: This study included 19,950 men aged 55 to 74 years at first screening in the European Randomized Study of Screening for Prostate Cancer. Factors such as age, Charlson comorbidity index, family history of prostate cancer, vasectomy status, International Prostate Symptom Score (IPSS), digital rectal examination (DRE) status, transrectal ultrasound (TRUS) findings, prostate volume, and prostate-specific antigen (PSA) level were evaluated. Participants were followed for a median of 11.1… More >

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ARTICLE

Sarfraz Ahmad, Rustom Pervez Manecksha, Ivor Michael Cullen, Robert Joseph Flynn, Thomas Eugene Dermott McDermott, Ronald Grainger, John Alan Thornhill
Canadian Journal of Urology, Vol.18, No.6, pp. 6025-6030, 2011
Abstract Introduction: Reliable quantification of prostate volume is important to correctly select patients with benign prostatic hyperplasia (BPH) most likely to benefit from medical therapy [e.g. 5 alpha-reductase inhibitors (5-ARIs)] and in selecting appropriate surgical approach. We aim to determine the reliability of digital rectal examination (DRE) in estimation of prostate volume which may be helpful in patient selection for 5-ARIs therapy.
Materials and methods: Patients requiring transrectal ultrasound (TRUS) guided prostate biopsy were recruited in this prospective study. DRE was performed twice for each patient. Clinicians categorized prostate volume on DRE into small, medium and large, and… More >

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ARTICLE

Gina M. Badalato¹, Matthew S. Wosnitzer¹, Matthew D. Truesdale¹, Marco Sandri², Woo Jin Ko¹, Jaime Landman¹, Ketan K. Badani¹
Canadian Journal of Urology, Vol.18, No.6, pp. 6031-6036, 2011
Abstract Introduction: Bioimpedance spectroscopy (BIS) is a novel, precise quantification of body composition (BC) using low electrical currents through tissue. Accurate BC quantification may better predict postoperative outcomes. We compared BIS-BC and body mass index (BMI) for correlation with post-surgical outcomes in robotic assisted radical prostatectomy (RARP) patients.
Materials and methods: Preoperative BIS-BC and BMI analyses were conducted on men with biopsy-proven prostate cancer undergoing RARP. Height, weight, percentage and fat mass (PFM, FM), percentage and fat-free mass (PFFM, FFM), percentage and total body water (PTBW, TBW), and percentage and intracellular/extracellular water (PICW, PECW, ICW, ECW) were obtained… More >

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MINIMALLY INVASIVE AND ROBOTIC SURGERY

Dean S. Elterman^1,2, Jack Barkin^1,3, Sidney B. Radomski¹, Neil E. Fleshner¹, Brian Liu¹, Kira Bensimon¹, Samantha Arora¹, Michael Robinette¹, Antonio Finelli¹
Canadian Journal of Urology, Vol.18, No.6, pp. 6037-6042, 2011
Abstract Introduction: High-intensity focused ultrasound (HIFU) is a non-invasive technique that uses focused ultrasound waves to ablate tissue. This retrospective study evaluates the early HIFU experience at a single Canadian center.
Materials and methods: Ninety-five patients were treated between March 2006 and December 2007 using the Sonablate 500 device (Focus Surgery, Indianapolis, IN, USA). Follow-up was conducted at 3-month intervals and included serial prostate-specific antigen (PSA) measurements, assessment of erectile function using the International Index of Erectile Function (IIEF), and evaluation of continence rates using the Expanded Prostate Cancer Index Composite (EPIC) questionnaire. Early and late complications were… More >

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MINIMALLY INVASIVE AND ROBOTIC SURGERY

Jonathan N. Warner¹, Rafael N. Nunez¹, Chinedu O. Mmeje¹, Thomas V. Colby², Robert G. Ferrigni¹, Mitchell R. Humphreys¹, Paul E. Andrews¹, Erik P. Castle¹
Canadian Journal of Urology, Vol.18, No.6, pp. 6043-6049, 2011
Abstract Introduction: We evaluate the impact of margin length, location, and pathologic stage on biochemical recurrence (BCR) after robot assisted radical prostatectomy (RARP) at 37 months of follow up.
Materials and methods: A total of 1420 patients underwent a robot assisted radical prostatectomy between March 2004 and May 2010. Patients who received adjuvant therapy, those who never achieved an undetectable prostate-specific antigen (PSA), and those who had less than 18 months of follow up were excluded. Patients were then divided and evaluated based on margin status.
Results: In total, 419 patients were included in the analysis. Eighty-three had a… More >

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HOW I DO IT

Faisal Ahmed, Tiffany Sotelo
Canadian Journal of Urology, Vol.18, No.6, pp. 6050-6053, 2011
Abstract Symptomatic pelvic organ prolapse can afflict up to 10% of women. Urinary incontinence, voiding dysfunction or difficulty possibly related to bladder outlet obstruction are common symptoms. Infrequently hydronephrosis or defecatory dysfunction can be seen. The management of pelvic organ prolapse (POP) should start with adequate assessment of all pelvic floor complaints. If a patient is not symptomatic, surgical intervention is usually not indicated. While the use of a variety of graft materials are available today including porcine, dermal and synthetic grafts, that are used in some surgical approaches to pelvic organ prolapse, other more conservative More >

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CLINICAL TRIALS

Eric Winquist, George Rodrigues
Canadian Journal of Urology, Vol.18, No.6, pp. 6054-6059, 2011
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RESIDENT’S CORNER

Ke Jia Teo, Chin Tiong Heng, David Consigliere, Ho Yee Tiong
Canadian Journal of Urology, Vol.18, No.6, pp. 6060-6063, 2011
Abstract The authors describe a case of iatrogenic right ureteric injury post duodenectomy and right hemi-colectomy. Renal autotransplantation was chosen as the treatment for the upper ureteric injury. This was successfully performed and the renal function of the transplanted kidney was subsequently preserved. The advantages and disadvantages of this approach are discussed. More >

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RESIDENT’S CORNER

Dock Winston¹, Jennifer K. Yates², Ravi Munver^1,2, Debra Fromer^1,2
Canadian Journal of Urology, Vol.18, No.6, pp. 6064-6065, 2011
Abstract Nephrogenic adenomas are rare benign lesions of the urinary tract occurring most frequently in the bladder of male patients. We report the case of a female patient presenting with gross hematuria, which lateralized to the left ureter on cystoscopy. At the time of ureteroscopy, two polypoid lesions were identified in an upper and lower pole calyx, which were found on biopsy to be nephrogenic adenomas. In addition to reporting this case, we review the literature for the pathophysiology of nephrogenic adenomas. More >

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RESIDENT’S CORNER

Ankur Gupta¹, Mohan Biyani¹, Mudit Gupta², Marc Eric Saltel³
Canadian Journal of Urology, Vol.18, No.6, pp. 6066-6068, 2011
Abstract Urinary bladder rupture associated with severe hypercreatinemia is a rare clinical presentation. We herein report a 60-year-old interesting patient who was found to have intraperitoneal bladder rupture and pseudo-renal failure. High rate of suspicion and timely diagnosis is the key in management of this condition, which led to complete recovery in our patient. More >

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