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ARTICLE

Leonard G. Gomella
Canadian Journal of Urology, Vol.19, No.3, pp. 6238-6238, 2012
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BOOK REVIEW

Peter T. Scardino, W. M Linehan, Michael J. Zelefsky, Nicholas J. Vogelzang, Brian I. Rini, Bernard H. Bochner, Joel Sheinfeld
Canadian Journal of Urology, Vol.19, No.3, pp. 6239-6239, 2012
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LEGENDS IN UROLOGY

Paul H. Lange
Canadian Journal of Urology, Vol.19, No.3, pp. 6240-6242, 2012
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REVIEW

Abhijith Dev Mally, Bishoy Gayed, Timothy Averch, Benjamin Davies
Canadian Journal of Urology, Vol.19, No.3, pp. 6243-6249, 2012
Abstract Introduction: There has been an increased incidence of small renal masses with a majority incidentally discovered in elderly patients or patients with several comorbidities. The historic role of renal biopsy has been limited due to initial concerns about accuracy and safety. This review analyses the current role of percutaneous renal biopsy.
Materials and methods: A comprehensive literature review of PubMed and MEDLINE for reports of percutaneous needle core biopsy and fine needle aspiration of renal tumors that were published from 1977 to 2012.
Results: With the adoption of new biopsy techniques, there is a very low risk of… More >

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ARTICLE

Jeffrey K. Mullins, Phillip M. Pierorazio, Elias S. Hyams, Sally E. Mitchell, Mohamad E. Allaf
Canadian Journal of Urology, Vol.19, No.3, pp. 6250-6254, 2012
Abstract Introduction: We report the outcomes of a small series of patients with refractory chylous ascites following urologic surgery treated with lymphangiography +/- sclerotherapy.
Materials and methods: Retrospective review revealed three patients who underwent lymphangiography for prolonged lymphatic leak following urological surgery. Contrast material is injected slowly into a lymphatic vessel on the dorsum of the foot and serial imaging is used to capture the location and degree of lymphatic leak in order to guide definitive treatment. Demographic and clinical details were collected and are reported.
Results: Three patients were identified from 2005-2008 (one following donor nephrectomy and two… More >

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EDITORIAL COMMENT

Viraj A. Master
Canadian Journal of Urology, Vol.19, No.3, pp. 6255-6255, 2012
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ARTICLE

Neil D’Souza¹, D. Andrew Loblaw¹, Alexandre Mamedov², Linda Sugar³, Lori Holden¹
Canadian Journal of Urology, Vol.19, No.3, pp. 6256-6260, 2012
Abstract Introduction: Estimating the risk of extraprostatic extension and the probability of recurrence with different treatment modalities is common practice in cancer management. A strong predictor of recurrence and organ-confined disease is tumor grade. However, differences exist between genitourinary and non-specialist pathologists in grading prostate cancer. As such, the primary objective of this study was to assess the accuracy of non-specialist prostate cancer biopsies at our institution by analyzing the proportion of cases changing pathologic risk category upon expert review.
Materials and methods: Log books from 2003, where our genitourinary pathologists reviewed prostate needle-core biopsies, were used to… More >

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ARTICLE

Ulf W. Tunn¹, Amulf Stenzl², Wolfgang Schultze-Seemann³, Arne Strauss⁴, Manfred Kindler⁵, Kurt Miller⁶, Manfred P. Wirth⁷, Niko Zantl⁸, Matthias Schulze⁹, Christoph May¹⁰, Amelie Ruebel¹⁰, Katrin Birkholz¹⁰, Viktor Gruenwald¹¹
Canadian Journal of Urology, Vol.19, No.3, pp. 6261-6267, 2012
Abstract Introduction: Approximately 30% of patients with renal cell cancer (RCC) develop bone metastasis, causing skeletal-related events (SREs): pathologic fracture, spinal cord compression, surgery to bone, and radiotherapy. Zoledronic acid demonstrated significant clinical benefit in RCC patients in a retrospective analysis. The primary objective of this prospective study was to evaluate the proportion of patients experiencing ≥ 1 SRE during 12 months of zoledronic acid treatment and to verify the retrospective data.
Materials and methods: Fifty patients with histologically confirmed RCC and evidence of ≥ 1 cancer-related bone lesion, and ≤ 3 prior bisphosphonate applications were enrolled across… More >

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EDITORIAL COMMENT

Shi-Ming Tu, Adrienne H. Chen
Canadian Journal of Urology, Vol.19, No.3, pp. 6268-6268, 2012
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ARTICLE

Stavros Gravas, Kostas Efstathiou, Ioannis Zachos, Michael D. Melekos, Vassilios Tzortzis
Canadian Journal of Urology, Vol.19, No.3, pp. 6269-6273, 2012
Abstract Introduction: To assess the learning curve for fluorescence cystoscopy using hexaminolevulinate hydrochloride (HAL) in patients with bladder cancer.
Material and methods: Fifty patients underwent bladder instillation with HAL. Two senior residents separately inspected the bladder using white light cystoscopy, followed by fluorescence cystoscopy, and mapped the lesions. An experienced photodynamic diagnosis (PDD)-trained urologist also performed both cystoscopies, mapped and resected or cold biopsied suspect lesions under the supervision of another experienced urologist. To evaluate the learning curve, patients were divided into five subgroups: group 1 (patients 1–10), group 2 (11–20), group 3 (21–30), group 4 (31–40), and… More >

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ARTICLE

Stephen Faddegon, Sara L. Best, Ephrem O. Olweny, Yung K. Tan, Samuel K. Park, Saad A. Mir, Jeffrey A. Cadeddu
Canadian Journal of Urology, Vol.19, No.3, pp. 6274-6279, 2012
Abstract Introduction: Growing evidence suggests that phosphodiesterase-5 inhibitors may mitigate ischemia-related renal damage through multiple mechanisms. We evaluated the role of tadalafil in renal function preservation during experimentally induced ischemia/reperfusion injury (IRI) in a solitary kidney porcine model.
Materials and methods: Ten adult female pigs underwent left laparoscopic nephrectomy followed by a 1 week recovery period. They were then randomized to tadalafil versus no treatment prior to cross-clamping the contralateral renal hilum for 90 minutes. The experimental group received 40 mg tadalafil in two equally divided doses, 12 hours before and just prior to surgery. Serum creatinine for… More >

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ARTICLE

Mark S. Soloway, Viacheslav Iremashvili, Michael A. Gorin, Ahmed Eldefrawy, Ramgopal Satyanarayana, Murugesan Manoharan
Canadian Journal of Urology, Vol.19, No.3, pp. 6280-6286, 2012
Abstract Introduction: The objective of this report is to describe the oncologic outcomes of men with margin-positive prostate cancer who were managed expectantly following radical prostatectomy.
Materials and methods: Between January 1992 and January 2011, 2166 men underwent an open radical prostatectomy by a single surgeon. Of these patients, 1592 (74%) had complete data and met the inclusion criteria of negative lymph nodes and no history of neoadjuvant or adjuvant therapy. This cohort was dichotomized by the presence or absence of at least one positive surgical margin. Groups were compared for differences in recurrence-free and overall survival.
Results: In… More >

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ARTICLE

Lenny Radomski¹, Johan Gani², Greg Trottier¹, Antonio Finelli¹
Canadian Journal of Urology, Vol.19, No.3, pp. 6287-6292, 2012
Abstract Introduction: Active surveillance for low risk prostate cancer has become an acceptable management strategy. However, a percentage of these patients in active surveillance move on to active treatment. Our aim was to examine urinary incontinence (UI) rates in men who move on to treatment from active surveillance and compare it to quoted rates in the literature. We examined the question that a potential delay in the treatment of prostate cancer in those on active surveillance may result in an increase in incontinence rates.
Materials and methods: From July 1992 to June 2009, 443 men at our institution… More >

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EDITORIAL COMMENT

Scott Eggener
Canadian Journal of Urology, Vol.19, No.3, pp. 6292-6292, 2012
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ARTICLE

Anup A. Vora, Andrew Harbin, Robert Rayson, Keith Christiansen, Reza Ghasemian, Jonathan Hwang, Mohan Verghese
Canadian Journal of Urology, Vol.19, No.3, pp. 6293-6298, 2012
Abstract Introduction: Radical cystectomy is associated with significant morbidity, with rates of gastrointestinal complications as high as 30%. Alvimopan is a mu opioid receptor antagonist that has been shown in randomized control trials to accelerate gastrointestinal recovery in patients undergoing bowel resection with primary anastamosis. We report our experience with gastrointestinal recovery for patients undergoing cystectomy with urinary diversion treated with alvimopan.
Materials and methods: Between January 2008 and August 2011, 50 consecutive patients underwent radical cystectomy with urinary diversion at our institution. The first 27 patients in our study did not receive alvimopan preoperatively. The latter 23… More >

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EDITORIAL COMMENT

William C. Huang
Canadian Journal of Urology, Vol.19, No.3, pp. 6298-6298, 2012
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RESIDENT’S CORNER

Kelly A. Healy¹, Andrew Margules², Chandan Kundavaram¹, Scott G. Hubosky¹, Costas D. Lallas¹
Canadian Journal of Urology, Vol.19, No.3, pp. 6299-6302, 2012
Abstract Pelvic kidneys are typically asymptomatic, but surgical intervention may be required in select cases.Laparoscopic pelvic nephrectomy is a feasible option. Given the highly variable vascular anatomy, careful surgical planning and meticulous technique are necessary. We present our experience with this minimally invasive approach. A 46-year-old male with a painful, non-functioning left pelvic kidney initially underwent left ureteral stent placement. He was noncompliant and lost to follow up. He re-presented and elected for laparoscopic pelvic nephrectomy. The procedure was performed without complications. Key features included detailed preoperative vascular imaging, ureteral catheterization, optimal port placement, and dissection More >

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RESIDENT’S CORNER

Yu Seob Shin¹, A Ram Doo², Myung Ki Kim¹, Young Beom Jeong¹, Hyung Jin Kim¹
Canadian Journal of Urology, Vol.19, No.3, pp. 6303-6305, 2012
Abstract Peritoneal seeding with no further metastases of prostate cancer is very rare. To the best of our knowledge, there are only three cases reported in the available literature. There has not yet been a report of a patient undergoing robot-assisted laparoscopic radical prostatectomy (RALRP) that might have resulted in peritoneal seeding. We describe a patient who presented with a prostate-specific antigen (PSA) recurrence and who was found to have a solitary metastasis on the liver, 2 years after RALRP. The patient underwent open excision of the mass, which was densely adherent to the liver. Pathologic More >

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RESIDENT’S CORNER

Lindsey A. Herrel¹, Ryan M. Butterworth², Syed M. Jafri¹, Carl Ying¹, Keith A. Delman³, David A. Kooby³, Kenneth E. Ogan¹, Daniel J. Canter¹, Viraj A. Master¹
Canadian Journal of Urology, Vol.19, No.3, pp. 6306-6309, 2012
Abstract Inguinal lymphadenectomy plays a critical role in the diagnosis and treatment of several neoplastic diseases. Frequently, bilateral lymphadenectomy is undertaken for staging and/or treatment of genitourinary cancers. Our objective was to determine if bilateral endoscopic lymphadenectomy could be performed simultaneously, in an effort to decrease overall anesthetic and operative time. This was accomplished by utilizing two carbon dioxide insufflators concurrently. This approach requires careful positioning of the patient, surgical team, and instrumentation, as well as special anesthetic considerations necessary to avoid severe hypercarbia. Simultaneous bilateral endoscopic inguinal lymphadenectomy is a technically feasible and efficient surgical More >

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RESIDENT’S CORNER

Akl C. Fahed¹, Daisuke Nonaka², Jamie A. Kanofsky³, William C. Huang³
Canadian Journal of Urology, Vol.19, No.3, pp. 6310-6313, 2012
Abstract Mucinous cystadenocarcinomas of the urachus are rare. Mucinous benign or premalignant tumors are even rarer, yet pose a challenge in diagnosis and management. We report a case of a 66-year-old man with lower abdominal pain who had a large cystic tumor at the dome of the bladder. En-bloc resection of the tumor with partial cystectomy revealed mucinous cystadenocarcinoma in situ. We reviewed the characteristics of all seven previously reported cases. These tumors are pre-malignant and can cause significant morbidity and mortality. They need to be treated similar to conventional mucinous cystadenocarcinoma by wide surgical resection More >

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HOW I DO IT

Alvaro Morales, Christine P. Collier, Albert F. Clark
Canadian Journal of Urology, Vol.19, No.3, pp. 6314-6318, 2012
Abstract The biochemical diagnosis of male hypogonadism remains a controversial issue. The problem is compounded by the variety of laboratory assays available to measure serum testosterone (T) and the limited understanding, among clinicians, of their relative diagnostic validity. It is widely accepted that only the testosterone not bound to sex hormone-binding globulin is metabolically active. Therefore, for diagnostic purposes, it is common practice to order the measurement of free T (FT) or bioavailable T (BAT).
Our objective is to describe the methods available for measuring FT and to review the literature to determine the relevance of… More >

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CLINICAL TRIALS

George Rodrigues, Eric Winquist
Canadian Journal of Urology, Vol.19, No.3, pp. 6319-6323, 2012
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