Open Access

EDITORIAL

Leonard G. Gomella
Canadian Journal of Urology, Vol.20, No.1, pp. 6592-6592, 2013
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LEGENDS IN UROLOGY

William L. Parry
Canadian Journal of Urology, Vol.20, No.1, pp. 6593-6596, 2013
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Open Access

ARTICLE

Christopher Whelan¹, Laura Crocitto¹, Mark Kawachi¹, Kevin Chan¹, David Smith², Timothy Wilson¹, Steven Smith^1,3
Canadian Journal of Urology, Vol.20, No.1, pp. 6597-6602, 2013
Abstract Introduction: In patients with prostate cancer, luminal prostate-specific antigen (PSA) enters the circulation because the basement membrane and glandular epithelium are damaged. Given that excess mobilization of prostate cells during prostatic massage can influence normalization in diagnostic testing, we studied PSA mRNA levels in expressed prostatic secretions (EPS) from patients undergoing biopsy for prostate cancer to determine if prostate cells are preferentially mobilized from patients with prostate cancer during prostatic massage.
Materials and methods: Quantitative Reverse-Transcription PCR (qRT-PCR) was used to measure the RNA levels of GAPDH, PSA, TMPRSS2:ERG and PCA3 in EPS specimens obtained from patients… More >

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Open Access

ARTICLE

Jack M. Zuckerman, Bijan Shekarriz, Jyoti Upadhyay
Canadian Journal of Urology, Vol.20, No.1, pp. 6603-6606, 2013
Abstract Introduction: Continuous urinary incontinence in female patients can be a diagnostic dilemma if traditional imaging fails to identify a source. Vaginography has been used to diagnose vaginal ectopic ureters in the past with mixed results.
Materials and methods: Institutional review board approval was obtained for a retrospective review. Five teenage females with continuous incontinence and prior negative imaging work ups underwent high pressure vaginography. Their findings and treatment outcomes are reviewed.
Results: A vaginal ectopic ureter was diagnosed in each of the five patients at a mean age 15.8 years. Each had undergone prior magnetic resonance urography that More >

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ARTICLE

Peter M. Grin^1,2, Paulina M. Kowalewska³, Waleed Alhazzani¹, Alison E. Fox-Robichaud^1,2
Canadian Journal of Urology, Vol.20, No.1, pp. 6607-6614, 2013
Abstract Introduction: Urinary tract infections (UTIs) are the most common infections affecting women, and often recur. Lactobacillus probiotics could potentially replace low dose, long term antibiotics as a safer prophylactic for recurrent UTI (rUTI). This systematic review and meta-analysis was performed to compile the results of existing randomized clinical trials (RCTs) to determine the efficacy of probiotic Lactobacillus species in preventing rUTI.
Materials and methods: MEDLINE and EMBASE were searched from inception to July 2012 for RCTs using a Lactobacillus prophylactic against rUTI in premenopausal adult women. A random-effects model meta-analysis was performed using a pooled risk ratio,… More >

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ARTICLE

Daniel S. McPartlin^1,2, Adam P. Klausner^1,2, Charles U. Nottingham¹, Jeffrey P. Wolters¹, Albert Petrossian¹, Laura R. Carucci³, B. Mayer Grob^1,2
Canadian Journal of Urology, Vol.20, No.1, pp. 6615-6619, 2013
Abstract Introduction: The purpose of this study was to evaluate the yield of cystoscopy in detecting bladder malignancy following incidentally identified bladder wall thickening observed on computed tomography (CT) scans.
Methods and materials: Data from 3000 consecutive patients who underwent diagnostic cystoscopy at a single institution from 2006-2009 were collected retrospectively. All prior CT scan reports were reviewed, and patients whose sole indication for cystoscopy was incidentally detected bladder wall thickening were identified. Patients were categorized as diffuse thickening, focal thickening, or focal bladder mass based on the radiologist's report. Collected data included patient age, gender, race, smoking… More >

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ARTICLE

Pietro Pepe, Francesco Aragona
Canadian Journal of Urology, Vol.20, No.1, pp. 6620-6624, 2013
Abstract Introduction: To evaluate Prostate Cancer Prevention Trial (PCPT) risk calculator versus prostate cancer gene 3 (PCA3) score versus case-finding protocol accuracy in prostate cancer diagnosis in patients with prostate-specific antigen (PSA) below 10 ng/mL submitted to repeat saturation biopsy (SPBx).
Materials and methods: From December 2010 to December 2011, 100 patients (median 66 years) underwent a SPBx (median 30 cores); the indications for repeat biopsy were those of a case-finding protocol: PSA values between 4.1 ng/mL-10 ng/mL or 2.6 ng/mL-4 ng/mL with F/T PSA ≤ 25% and ≤ 20%, respectively. All patients had negative digital rectal examination… More >

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COMMENTARY

Kevin C. Zorn, Mounsif Azizi
Canadian Journal of Urology, Vol.20, No.1, pp. 6625-6625, 2013
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ARTICLE

Michael Metcalfe¹, Eric Estey², Niels-Erik Jacobsen², Don Voaklander³, Adrian S. Fairey²
Canadian Journal of Urology, Vol.20, No.1, pp. 6626-6631, 2013
Abstract Introduction: We examined the association between type of urinary diversion and quality of life (QoL) in patients who underwent radical cystectomy for primary bladder cancer using a validated, disease-specific instrument.
Materials and methods: A cohort of 314 consecutive patients treated with radical cystectomy and urinary diversion for primary bladder cancer between January 2000 and December 2006 was analyzed. Participants were mailed the validated Functional Assessment of Cancer Therapy–Vanderbilt Cystectomy Index (FACT-VCI) questionnaire. Univariable and multivariable linear regression analyses were used to examine the association between type of urinary diversion (ileal conduit versus orthotopic neobladder) and QoL.
Results: Eighty-four… More >

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COMMENTARY

Daniel J. Canter
Canadian Journal of Urology, Vol.20, No.1, pp. 6632-6632, 2013
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ARTICLE

Tal Ben-Zvi¹, Pierre-Alain Hueber¹, Firas Abdollah², Daniel Liberman¹, Naeem Bhojani¹, Gagan Gautam³, Kevin C. Zorn^1,3
Canadian Journal of Urology, Vol.20, No.1, pp. 6633-6639, 2013
Abstract Introduction: To evaluate a hybrid technique involving GreenLight 120W HPS vapor incision tissue removal in prostate glands > 80 cc.
Materials and methods: Vapor incision technique (VIT) was performed in 25 consecutive men with a prostate > 80 cc by a single surgeon from May 2010 until September 2010. VIT involved adenoma incisions at 5 and 7-o'clock positions followed by 3, 9 and 12 o'clock down to the surgical capsule. Side-fire vaporization along the capsule excised transurethral resection of the prostate (TURP) like tissue strips for later retrieval. Functional evaluations were performed at 1 and 3 months.… More >

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RESIDENT’S CORNER

Richard W. Norman¹, Anna Sheridan-Jonah¹, Jennifer Merrimen^1,2, Rekha Gupta^1,2
Canadian Journal of Urology, Vol.20, No.1, pp. 6640-6642, 2013
Abstract We report a rare case of adult granulosa cell tumor of the testis in a 68-year-old man. A case and literature review of the associated clinical features, histopathological characteristics and immunochemistry are presented. The tumor is typically slow growing but has a higher risk of malignancy when > 5 cm. Our patient was disease-free 18 months following a right radical orchiectomy. More >

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RESIDENT’S CORNER

Adam B. Shrewsberry¹, Gabriel L. Sica², Adeboye O. Osunkoya^1,2, Daniel J. Canter¹
Canadian Journal of Urology, Vol.20, No.1, pp. 6643-6645, 2013
Abstract Epithelioid angiomyolipomas, or perivascular epithelioid cell tumors (epithelioid PEComas) of the kidney, are histologically related to renal angiomyolipomas (AMLs). However, in contrast to typical AMLs, this rare tumor can exhibit an aggressive clinical course with approximately 50% of reported cases demonstrating disease progression. In this report, we present a case of a 24-year-old female with a history of stone disease who was incidentally found to have a 9.0 cm right renal mass that was difficult to characterize radiographically preoperatively. The patient underwent a right radical nephrectomy, and pathology revealed a renal epithelioid PEComa. More >

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RESIDENT’S CORNER

Ryan S. Hsi¹, Christopher J. Welty¹, Mathew D. Sorensen¹, Aashiyana F. Koreishi², Hunter Wessells¹
Canadian Journal of Urology, Vol.20, No.1, pp. 6646-6648, 2013
Abstract We report the first known case of concurrent partial cystectomy and cesarean delivery in a pregnant female with bladder pheochromocytoma. A 28-year-old G4P2 female presented at 28 weeks gestation with labile blood pressures requiring three antihypertensive medications. Urinary catecholamines were elevated, and a subsequent MRI showed a 2.6 cm x 3.2 cm bladder wall mass. She underwent combined cesarian section and partial cystectomy at 37 weeks. Fluid resuscitation and vasopressors were required in the immediate postoperative period. While bladder pheochromocytoma with pregnancy is a rare occurrence, concurrent delivery and removal of the bladder tumor can More >

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Open Access

HOW I DO IT

Patrick J. Shenot, J. Ryan Mark
Canadian Journal of Urology, Vol.20, No.1, pp. 6649-6655, 2013
Abstract Overactive bladder is a highly prevalent condition that may have significant impact on quality of life. This condition may be idiopathic or may have a neurogenic etiology. Antimuscarinics have long been the preferred agents for the treatment of this condition. OnabotulinumtoxinA, an injectible agent that prevents presynaptic release of acetylcholine at the neuromuscular junction, has emerged as an important option in the management of patients with urinary incontinence caused by refractory detrusor overactivity. This manuscript describes our technique for performing utilizing this therapy, describes key equipment needed and provides technical tips for avoiding common pitfalls. More >

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MINIMALLY INVASIVE AND ROBOTIC SURGERY

Michael Belsante, Sunshine Murray, Benjamin Dillon, Philippe Zimmern
Canadian Journal of Urology, Vol.20, No.1, pp. 6656-6661, 2013
Abstract Introduction: Use of robotic mesh sacrocolpopexy (RMS) has increased for management of pelvic organ prolapse (POP). We present our experience with mid term follow up.
Materials and methods: A retrospective chart review of consecutive patients who had RMS was performed. Patients underwent history and physical exam including POP-Q classification. In cases of bladder involvement a standing voiding cystourethrogram and urodynamics with vaginal pack reduction of the prolapse were done. Indication for RMS was patient preference, BMI < 30, no prior major abdominal surgery, and age < 80. We utilized Marlex mesh and absorbable polyglactin sutures to anchor… More >

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MINIMALLY INVASIVE AND ROBOTIC SURGERY

L. Spencer Krane, Patrick W. Mufarrij, Theodore B. Manny, Ashok K. Hemal
Canadian Journal of Urology, Vol.20, No.1, pp. 6662-6667, 2013
Abstract Introduction: Partial nephrectomy without renal vascular occlusion has been introduced to improve outcomes in patients undergoing robotic partial nephrectomy (RPN). We prospectively evaluated unclamped RPN at our institution and compared this to other clamping techniques in a non-randomized fashion.
Materials and methods: Ninety-five consecutive patients who successfully completed RPN between June 2010 and October 2011 are included in this analysis. All RPNs were performed by a single surgeon. Clamping technique was artery and vein (AV), artery alone (AO), or unclamped (U), without hypotensive anesthesia. Clamping decision was based on surgeon preference and feasibility of minimizing ischemia. All… More >

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