Open Access

EDITORIAL

Leonard G. Gomella
Canadian Journal of Urology, Vol.20, No.5, pp. 6888-6888, 2013
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LEGENDS IN UROLOGY

Andrew V. Schally
Canadian Journal of Urology, Vol.20, No.5, pp. 6889-6892, 2013
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REVIEW

Louise C. McLoughlin, Niall F. Davis, Catherine Dowling, Molly P. Eng, Richard E. Power
Canadian Journal of Urology, Vol.20, No.5, pp. 6893-6896, 2013
Abstract Introduction: Ureteral diverticulum is a rare urological condition with only 45 cases described in the literature. These previously reported cases vary in their presentation, diagnosis and management and there is no consensus in the literature on the best diagnostic tool available. We describe our experience on diagnosing and managing this condition in two patients and provide a descriptive review of the current literature on ureteral diverticulum.
Materials and methods: A Medline search was performed to identify all reported cases of ureteral diverticulum. Key words used were: ureteral diverticulum; abortive bifid ureter; congenital diverticulum; acquired diverticulum. We also… More >

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ARTICLE

Priya N. Werahera^1,2, E. David Crawford³, Francisco G. La Rosa¹, Kathleen C. Torkko¹, Beth Schulte⁴, Holly T. Sullivan¹, Adrie van Bokhoven¹, M. Scott Lucia¹, Fernando J. Kim⁴
Canadian Journal of Urology, Vol.20, No.5, pp. 6897-6906, 2013
Abstract Introduction: Prostate biopsies are usually taken from the peripheral rather than anterior region of the prostate. Consequently, tumors originating from the anterior apical region and transition zones may be under-sampled. We examined whether addition of transrectal anterior biopsy (TAB) would improve efficacy of prostate biopsies.
Materials and methods: Simulations of TAB and sextant biopsy (SB) were performed using computer models of 86 autopsy prostates (AP) and 40 radical prostatectomy (RP) specimens. TAB was obtained bilaterally from apex, mid, and base regions by advancing the biopsy needle 5 mm-35 mm beyond the prostatic capsule. A phase I clinical… More >

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ARTICLE

Nathan A. Bockholt¹, Eric M. DeRoo¹, Kenneth G. Nepple¹, Joseph M. Modrick², Mark C. Smith², Bernard Fallon¹, A. Curtis Hass², Chad R. Tracy¹, James A. Brown¹
Canadian Journal of Urology, Vol.20, No.5, pp. 6907-6912, 2013
Abstract Introduction: We report the first 100 patients who underwent prostate brachytherapy as monotherapy with 125I at an institution with moderate volume radical prostatectomy but low volume brachytherapy (< 2 cases per month). Learning curve and quality improvement was assessed by way of achieving prescription dose targets.
Materials and methods: From May 2002 to August 2006, 100 patients underwent prostate 125I brachytherapy monotherapy via preplanned approach. Preoperative planned dose to 100% of prostate gland (D100) was 145 Gy and postoperative confirmed dose was assessed by computed tomography. The cohort was divided into quartiles and recurrence was assessed using… More >

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COMMENTARY

Xinglei Shen¹, Timothy N. Showalter²
Canadian Journal of Urology, Vol.20, No.5, pp. 6913-6914, 2013
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ARTICLE

Daniel J. Canter¹, Katherine Mallin², Robert G. Uzzo³, Brian L. Egleston³, Jay Simhan³, John Walton³, Marc C. Smaldone³, Viraj A. Master¹, Gennady Bratslavsky⁴, Alexander Kutikov³
Canadian Journal of Urology, Vol.20, No.5, pp. 6915-6921, 2013
Abstract Introduction: To assess the impact of size at presentation in patients with adrenocortical carcinoma (ACC) on rates of synchronous metastatic disease and survival following resection using a large administrative dataset.
Materials and methods: We queried the National Cancer Database (NCDB) dataset to assemble a cohort of patients with ACC based on SEER staging (1985-2000). Patients were stratified into three groups based on surgical tumor size cutoffs: < 4 cm, 4 cm-6 cm, and > 6 cm. Rates of metastatic disease at presentation in all ACC patients as well as relative survival for patients after resection of localized… More >

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ARTICLE

Jessica N. Lange¹, Linda Easter¹, Robert Amoroso¹, Debra Benfield¹, Patrick W. Mufarrij², John Knight³, Ross P. Holmes³, Dean G. Assimos³
Canadian Journal of Urology, Vol.20, No.5, pp. 6922-6926, 2013
Abstract Introduction: Certain dietary modifications limit the risk of stone recurrence. Compliance is an important component of dietary therapy for stone prevention, and self-efficacy is an important ingredient of compliance. We developed an internet program to facilitate dietary compliance for stone prevention and performed a pilot study to assess its effectiveness.
Materials and methods: The internet program provides information regarding dietary modifications including increased fluid consumption, limited animal protein, sodium, and oxalate intake, and adequate calcium consumption. Participants record their daily food and fluid intake and receive immediate feedback as to whether they were compliant or not. Five… More >

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ARTICLE

Gwen M. Grimsby, Mark D. Tyson, Christopher E. Wolter
Canadian Journal of Urology, Vol.20, No.5, pp. 6927-6932, 2013
Abstract Introduction: To compare the outcome of single incision and retropubic midurethral slings when performed with and without concomitant repair of pelvic organ prolapse (POP).
Materials and methods: A retrospective chart review was conducted of all midurethral slings performed with and without concomitant POP repair by a single provider from September 2008 to April 2010. Prolapse was repaired transvaginally with light-weight polypropylene mesh or robotically via sacrocolpopexy based on the nature of the prolapse and surgeon preference. Success of the sling procedure was defined as complete resolution of leakage or great improvement of leakage based on the Patient… More >

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ARTICLE

Matthew A. Morgan¹, Nathan R. Roberts², Laura A. Pino¹, Edouard J. Trabulsi^2,3, Daniel B. Brown^1,3, Leonard G. Gomella^2,3, Costas D. Lallas^2,3
Canadian Journal of Urology, Vol.20, No.5, pp. 6933-6937, 2013
Abstract Introduction: Partial nephrectomy has a 3%-4% incidence of local treatment failure. This study is to present a series of percutaneous cryoablation for locally recurrent renal cell carcinoma after partial nephrectomy.
Materials and methods: Five consecutive patients were referred to our quaternary center’s multidisciplinary Small Renal Mass (SRM) Center for assessment after failure of partial nephrectomy. Tumor size and location was noted. CT-guided cryoablation was performed using an argon/helium-based system (Healthtronics, Austin, Texas, USA). Patients were admitted overnight for observation. Patients were followed with serial imaging, laboratory tests and examination at our SRM Center. Tumor size, location, and… More >

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COMMENTARY

Jay D. Raman
Canadian Journal of Urology, Vol.20, No.5, pp. 6938-6938, 2013
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ARTICLE

Rachel A. Moses¹, Lawrence M. Dagrosa¹, Elias S. Hyams¹, Peter L. Steinberg², Vernon M. Pais¹
Canadian Journal of Urology, Vol.20, No.5, pp. 6939-6943, 2013
Abstract Introduction: The purpose of this study is to evaluate predictors of poor compliance after treatment of urinary stone disease.
Materials and methods: This study was a retrospective analysis of patients who underwent stent removal following percutaneous nephrolithotomy (PCNL) or ureteroscopy (URS) between 2008-2012. All patients were scheduled for follow up evaluation and renal ultrasound at 4-6 weeks following stent removal. Patients were stratified based on appointment compliance and demographic variables including gender, age, insurance type (Government Assisted Insurance [GAI] or Private Insurance [PI]), initial procedure, season, distance between home and clinic, average monthly gas price at follow… More >

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ARTICLE

Vimoj J. Nair¹, Janos Szanto², Eric Vandervoort², Ilias Cagiannos³, Rodney Breau³, Colin Malone¹, Leonard Avruch⁴, Jason Pantarotto¹, Shawn Malone¹
Canadian Journal of Urology, Vol.20, No.5, pp. 6944-6949, 2013
Abstract Introduction: Stereotactic ablative body radiotherapy (SABR) is currently under study regarding its clinical application in management of patients with kidney tumors. CyberKnife can accurately deliver ablative tumor radiation doses while preserving kidney function. We report Canada's first use of CyberKnife SABR system in treating primary kidney tumors.
Materials and methods: Between January 2011 and February 2012, we treated three patients with renal tumors using CyberKnife SABR. Two patients had tumors in solitary kidney. The third patient had a recurrent tumor after two previous radiofrequency ablation treatments. Platinum seed fiducials were used for real time tumor tracking. Magnetic… More >

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COMMENTARY

Lee E. Ponsky
Canadian Journal of Urology, Vol.20, No.5, pp. 6950-6950, 2013
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PEDIATRIC UROLOGY

Ahmed S. Safwat¹, Hisham M. Hammouda¹, Adel A. Kurkar¹, Nabil K. Bissada²
Canadian Journal of Urology, Vol.20, No.5, pp. 6951-6955, 2013
Abstract Introduction: To evaluate the outcome of bilateral laparoscopic Fowler-Stephens orchidopexy (BLFSO) for bilateral intra-abdominal testes.
Materials and methods: Prospectively, all patients with bilateral intra-abdominal testes between 2006 and 2010 were included in this study. Patients’ data were analyzed for age, procedure whether single stage or staged Fowler-Stephens, intraoperative and postoperative complications, and follow-up results.
Results: BLFSO was performed in a total of 48 testes in 24 boys with a median age of 31.6 months (range 12 to 150). All procedures were performed on an outpatient basis. Of the 24 boys, six were managed with a single stage BLFSO. More >

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COMMENTARY

Lane S. Palmer
Canadian Journal of Urology, Vol.20, No.5, pp. 6956-6956, 2013
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HOW I DO IT

Roger F. Valdivieso, Pierre-Alain Hueber, Kevin C. Zorn
Canadian Journal of Urology, Vol.20, No.5, pp. 6957-6961, 2013
Abstract Radical prostatectomy remains the standard treatment for long term cure of clinically localized prostate cancer, offering excellent oncologic outcomes, with cancer-specific survival approaching 95% at 15 years after surgery. The introduction of the “da Vinci Robotic Surgical System” (Intuitive Surgical, Sunnyvale, CA, USA) has been another important step toward a minimally invasive approach to radical prostatectomy. Technologic peculiarities, such as three-dimensional vision, wristed instrumentation with seven degrees of freedom of motion, lack of tremor, a 10x-magnifcation and a comfortable seated position for the surgeon has added value to the surgeon and patient. In this frst More >

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RESIDENT’S CORNER

Fahad Alyami, Jeffrey Himmelman, Thomas Whelan
Canadian Journal of Urology, Vol.20, No.5, pp. 6962-6963, 2013
Abstract A search of the literature finds that there have been many case reports documenting a wide array of objects found within the bladder, ranging from magnets and paper clips to telephone and aluminum wire. The goal of treatment is to remove the object quickly, using the least invasive method possible. Therefore, the ideal treatment is removal through endoscopic means; however, in some cases, the size, mobility and shape of the foreign body can prevent its removal endoscopically and more invasive means must be employed. We present a case of a patient who inserted 150 magnetic More >

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RESIDENT’S CORNER

Heather J. Chalfin, Grzegorz T. Gurda, Hans-Joerg Hammers, George J. Netto, Trinity J. Bivalacqua
Canadian Journal of Urology, Vol.20, No.5, pp. 6964-6967, 2013
Abstract Small renal cell carcinoma (RCC) tumors are believed to have a negligible risk of metastasis. We report on a 77-year-old man presenting with extremity weakness who was found to have a 2.5 cm brain metastasis from a subsequently discovered 1.6 cm clear cell RCC primary tumor. We review what is known about synchronous and metachronous metastasis from small renal tumors and prognostic features informing treatment for such lesions. More >

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RESIDENT’S CORNER

Michael W. Sourial¹, Nicole van Rossum², Robert Sabbagh¹
Canadian Journal of Urology, Vol.20, No.5, pp. 6968-6970, 2013
Abstract We herein report the case of a left adrenal lymphangioma in a 52-year-old asymptomatic female and review the pertinent literature relatable to this rare, benign lesion. More >

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RESIDENT’S CORNER

Patrick A. Cockerill, Mitra R. de Cógáin, Amy E. Krambeck
Canadian Journal of Urology, Vol.20, No.5, pp. 6971-6973, 2013
Abstract Several medications or their metabolites have been associated with urolithiasis, although overall they remain an infrequent cause of urolithiasis. Guaifenesin stones were originally reported as complexed with ephedrine, and subsequent reports have demonstrated pure guaifenesin stones, occurring after long term abuse. We report a case of a 23-year-old male who ingested a large, one time dose of guaifenesin, resulting in acute bilateral ureteral obstruction, which, to our knowledge, is the frst such reported case in the literature. More >

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RESIDENT’S CORNER

Xiaolong S. Liu¹, Portia A. Kreiger², Sharon W. Gould³, Jennifer A. Hagerty¹
Canadian Journal of Urology, Vol.20, No.5, pp. 6974-6977, 2013
Abstract Congenital urethral polyps are a rare entity. Most commonly, they present as benign posterior urethral growths in the pediatric male patient. However, reports of urethral polyps in female patients or even those with an anterior urethral location can also be found in the literature. Patients can present with a spectrum of symptoms including dysuria, hematuria, and obstructive type urinary complaints. Diagnosis in these cases includes a combination of medical imaging (e.g. ultrasound, fluoroscopic, CT or MRI), direct endoscopic visualization, and final surgical pathology. Treatment involves surgical removal either via an endoscopic or open approach. More >

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ABSTRACT

Canadian Journal of Urology, Vol.20, No.5, pp. 6978-6996, 2013
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