Open Access

EDITORIAL

Thomas W. Jarrett
Canadian Journal of Urology, Vol.20, No.6, pp. 6997-6997, 2013
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LEGENDS IN UROLOGY

Robert C. Flanigan
Canadian Journal of Urology, Vol.20, No.6, pp. 6998-7000, 2013
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BOOK REVIEW

Roger R. Dmochowski, Mickey M. Karram, William Stuart Reynolds
Canadian Journal of Urology, Vol.20, No.6, pp. 7001-7001, 2013
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ARTICLE

Hong Truong^1,*, Jennifer Logan^1,*, Baris Turkbey², M. Minhaj Siddiqui¹, Soroush Rais-Bahrami¹, Anthony N. Hoang¹, Chad Pusateri¹, Brian Shuch¹, Annerleim Walton-Diaz¹, Srinivas Vourganti¹, Jeffrey Nix¹, Lambros Stamatakis¹, Colette Harris¹, Celene Chua¹, Peter L. Choyke², Bradford J. Wood³, Peter A. Pinto^1,3
Canadian Journal of Urology, Vol.20, No.6, pp. 7002-7007, 2013
Abstract Introduction: Prior studies of volumetric effects of 5α-reductase inhibitors (5ARIs) on the prostate have used transrectal ultrasound which provides poor differentiation of prostatic zones. We utilized high-resolution prostate MRI to evaluate the true dynamic effects of 5ARI in men who underwent multiple MRIs.
Materials and methods: A retrospective study of patients who underwent serial 3.0 Tesla prostate MRI from 2007 to 2012 and were treated with 5ARI were studied. Nineteen patients who had a baseline MRI prior to 5ARI initiation and subsequent MRI follow up were selected. A randomly selected group of 40 patients who had not… More >

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ARTICLE

Jesse D. Sammon^1,2,*, Bartosz F. Kaczmarek^1,2,*, Praful Ravi¹, Maxine Sun³, Florian Roghmann³, Shyam Sukumar^1,2, Khurshid Ghani^1,2, Pranav Sharma^1,2, Pierre I. Karakiewicz³, James O. Peabody¹, Jack S. Elder¹, Mani Menon¹, Quoc-Dien Trinh^1,2,4
Canadian Journal of Urology, Vol.20, No.6, pp. 7008-7014, 2013
Abstract Introduction: Though the prevalence of metastatic prostate cancer is decreasing, the rate of admission from the emergency department (ED) is increasing. Little is known about the implications of metastatic site on a patient's ED course and admission.
Materials and methods: A weighted estimate of 15,367 patients with metastatic prostate cancer who presented to the ED between January 1, 2006 and December 31, 2009 was abstracted from the United States Nationwide Emergency Department Sample (NEDS). Descriptive statistics were used to elaborate patient and hospital characteristics of the metastatic prostate cancer population and logistic regression models were fitted to… More >

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ARTICLE

Daniel J. Sadowski¹, Chandy S. Ellimoottil², Ajay Tejwani³, Alex Gorbonos¹
Canadian Journal of Urology, Vol.20, No.6, pp. 7015-7020, 2013
Abstract Introduction: Proton therapy (PT) for prostate cancer is an expensive treatment with limited evidence of benefit over conventional radiotherapy. We sought to study whether online information on PT for prostate cancer was balanced and whether the website source influenced the content presented.
Materials and methods: We applied a systematic search process to identify 270 weblinks associated with PT for prostate cancer, categorized the websites by source, and filtered the results to 50 websites using predetermined criteria. We then used a customized version of the DISCERN instrument, a validated tool for assessing the quality of consumer health information,… More >

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ARTICLE

Nebojsa Ladjevic^1,4, Otas Durutovic^2,4, Ivana Likic-Ladjevic⁴, Natasa Lalic³, Ana Mimic¹, Natasa Dencic¹, Svetlana Sreckovic¹, Zoran Dzamic², Milan Terzic⁴, Aleksandar Vuksanovic^2,4, Dragica Milenkovic-Petronic^2,4
Canadian Journal of Urology, Vol.20, No.6, pp. 7021-7027, 2013
Abstract Introduction: Inflammation plays a key role in the development of benign prostatic hyperplasia. Prostaglandin E2 (PGE2) is an important inflammation factor found in enlarged prostatic tissue that can be the main cause of inflammatory pain. The aim of this study was to investigate whether epidural anesthesia can block the negative effects of prostaglandin mediators during prostate surgery.
Materials and methods: The study included 60 patients who underwent open prostatectomy. All patients were randomly allocated to one of two study groups. The first group received general anesthesia and the second group a combination of general and epidural anesthesia.… More >

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ARTICLE

Ciprian Chira^1,2, Guila Delouya^1,2, Nelson Gruszczynski¹, David Donath^1,2, Daniel Taussky^1,2
Canadian Journal of Urology, Vol.20, No.6, pp. 7028-7034, 2013
Abstract Introduction: To examine the outcome of deferred permanent seed brachytherapy (BT) for localized low or intermediate risk prostate cancer in order to identify predictors of delayed therapy (DT).
Materials and methods: We studied 714 patients treated with BT with or without external radiotherapy. DT was defined as no treatment for > 350 days after the first biopsy with cancer. Factors influencing DT were analyzed. PSA outcome was assessed only in patients with a follow up ≥ 24 months. Patients with DT were compared to patients treated < 350 days using non-parametric tests. Multivariate analysis was performed using… More >

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ARTICLE

Tin C. Ngo¹, Michael P. Hurley², Alan E. Thong¹, Seung Hyun Jeon³, John T. Leppert^1,4, Benjamin I. Chung¹
Canadian Journal of Urology, Vol.20, No.6, pp. 7035-7041, 2013
Abstract Introduction: To identify factors associated with the development of chronic kidney disease (CKD) after nephrectomy and to create a clinical model to predict CKD after nephrectomy for kidney cancer for clinical use.
Materials and methods: We identified 144 patients who had normal renal function (eGFR > 60) prior to undergoing nephrectomy for kidney cancer. Selected cases occurred between 2007 and 2010 and had at least 30 days follow up. Sixty-six percent (n = 95) underwent radical nephrectomy and 62.5% (n = 90) developed CKD (stage 3 or higher) postoperatively. We used univariable analysis to screen for predictors… More >

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ARTICLE

Cynthia P. Leung¹, Adam P. Klausner¹, Joseph R. Habibi¹, Ashley B. King¹, Adam S. Feldman²
Canadian Journal of Urology, Vol.20, No.6, pp. 7042-7045, 2013
Abstract Introduction: Audience response systems (ARS) have not been used to gauge knowledge transfer and retention in the setting of large medical conferences. In this study, we explore the utility of an ARS as an educational tool in the setting of a large urology conference.
Materials and methods: At the 2011 joint meeting of the Mid-Atlantic and New England sections of the American Urological Association, conference attendees were able to use a web-based and cell-phone accessed ARS. At the meeting, six ARS questions were asked during five point-counterpoint debate topics covering areas of prostate cancer, incontinence, pediatrics, stone… More >

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ARTICLE

Jen-Jane Liu, David P. Guo, Harcharan Gill
Canadian Journal of Urology, Vol.20, No.6, pp. 7046-7049, 2013
Abstract Introduction: We reviewed the consultation patterns for difficult urethral catheter placement in tertiary care hospitals and developed a treatment algorithm for this common request.
Materials and methods: We identified all urethral catheter consults obtained by urology residents at three tertiary care hospitals from October 2009 through October 2010. Only consults for inability to place urethral catheter by the referring team were included; hematuria or clot retention were excluded. Patient age, date of consultation, consulting service, prior urologic history, initial number of attempts, and final outcome were recorded.
Results: Eighty-one consults were recorded. Seventy-seven (96%) were male; the median… More >

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ARTICLE

Daniel A. Pérez-Fentes¹, Francisco Gude², Miguel Blanco¹, Rosa Novoa¹, Camilo García Freire¹
Canadian Journal of Urology, Vol.20, No.6, pp. 7050-7059, 2013
Abstract Introduction: The aim of this study is to identify surgical, patient- and stone-related factors predictive of clinical success and complications after percutaneous nephrolithotomy (PCNL).
Materials and methods: We prospectively studied 100 consecutive PCNL procedures. Univariate and multiple regression models were used in order to identify which variables could act as independent predictors of PCNL outcomes. Success was defined as complete absence of fragments in a non-contrast CT. The Clavien-modified grading system was used to classify the complications.
Results: Univariate analysis showed that patients rendered stone-free had a significantly lower stone burden, shorter operating times, single stones and non-struvite… More >

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RESIDENT’S CORNER

Samantha Low¹, Maleeha Azim¹, Elaine Wan², Vimal Hariharan²
Canadian Journal of Urology, Vol.20, No.6, pp. 7060-7063, 2013
Abstract Simple renal cysts are most commonly found in the elderly, male population. The majority of simple renal cysts remain untreated, except on the rare occasion when they become complicated with hemorrhage, infection, or rupture.
We present the case of a 31-year-old female with a simple renal cyst which was initially treated as acute pyelonephritis. A high clinical suspicion led to the diagnosis of an infected renal cyst, which was treated with antibiotic therapy and radiological drainage. There were minimal complications, and the patient made an uneventful recovery. More >

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RESIDENT’S CORNER

Robert J. Hartman, Jr.¹, Brian T. Helfand², William W. Lin²
Canadian Journal of Urology, Vol.20, No.6, pp. 7064-7066, 2013
Abstract Retroperitoneal fibrosis (RPF) is a rarely occurring disease process characterized by the development of fibrous plaques that encase retroperitoneal organs and major vessels. The most common sequelae is obstructive uropathy secondary to ureteral compression. Ureterolysis with intraperitoneal transposition and omental wrapping has historically been a popularized means to relieve ureteral obstruction. We present the case of a 47-year-old man with bilateral hydronephrosis secondary to RPF. Due to insufficient length of omentum, we report the first documented use of SurgiWrap to wrap the ureters to minimize the future possibility of recurrent/continued fibrosis, compression, and ureteral obstruction. More >

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RESIDENT’S CORNER

Zulfiqar Butt¹, Jack Slatnik², Eric P. Estey¹
Canadian Journal of Urology, Vol.20, No.6, pp. 7067-7069, 2013
Abstract Angiomyofibroblastoma (AMF) is a rare benign tumor of the female genital tract. Three cases of AMF-like tumors of the male genital tract have been reported in the literature. We present the first documented case of an AMF-like soft tissue tumor of the male pelvis excised with robotic assisted laparoscopic surgery. More >

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RESIDENT’S CORNER

Austin D. DeRosa¹, Kevin G. Baldie¹, Adeboye O. Osunkoya², John G. Pattaras^1,3
Canadian Journal of Urology, Vol.20, No.6, pp. 7070-7072, 2013
Abstract Hemangiopericytomas are rare mesenchymal lesions arising from pericytes within the walls of capillaries. They often have an unpredictable course. We present a case of a large retroperitoneal hemangiopericytoma in a 65-year-old woman who initially presented with upper gastrointestinal discomfort. Following exptirpative surgery, pathology was consistent with hemangiopericytoma of low malignant potential. Widespread metastasis was discovered on follow up imaging, 17 months following surgery. To our knowledge, this is the first case report demonstrating a primary retroperitoneal hemangioperictoma with confirmed metastases. More >

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HOW I DO IT

Roger F. Valdivieso, Pierre-Alain Hueber, Kevin C. Zorn
Canadian Journal of Urology, Vol.20, No.6, pp. 7073-7078, 2013
Abstract The introduction of the “da Vinci Robotic Surgical System” (Intuitive Surgical, Sunnyvale, CA, USA) has been an important step toward a minimally invasive approach to radical prostatectomy. Technological peculiarities, such as three-dimensional vision, wristed instrumentation with seven degrees of freedom of motion, lack of tremor, 10x magnification, and a comfortable seated position for the surgeon, have added value to the procedure for both the surgeon and the patient. In this article, we describe the 9-step surgical technique for robot-assisted radical prostatectomy (RARP) that is currently used in our institution (University of Montreal Hospital Center (CHUM) More >

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MINIMALLY INVASIVE AND ROBOTIC SURGERY

Solomon L. Woldu, Trushar Patel, Edan Y. Shapiro, Ari M. Bergman, Ketan K. Badani
Canadian Journal of Urology, Vol.20, No.6, pp. 7079-7083, 2013
Abstract Introduction: There are many concerns expressed by urologists performing robotic assisted laparoscopic prostatectomy (RALP) regarding management of the dorsal vein complex (DVC). We sought to examine the influence of delayed DVC ligation versus standard DVC ligation on the apical surgical margin status and other key surgical parameters following RALP.
Materials and methods: The Columbia University Urologic Oncology Database was retrospectively reviewed to identify patients who underwent RALP between 2008-2011. Operative records were analyzed to determine whether the DVC was ligated in the 'standard' or 'delayed' manner. The standard group had the DVC ligated prior to the apical… More >

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MINIMALLY INVASIVE AND ROBOTIC SURGERY

Kyrollis Attalla¹, Syed Johar Raza¹, Shabnam Rehman¹, Rakeeba Din¹, Andrew Stegemann¹, Erinn Field¹, Leslie Curtin¹, Sandra Sexton¹, Marlene Bienko¹, Mahendra Bhandari², Khurshid A. Guru¹
Canadian Journal of Urology, Vol.20, No.6, pp. 7084-7090, 2013
Abstract Introduction: Robot-assisted surgery (RAS) has been integrated into the surgical armamentarium and generated wide-spread interest among practicing, non-robotic surgeons (NRS). While methods for training novice NRS have emerged, the effectiveness of these training programs has endured minimal scrutiny. This study aims to establish effectiveness of the RAS training (RAST) program.
Materials and methods: A formal RAST program was established at Roswell Park Cancer Institute (RPCI) in 2008. From July 2010 to October 2012, 43 NRS participated in the program. The 1 to 4 week program included the validated fundamental skills of robotic surgery (FSRS) curriculum, hands-on bedside… More >

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