Open Access

EDITORIAL

Leonard G. Gomella
Canadian Journal of Urology, Vol.22, No.1, pp. 7589-7589, 2015
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LEGENDS IN UROLOGY

Joseph A. Smith
Canadian Journal of Urology, Vol.22, No.1, pp. 7590-7593, 2015
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REVIEW

Theodora Stasinou¹, Andreas Bourdoumis², Peter Owegie², Stefanos Kachrilas², Noor Buchholz², Junaid Masood²
Canadian Journal of Urology, Vol.22, No.1, pp. 7594-7598, 2015
Abstract Introduction: Calcification of the vas deferens and seminal vesicles is a rare condition of unknown incidence. It has been described in association with diabetes, hyperparathyroidism and genitourinary tuberculosis, amongst other conditions. Little is known about the clinical significance and management of this condition. We review the literature in an effort to find answers about an entity that is frequently appreciated as an incidental finding.
Materials and methods: An electronic database search was performed (Medline) using the key words: vas deferens; seminal vesicles; calcification, alone or in combination. Articles were selected according to relevance and quality of… More >

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ARTICLE

Tsz Kin Lee¹, Rodney Henry Breau², Ranjeeta Mallick³, Libni Eapen⁴
Canadian Journal of Urology, Vol.22, No.1, pp. 7599-7606, 2015
Abstract Introduction: The Expanded Prostate Cancer Index Composite (EPIC) is a validated and widely adopted instrument that measures patient quality of life. This study aims to describe and compare patient quality of life in the bowel, urinary, and sexual domains across different prostate cancer treatments.
Materials and methods: A systematic review of English articles published prior to 2012 was conducted. Peer reviewed articles reporting longitudinal EPIC data in a statistically analyzable form with clearly defined time points were included. Articles were assessed by content experts to ensure optimal treatment quality.
Screening of studies and extraction of data… More >

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ARTICLE

Antonio Cusano, Peter Haddock, Ilene Staff, Max Jackson, Fernando Abarzua-Cabezas, Ryan Dorin, Anoop Meraney, Joseph Wagner, Steven Shichman, Stuart Kesler
Canadian Journal of Urology, Vol.22, No.1, pp. 7607-7613, 2015
Abstract Introduction: Urologic malignancies are often diagnosed at an older age, and are increasingly managed utilizing robotic-assisted surgical techniques. As such, we assessed and compared peri-postoperative complication rates following robotic urologic surgery in elderly and younger patients.
Materials and methods: A retrospective analysis of IRB-approved databases and electronic medical records identified patients who underwent robotic-assisted urologic surgery between December 2003-September 2013. Patients were grouped according to surgical procedure (partial nephrectomy, radical cystectomy, radical prostatectomy) and age at surgery (≤74 or ≥75 years old). Associations between age, comorbidities, Charlson comorbidity index (CCI), and patient outcomes were evaluated within… More >

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ARTICLE

Vasan Satya Srini¹, Rahul Kumar Reddy¹, Tamar Shultz², Bela Denes³
Canadian Journal of Urology, Vol.22, No.1, pp. 7614-7622, 2015
Abstract Introduction: Erectile dysfunction (ED) has been shown to be associated with a number of physical conditions and affects not only physical but also psychosocial health. Currently oral, on-demand phosphodiesterase type 5 inhibitors (PDE5i) are preferred first line treatment. Though effective, these drugs have limitations and are associated with significant non-compliance, side effects and do not reverse the underlying pathology. Non-invasive low intensity shockwave therapy (LISWT) has been shown to significantly improve erectile function in men previously PDE5i dependent. We describe our experience and results with this therapy in an Indian population of men with ED. This… More >

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ARTICLE

Chad A. Reichard, Irene Makovey, Daniel A. Shoskes
Canadian Journal of Urology, Vol.22, No.1, pp. 7623-7626, 2015
Abstract Introduction: To identify a cohort of chronic pelvic pain syndrome (CPPS) patients who considered their symptoms completely resolved and analyze their demographics, clinical phenotype, treatments and NIH-Chronic Prostatitis Symptom Index (CPSI) scores.
Materials and methods: We identified 35 CPPS patients who at the follow up, reported their symptoms completely resolved (“cured”). Demographics, UPOINT phenotypes, treatments, and CPSI scores were examined. We also compared these variables to a database of 220 previously evaluated CPPS patients.
Results: Patients ranged in age from 19 to 72 years. Median follow up was 12 months. Mean change in CPSI sub scores before and after… More >

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ARTICLE

Stephan Seklehner^1,2, Melissa A. Laudano¹, Joseph Del Pizzo¹, Bilal Chughtai¹, Richard K. Lee¹
Canadian Journal of Urology, Vol.22, No.1, pp. 7627-7634, 2015
Abstract Introduction: To assess trends in the usage of extracorporeal shockwave lithotripsy (SWL) and ureteroscopy (URS) in the treatment of renal calculi.
Materials and methods: An analysis of the 5% Medicare Public Use Files (years 2001, 2004, 2007 and 2010) was performed to evaluate changes in the use of SWL and URS to treat renal calculi. Patients were identified using ICD-9 (cm) and CPT codes.
Statistical analyses, including the Fisher, χ2 tests, and multivariate logistic regression analysis were performed using SAS 9.3 (SAS Institute Inc., Cary, NC, USA) and SPSS v20 (IBM Corp., Armonk, NY, USA).
Results: The absolute… More >

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ARTICLE

Sergio Faria, Fabio Cury, Luis Souhami
Canadian Journal of Urology, Vol.22, No.1, pp. 7635-7639, 2015
Abstract Introduction: Surgery and luteinizing hormone-releasing hormone (LHRH) analogs are standard androgen deprivation treatments (ADT) for patients with advanced prostate cancer. We performed a phase I study to explore if irradiation to the testes could be used as an alternative to ADT.
Materials and methods: All patients had advanced prostate cancer with normal testosterone levels before treatment and indication for long term castration. Treatment started with one LHRH analog injection (to induce a fast drop of testosterone) followed by irradiation to the whole scrotum. Two fractionation regimens were tested: 17 Gy in 2 fractions, and 24 Gy… More >

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ARTICLE

Neil B. Patel, M. Francesca Monn, Clinton D. Bahler, Chandru P. Sundaram
Canadian Journal of Urology, Vol.22, No.1, pp. 7640-7646, 2015
Abstract Introduction: To assess risk factors for unplanned readmission following open and minimally invasive partial nephrectomy (PN).
Materials and methods: From the National Surgical Quality Improvement Program database, patients with renal malignancy undergoing PN in 2011 or 2012 were reviewed. Using multivariable logistic regression, we identified variables associated with 30 day hospital readmission.
Results: Of the 2124 patients identified who underwent PN, 1253 (59%) were minimally invasive PN (MIPN) and 871 (41%) open PN (OPN). There were no differences in preoperative comorbidities between MIPN and OPN patients. The rate of unplanned hospital readmission for the entire cohort… More >

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COMMENTARY

Jay D. Raman
Canadian Journal of Urology, Vol.22, No.1, pp. 7647-7647, 2015
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ARTICLE

Renjian Jiang¹, Jeffrey J. Tomaszewski², Kevin C. Ward¹, Robert G. Uzzo³, Daniel J. Canter⁴
Canadian Journal of Urology, Vol.22, No.1, pp. 7648-7655, 2015
Abstract Introduction: To compare radiation related toxicities among men with low risk prostate cancer treated with single or multimodal radiation therapy.
Materials and methods: The SEER-Medicare linked database was used to assess the relationship between treatment type and toxicity among men with low risk prostate cancer treated with brachytherapy (BT), external beam radiation therapy (EBRT), or combined therapy between 2004 and 2007. Inverse probability of treatment weighting was utilized to minimize selection bias and control for confounding. Multivariate logistic regression models were used to explore the relationship between treatment and outcomes.
Results: Overall 1915 (43.9%), 1893 (43.4%),… More >

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ARTICLE

Paul H. Chung¹, Oussama M. Darwish¹, Claus G. Roehrborn¹, Payal Kapur², Yair Lotan¹
Canadian Journal of Urology, Vol.22, No.1, pp. 7656-7660, 2015
Abstract Introduction:We evaluated the risk of histologic upgrading and upstaging in patients who met strict active surveillance (AS) criteria on saturation biopsy and elected to undergo radical prostatectomy.
Materials and methods:A retrospective review was conducted of 362 consecutive, individual patients who underwent transrectal ultrasound guided saturation biopsy (32 cores) between 2006 and 2013. Thirty-one patients (9%) were eligible for AS based on Hopkins criteria for very low risk (VLR): stage T1c, prostate-specific antigen (PSA) density ≤ 0.15 ng/mL², Gleason ≤ 6, ≤ 2 cores and ≤ 50% core. Twenty patients (64%) elected radical prostatectomy, 2 (7%) elected radiation treatment… More >

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HOW I DO IT

Lior M. Hirsch¹, Michael J. Amirian¹, Scott G. Hubosky¹, Akhil K. Das¹, Babak Abai², Costas D. Lallas¹
Canadian Journal of Urology, Vol.22, No.1, pp. 7661-7665, 2015
Abstract Patients with a uretero-iliac artery fistula (UIAF) are at an elevated risk of life-threatening hemorrhage. Identification and treatment of the fistula may be challenging, and requires the combined expertise of a urologist and endovascular specialist. This manuscript provides a list of equipment needed and describes our technique for diagnosing and treating a UIAF. More >

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MINIMALLY INVASIVE AND ROBOTIC SURGERY

Mark W. Ball, Michael A. Gorin, Gautam Jayram, Phillip M. Pierorazio, Mohamad E. Allaf
Canadian Journal of Urology, Vol.22, No.1, pp. 7666-7670, 2015
Abstract Introduction: To describe our technique for robot-assisted radical nephrectomy (RARN) with inferior vena cava (IVC) tumor thrombectomy and to present initial results for our first two patients.
Materials and methods: Two patients with renal masses with infrahepatic IVC extension underwent RARN with IVC tumor thrombectomy using a four-arm configuration. Both cases were right-sided tumors. Vascular control was obtained with complete cross-clamping of the vena cava with robotic bulldog clamps. Intraoperative ultrasound was used to delineate extent of tumor extension. Specimens were removed en-bloc, and the IVC was closed with 2-layers of 4-0 Prolene. The specimen is extracted… More >

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RESIDENT’S CORNER

Duncan R. Morhardt, Lindsey Cox, John T. Stoffel
Canadian Journal of Urology, Vol.22, No.1, pp. 7671-7673, 2015
Abstract A 48-year-old man presented for evaluation of an expanding abdominal mass. Twenty years earlier, he had developed Fournier’s gangrene requiring extensive debridement. He underwent augmentation cystoplasty with a catheterizable stoma due to a proximal urethral stricture. Fifteen years later, he was found to have a 14 cm x 18 cm bladder augment calculus. Simpson obstetric forceps were passed into the augment to deliver a 1110 gram stone with minimal devitalization of the colonic augmentation tissue. This is the first report of stone management with obstetric forceps in an augmented bladder. The specimen itself is among More >

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RESIDENT’S CORNER

Timothy D. Lyon, Katherine M. Theisen, Kevin J. Rycyna, Ronald M. Benoit
Canadian Journal of Urology, Vol.22, No.1, pp. 7674-7676, 2015
Abstract Fibrin sealants are widely used during partial nephrectomy, however reports regarding the potential complications associated with their use are limited. We present the case of a 67-year-old male who developed delayed ureteral obstruction without hydronephrosis following partial nephrectomy in a solitary kidney. We hypothesize that the obstruction and absence of hydronephrosis were caused by extrinsic compression and subsequent inflammation due to the fibrin glue. Our report underscores the importance of a high index of suspicion for obstruction when acute kidney injury occurs following partial nephrectomy when fibrin glue is used, even in the absence of More >

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