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EDITORIAL

Peter J. Gilling
Canadian Journal of Urology, Vol.22, No.4, pp. 7853-7853, 2015
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LEGENDS IN UROLOGY

James W. L. Wilson
Canadian Journal of Urology, Vol.22, No.4, pp. 7854-7856, 2015
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LETTER

Jeffrey J. Leow, Quoc Dien Trinh
Canadian Journal of Urology, Vol.22, No.4, pp. 7857-7857, 2015
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ARTICLE

Rohini K. Hernandez¹, Karynsa Cetin¹, Melissa Pirolli², Jane Quigley², David Quach², Paul Smith³, Scott Stryker¹, Alexander Liede¹
Canadian Journal of Urology, Vol.22, No.4, pp. 7858-7864, 2015
Abstract Introduction: Canadian guidelines define castration-resistant prostate cancer (CRPC) at high risk of developing metastases using PSA doubling time (PSADT) <8 months, whereby men may be offered more frequent bone scans/imaging. We evaluated PSA data from nonmetastatic (M0) prostate cancer patients treated at urology and oncology clinics across the United States (US) to describe the proportion and characteristics of patients who met CRPC and high-risk criteria.
Materials and methods: We identified M0 prostate cancer patients aged ≥18 years receiving androgen deprivation therapy (ADT) in 2011 from electronic health records (EHR), covering 129 urology and 64 oncology practices across… More >

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ARTICLE

Laura-Maria Krabbe^*,1,2, Mary E. Westerman^*,1, Vitaly Margulis¹, Ganesh V. Raj¹, Arthur I. Sagalowsky¹, Kevin Courtney³, Yull Arriaga³, Yair Lotan¹
Canadian Journal of Urology, Vol.22, No.4, pp. 7865-7875, 2015
Abstract Introduction: To reassess use of perioperative chemotherapy in muscle-invasive bladder cancer (MIBC) following implementation of monthly multidisciplinary meetings to facilitate optimal oncologic treatment. We previously reported from 2003 to 2008 17% of eligible patients with bladder cancer received cisplatin-based neoadjuvant chemotherapy (NAC) at our institution.
Materials and methods: A retrospective review of all patients who underwent radical cystectomy (RC) between 2008 and 2012 was performed. Information on clinical and pathologic stage, renal function, perioperative chemotherapy (CTX) use and oncologic outcomes was collected. Rationale for utilization decisions was obtained from physician encounter notes. Primary outcome was use of… More >

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ARTICLE

Brian E. Weiss¹, Eugene J. Pietzak², Alan J. Wein², S. Bruce Malkowicz², Thomas J. Guzzo²
Canadian Journal of Urology, Vol.22, No.4, pp. 7876-7881, 2015
Abstract Introduction: This study sought to determine if the addition of perioperative mitomycin C (MMC) to treatment with bacillus Calmette-Guérin (BCG) after transurethral resection (TURBT) is superior to TURBT plus BCG alone in high grade non-muscle invasive bladder cancer (NMIBC).
Materials and methods: Data for 719 patients diagnosed with NMIBC at the University of Pennsylvania Health System between 1977 and 2009 was reviewed retrospectively. Of these patients, 120 had high grade disease and were treated with either BCG alone or with a single instillation of 40 mg of MMC perioperatively in addition to BCG and were thus included… More >

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ARTICLE

Pranav Sharma^1,*, Einar F. Sverrisson^2,*, Kamran Zargar-Shoshtari¹, Mayer N. Fishman¹, Wade J. Sexton¹, Shohreh I. Dickinson³, Philippe E. Spiess¹, Michael A. Poch¹, Scott M. Gilbert¹, Julio M. Pow-Sang¹
Canadian Journal of Urology, Vol.22, No.4, pp. 7882-7889, 2015
Abstract Introduction: We present our experience with minimally-invasive retroperitoneal lymph node dissection (MI-RPLND) in the post-chemotherapy (PC) setting for residual masses in patients with nonseminoma.
Materials and methods: Nineteen men who underwent PC MI-RPLND (14 – laparoscopic, 5 – robotic) for low-volume residual disease (no more than 5 clinically enlarged retroperitoneal masses, size < 5 cm, no adjacent organ or vascular invasion) between 2006 and 2011 were identified. Clinicodemographic information and pathological outcomes were reported.
Results: Median age of our study population was 32 (interquartile range [IQR]: 28-39). Most patients presented with clinical stage II disease (63%) and were… More >

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ARTICLE

Ladin A. Yurteri-Kaplan, Danielle D. Antosh, Cheryl B. Iglesia, Andrew I. Sokol, David Shveiky, Robert E. Gutman
Canadian Journal of Urology, Vol.22, No.4, pp. 7890-7895, 2015
Abstract Introduction: To determine the significance of bladder trabeculations seen on preoperative cystoscopy prior to midurethral sling surgery with respect to lower urinary tract symptoms and sling outcomes.
Materials and methods: This retrospective study included women with preoperative cystoscopy who underwent midurethral slings for urinary incontinence from 2006-2009. Cystoscopic findings of bladder trabeculations, as well as pre and postoperative urinary symptoms were recorded. Patients with and without bladder trabeculations were compared with respect to baseline characteristics, lower urinary tract symptoms, and sling outcomes.
Results: Of the 241 women included in the study, 14.9% had trabeculations on preoperative cystoscopy. At… More >

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ARTICLE

Richard S. Matulewicz, John C. Hairston
Canadian Journal of Urology, Vol.22, No.4, pp. 7896-7901, 2015
Abstract Introduction: To assure that patients with lower urinary tract symptoms (LUTS) benefit from interventions, urologists must practice careful selection of surgical candidates. Currently, 15%-30% of men do not benefit optimally from these invasive and potentially morbid procedures. Success rates following transurethral resection of the prostate (TURP) are higher if bladder outlet obstruction (BOO) is confirmed prior to the procedure by invasive pressure flow studies (PFS). However, PFS may not be performed because of many reasons. We report a study of a non-invasive method of assessing BOO.
Materials and methods: The UroCuff test was compared to invasive… More >

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ARTICLE

Nathan R. Starke, Jay Simhan, Timothy N. Clinton, Timothy J. Tausch, J. Francis Scott, Alexandra K. Klein, Allen F. Morey
Canadian Journal of Urology, Vol.22, No.4, pp. 7902-7906, 2015
Abstract Introduction: To present an updated experience using our previously reported lateral perineal "7-flap" technique for perineal urethrostomy (PU), highlighting its role in a variety of patients with advanced urethral stricture disease.
Materials and methods: All patients who underwent 7-flap PU from 2009-2013 were reviewed. PU was constructed by advancing a "7"-shaped laterally based perineal skin flap into a spatulated, amputated bulbomembranous urethra. The contralateral side of the amputated proximal urethra was then matured to the advanced perineal skin. Patients were stratified by body mass index (BMI) and outcomes were compared.
Results: Among 748 patients undergoing urethroplasty… More >

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ARTICLE

Adam C. Calaway¹, Gopal N. Gupta², Akshay Bhandari³, Daniel Eun⁴, Ronald S. Boris¹
Canadian Journal of Urology, Vol.22, No.4, pp. 7907-7913, 2015
Abstract Introduction: Nephron-sparing surgery is most crucial for patients with a small renal mass in a solitary kidney. Historically, a minimally invasive approach in this setting has been discouraged. Tumor enucleo-resection, long established in the management of hereditary renal tumor syndromes, is currently being evaluated as a viable surgical technique in the sporadic renal cell carcinoma (RCC) population. This approach may significantly reduce or eliminate the need for hilar clamping. We sought to evaluate our experience with robot-assisted enucleo-resection partial nephrectomy (EN-RAPN) in patients with solitary kidneys.
Materials and methods: Records of patients with a solitary kidney… More >

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ARTICLE

Jack Barkin¹, Demitri Diles², Billy Franks³, Todd Berner⁴
Canadian Journal of Urology, Vol.22, No.4, pp. 7914-7923, 2015
Abstract Introduction: Patients with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) often present with voiding and storage symptoms, which may require combination therapy with an alpha blocker and an antimuscarinic (AM). This study compared treatment persistence in LUTS/BPH patients on alpha blocker monotherapy with those using combination alpha blocker and AM therapy (AB/AM).
Materials and methods: Retrospective analysis of anonymized patient longitudinal prescription reimbursement claims data. All patients who had claims for any of four alpha blocker medications and six AM agents during an index period from April 1, 2011 to March 31,… More >

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RESIDENT’S CORNER

Matthew A. Uhlman, Eric D. Andresen, Douglas W. Storm
Canadian Journal of Urology, Vol.22, No.4, pp. 7924-7926, 2015
Abstract An 11-year-old female with spastic quadriplegia was seen in the emergency room with abdominal pain, vomiting and anorexia. Labs revealed possible pancreatitis and signs of a urinary tract infection. A CT scan was performed to assess her abdominal pain and demonstrated circumferential air within the bladder wall. Following cultures being drawn, she was started on broad spectrum antibiotics. Her urine eventually grew Klebsiella pneumoniae. Follow-up imaging 2 weeks later demonstrated resolution of the air. Emphysematous cystitis is an exceedingly rare condition in the pediatric population, with this report representing the second case within the literature. More >

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RESIDENT’S CORNER

Morris L. Jessop, Richard Vaughan, Osama Al-Omar
Canadian Journal of Urology, Vol.22, No.4, pp. 7927-7928, 2015
Abstract We report a case of a femoral hernia in a 9-year-old male. Femoral hernias in children are rare and a diagnostic challenge. Definitive treatment is with surgical repair. More >

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RESIDENT’S CORNER

Kevin J. Flynn^1,*, Hristos Z. Kaimakliotis^1,*, Liang Cheng², Chandru P. Sundaram¹
Canadian Journal of Urology, Vol.22, No.4, pp. 7929-7931, 2015
Abstract Primary renal extra-osseous osteosarcoma is an exceedingly rare and deadly kidney neoplasm with only 27 reported cases to date. Extra-osseous osteosarcoma is a mesenchymal sarcoma that produces osteoid, but has no skeletal or periosteal involvement and most commonly arises in the lower extremities. Yet, it can arise in other locations such as the kidney. Extra-osseous osteosarcoma behaves as a separate entity from osseous osteosarcoma and should be treated as such. The treatment is surgical resection. Five year overall survival is 46% for local and 10% for metastatic disease. Additionally, 45%-50% of patients experience disease recurrence. More >

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RESIDENT’S CORNER

David Crawley, Peter Haddock, Max Jackson, Jeffrey Kamradt, Stuart Kesler
Canadian Journal of Urology, Vol.22, No.4, pp. 7932-7934, 2015
Abstract A 64-year-old male presented with lower back pain, radiating in a sciatic-type distribution, swelling in his lower abdomen and right leg, and edema of the scrotum and penile shaft. A sonogram and CT imaging indicated an enhancing mass in the right kidney and a spinal metastasis. The right lower extremity and penoscrotal lymphedema was caused by lymphatic obstruction due to a sacral metastasis of renal cell carcinoma. He was treated with cytoreductive nephrectomy, radiation and a systemic tyrosine kinase inhibitor. Pelvic imaging is suggested to determine whether malignant lymphatic obstruction is present when presented with More >

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RESIDENT’S CORNER

Dwayne Tun Soong Chang¹, Isaac Andrew Thyer^1,2, Dickon Hayne^1,3, Darren Jonathan Katz⁴
Canadian Journal of Urology, Vol.22, No.4, pp. 7935-7937, 2015
Abstract We report the case of a man with idiopathic lymphocytic orchitis (LO) manifested by undifferentiated testicular pain and atrophy. Conventional investigation results were unremarkable. Oral ciprofloxacin only improved the pain temporarily. Scrotal exploration surgery was performed to exclude acute testicular torsion and a biopsy was taken during surgery for histological examination. Histology revealed severe LO with reduced spermatogenesis. A trial of oral steroids was initially effective but the effect was temporary. Due to chronic pain, he eventually underwent unilateral orchidectomy. Histology confirmed the initial diagnosis of LO. He was pain-free postoperatively. Idiopathic LO is a More >

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HOW I DO IT

Lior M. Hirsch, Larry E. Goldstein
Canadian Journal of Urology, Vol.22, No.4, pp. 7938-7941, 2015
Abstract In men with advanced carcinoma of the prostate being treated with androgen deprivation therapy (ADT), hot flashes can be a significant side effect of the treatment. In this paper we describe using acupuncture as a complementary alternative therapy for treatment of hot flashes in men. More >

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