Open Access

EDITORIAL

Leonard G. Gomella
Canadian Journal of Urology, Vol.22, No.6, pp. 8042-8042, 2015
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LEGENDS IN UROLOGY

Keong Tatt Foo
Canadian Journal of Urology, Vol.22, No.6, pp. 8043-8047, 2015
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REVIEW

E. David Crawford¹, Daniel P. Petrylak², Celestia S. Higano³, Adam S. Kibel⁴, Philip W. Kantoff⁵, Eric J. Small⁶, Neal D. Shore⁷, Anna Ferrari⁸
Canadian Journal of Urology, Vol.22, No.6, pp. 8048-8055, 2015
Abstract Introduction: Numerous treatments are approved for metastatic castration-resistant prostate cancer (mCRPC), including sipuleucel-T, an FDA-approved immunotherapy.
Materials and methods: In this paper we review recent data providing insights into the mechanism of action of sipuleucel-T which suggests sipuleucel-T may be most effective when administered to mCRPC patients with a low burden of disease. Published and presented data from the sipuleucel-T clinical trials NeoACT (NCT00715104), IMPACT (NCT00065442), ProACT (NCT00715078), PROTECT (NCT00779402), OpenACT (NCT00901342), STAMP (NCT01487863) and STAND (NCT01431391), individually or across trials, were included in this review.
Results: Overall, a growing body of evidence supports the concept that sipuleucel-T,… More >

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ARTICLE

Premal Patel¹, Jasmir G. Nayak^1,2, Zlatica Biljetina⁴, Bryan Donnelly³, Kiril Trpkov⁴
Canadian Journal of Urology, Vol.22, No.6, pp. 8056-8062, 2015
Abstract Introduction: Limited data exist on long term pathological outcomes in patients with initial prostate biopsies showing either high-grade intraepithelial neoplasia (HGPIN) or benign findings, who are subsequently diagnosed with prostate cancer.
Materials and methods: Preoperative characteristics of patients showing either HGPIN or benign initial prostate biopsies were investigated and compared in patients with and without a subsequent diagnosis of prostate cancer. We also compared the biopsy and prostatectomy findings in patients with prostate cancer in both groups.
Results: We evaluated 161 and 85 patients with initial HGPIN and benign prostate biopsies, respectively, who underwent a subsequent biopsy. After… More >

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ARTICLE

Zachary L. Smith¹, Eugene J. Pietzak¹, Chelsey K. Meise², Keith Van Arsdalen¹, Alan J. Wein¹, S. Bruce Malkowicz¹, Thomas J. Guzzo¹
Canadian Journal of Urology, Vol.22, No.6, pp. 8069-8073, 2015
Abstract Introduction: The Fuhrman grading system (FGS) is the most widely utilized pathological classification and predictor of renal cell carcinoma (RCC) prognosis. The aim of this study was to test the prognostic ability of a simplified two-tier FGS.
Materials and methods: We reviewed the data of 509 patients with clear cell RCC who underwent radical or partial nephrectomy between January 1994 and April 2007. The conventional four-tier (I, II, III, IV) FGS was compared to a simplified two-tier FGS in which grades I and II were combined (low grade) and grades III and IV were combined (high grade).… More >

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ARTICLE

Joseph Wagner, Peter Haddock
Canadian Journal of Urology, Vol.22, No.6, pp. 8074-8078, 2015
Abstract Introduction: Bladder neck contractures (BNC) are an uncommon complication following radical prostatectomy. Occasionally, BNCs can be refractory to endoscopic approaches. We describe the effectiveness of a novel robotic-assisted laparoscopic catheterizable bladder augment in treating recalcitrant BNCs.
Materials and methods: Patients undergoing robotic-assisted radical prostatectomy (RALP) between 2004-2014 who developed a postoperative BNC were identified. We documented our experience with robotic-assisted laparoscopic catheterizable bladder augment for recalcitrant BNCs. Total operative time, robotic time, estimated surgical blood, length of hospital stay, serum creatinine, complications, and postoperative course/upper tract imaging were recorded.
Results: Thirty-six of 2002 RALP patients (1.8%) experienced a… More >

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ARTICLE

Victor Srougi, Guilherme P. Padovani, Giovanni S. Marchini, Fabio C. Vicentini, Eduardo Mazzucchi, Miguel Srougi
Canadian Journal of Urology, Vol.22, No.6, pp. 8079-8084, 2015
Abstract Introduction: To evaluate the outcomes of ureteral strictures treatment after endoureterotomy using the holmium laser or open/laparoscopic surgery.
Material and methods: From a database of 1101 patients that underwent semi-rigid holmium laser ureterolithotripsy from 2003 to 2013, we performed a search for patients treated for ureteral stricture. Parameters analyzed included patient demographic, stone burden, and ureteral stricture characteristics. Treatment included holmium laser endoureterotomy for stenosis ≤1 cm and open/laparoscopic repair for stenosis >1 cm or for failed endoscopic treatment. Outcomes and complications were assessed. Success was defined as symptom improvement and radiographic obstruction resolution.
Results: Of all the… More >

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ARTICLE

Seth A. Cohen¹, Ryan P. Kopp¹, Kerrin L. Palazzi¹, Michael A. Liss¹, Reza Mehrazin², Jason Woo¹, Hak J. Lee¹, Ramzi Jabaji¹, Kyle Gillis¹, Song Wang¹, Robert W. Wake², Anthony L. Patterson², Ithaar H. Derweesh¹
Canadian Journal of Urology, Vol.22, No.6, pp. 8085-8092, 2015
Abstract Introduction: To investigate the association of C-reactive protein (CRP), a marker of systemic inflammation, with renal functional decline in patients undergoing partial nephrectomy (PN) for renal mass.
Materials and methods: Retrospective study of patients who underwent PN between February 2006-March 2011, with ≥6 months follow-up. Data was analyzed between two groups: CRP increase ≥0.5 mg/L from 6 months postoperative ("CRP rise," CRPR) versus no CRP increase ≥0.5 ("CRP stable," CRPS). Primary outcome was change in estimated glomerular filtration rate (ΔeGFR, mL/min/1.73 m²), with de novo postoperative stage III chronic kidney disease (stage III-CKD, eGFR <60 mL/min/1.73 m²)… More >

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ARTICLE

Seth A. Cohen¹, Ryan P. Kopp¹, Kerrin L. Palazzi¹, Michael A. Liss¹, Reza Mehrazin², Jason Woo¹, Hak J. Lee¹, Ramzi Jabaji¹, Kyle Gillis¹, Song Wang¹, Robert W. Wake², Anthony L. Patterson², Ithaar H. Derweesh¹
Canadian Journal of Urology, Vol.22, No.6, pp. 8085-8092, 2015
Abstract Introduction: To investigate association of C-reactive protein (CRP), a marker of systemic inflammation, with renal functional decline in patients undergoing partial nephrectomy (PN) for renal mass.
Materials and methods: Retrospective study of patients who underwent PN between February 2006-March 2011, with ≥6 months follow up. Data was analyzed between two groups: CRP increase ≥0.5 mg/L from 6 months postoperative ("CRP rise," CRPR), versus no CRP increase ≥0.5 ("CRP stable," CRPS). Primary outcome was change in estimated glomerular filtration rate (ΔeGFR, mL/min/1.73 m²), with de novo postoperative stage III chronic kidney disease (stage III-CKD, eGFR <60 mL/min/1.73 m²)… More >

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ARTICLE

Murtaza Dungerwalla¹, Nicholas Davies², Marlon Perera¹, Nathan Papa¹, Nathan Lawrentschuk^1,3,4
Canadian Journal of Urology, Vol.22, No.6, pp. 8093-8098, 2015
Abstract Introduction: Manual bladder washouts (MBWs) are an integral skill for healthcare workers dealing with urological patients. Despite this they are often overlooked by educators and omitted from formal teaching curricula. We aimed to determine the level of competence and training among healthcare workers in performing a MBW.
Materials and methods: Following a literature review for correct MBW technique, a 15-question survey was developed to assess knowledge and self-reported competency of doctors and nurses in performing a MBW. Two hundred paper and email-based surveys were distributed to doctors and nurses in the urology wards of Australian public and… More >

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COMMENTARY

Richard J. Macchia
Canadian Journal of Urology, Vol.22, No.6, pp. 8099-8099, 2015
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ARTICLE

Tim A. Ludwig^1,*, Philip Reiss^1,*, Marco Wieland², Andreas Becker¹, Margit Fisch¹, Felix K. Chun¹, Roland Dahlem¹
Canadian Journal of Urology, Vol.22, No.6, pp. 8100-8104, 2015
Abstract Introduction: The aim was to perform a feasibility study of the new artificial sphincter device ARTUS in human cadavers. ARTUS is a new electro-mechanical device, which may prevent urethral damage due to a new working principle which is to perform only sequential pressure on successive parts of the urethra.
Material and methods: The implantation of the ARTUS device was performed in six cadavers (3 males, 3 females) with different body mass indices. Subsequently the basic operation data (operation time, cuff size, length of wires, complication) were assessed.
Results: The implantation of the ARTUS device is performed easily by… More >

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RESIDENT’S CORNER

Andrew J. Davidiuk, David D. Thiel
Canadian Journal of Urology, Vol.22, No.6, pp. 8105-8107, 2015
Abstract Spontaneous retroperitoneal hematoma (SRH) is a rare, potentially lethal entity that can arise from a variety of etiologies. We present a case of SRH secondary to hemorrhage from the right inferior adrenal artery in a 22-year-old woman. The patient presented to the emergency room with significant right flank pain, and computed tomography (CT) demonstrated a large, right-sided retroperitoneal hematoma with no identifiable etiology. Renal angiography revealed active extravasation from the right inferior adrenal artery. The patient was definitively treated with endovascular coiling of the ruptured artery, and long-term follow-up demonstrated resolution of the retroperitoneal hematoma. More >

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RESIDENT’S CORNER

Shuvro De, Michael J. Belsante, Timothy J. Tausch, Jay Simhan
Canadian Journal of Urology, Vol.22, No.6, pp. 8108-8111, 2015
Abstract Fournier’s gangrene is an uncommon necrotizing infection affecting the genital and perineal area. Penile involvement in particular is rare owing to its rich vascular supply. In this report, we document a case of Fournier’s gangrene involving penile and urethral tissue requiring multiple debridements resulting in significant penile deformity and a non-healing wound. Eventually, the patient underwent penectomy and perineal urethrostomy creation. In this case, penectomy and perineal urethrostomy provide a functional outcome for highly refractory and complex patients with Fournier’s gangrene involving penile tissue. More >

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RESIDENT’S CORNER

Simon Ouellet, Claudio Jeldres, Hugo Simard, Robert Sabbagh, Michel Carmel
Canadian Journal of Urology, Vol.22, No.6, pp. 8112-8114, 2015
Abstract Orthotopic ileal neobladder has been frequently performed as urinary diversion after cystectomy over the last decades. We report an unusual complication of very large calculi in a Studer ileal neobladder. Due to its size, open cystolithotomy was performed. More >

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