Open Access

EDITORIAL

Thomas W. Jarrett
Canadian Journal of Urology, Vol.23, No.1, pp. 8115-8115, 2016
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LEGENDS IN UROLOGY

Karl Storz
Canadian Journal of Urology, Vol.23, No.1, pp. 8116-8120, 2016
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REVIEW

Jathin Bandari, Thomas W. Fuller, Robert M. Turner II, Louis A. D’Agostino
Canadian Journal of Urology, Vol.23, No.1, pp. 8121-8126, 2016
Abstract Introduction: Percutaneous renal biopsy (PRB) is a safe and effective modality for sampling kidney tissue. In limited circumstances, alternative methods for kidney biopsy may be indicated. Historical contraindications for PRB such as bleeding diathesis, morbid obesity and solitary kidney have been called into question in the literature. We present a review of the literature on PRB and the risks and benefits associated with alternatives.
Materials and methods: A review of the literature was performed through MEDLINE and PubMed. A total of 726 articles exist under the query, "percutaneous renal biopsy." Large series describing indications, contraindications, procedural methods,… More >

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ARTICLE

Christopher M. Russell^*, Pranav Sharma^*, Gautum Agarwal, John S. Fisher, George J. Richard, Philippe E. Spiess, Julio M. Pow-Sang, Michael A. Poch, Wade J. Sexton
Canadian Journal of Urology, Vol.23, No.1, pp. 8127-8134, 2016
Abstract Introduction: To evaluate whether varying degrees of seminomatous elements in the primary orchiectomy specimen would be predictive of patient morbidity during post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND) since the desmoplastic reaction with seminoma is associated with increased intraoperative complexity.
Materials and methods: We retrospectively identified 127 patients who underwent PC-RPLND for residual retroperitoneal masses. Clinicodemographic, intraoperative, and 30 day postoperative outcomes were compared for patients with pure seminoma (SEM), mixed germ cell tumors (GCT) containing seminoma elements (NS+SEM), and tumors with no seminoma elements (NS). Multivariate logistic regression was used to determine independent predictors of intraoperative and… More >

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ARTICLE

Yagil Barazani, A. Scott Polackwich Jr., Edmund S. Sabanegh, Jr.
Canadian Journal of Urology, Vol.23, No.1, pp. 8135-8140, 2016
Abstract Introduction: To identify pre-treatment clinical variables and hormonal responses predictive of successful spermatogenic response to empiric medical therapy (EMT), then to create a nomogram to guide clinical therapy.
Materials and methods: All men who had been treated at our institution with EMT for moderate-severe oligospermia (≤10 million sperm/mL) from 2003 to 2014 were included in our study. Men with hypogonadotropic hypogonadism, azoospermia, or those who had varicocelectomy or had received fertility altering medications within 6 months of initiating EMT were excluded, as well as those who did not obtain a follow up semen analysis. Pre-treatment clinical variables,… More >

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ARTICLE

Firas Abdollah¹, Dane E. Klett¹, Jesse D. Sammon¹, Deepansh Dalela¹, Akshay Sood¹, Linda Hsu¹, Mireya Diaz¹, Nilesh Gupta², James O. Peabody¹, Quoc-Dien Trinh³, Mani Menon¹
Canadian Journal of Urology, Vol.23, No.1, pp. 8141-8150, 2016
Abstract Introduction: To develop a nomogram to predict lymph node invasion (LNI) in the contemporary North American patient treated with robot-assisted radical prostatectomy (RARP).
Materials and methods: We included 2,007 patients treated with RARP and pelvic lymph node dissection (PLND) at a single institution between 2008 and 2012. D’Amico low risk patients underwent an obturator and hypogastric PLND, while extended PLND was reserved for intermediate/high risk patients. Logistic regression analysis tested the relationship between LNI and all available predictors. Independent predictors of LNI were used to develop a novel nomogram. Discrimination, calibration and decision-curve analysis were used to… More >

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ARTICLE

Wassim M. Bazzi¹, Amy L. Tin², Daniel D. Sjoberg², Melanie Bernstein¹, Paul Russo¹
Canadian Journal of Urology, Vol.23, No.1, pp. 8151-8154, 2016
Abstract Introduction: To explore whether the association between preoperative neutrophil-to-lymphocyte ratio (NLR) elevation and worse survival is of use prognostically or merely a reflection of medical comorbidities in clear cell renal cell carcinoma (CC RCC).
Materials and methods: We identified 1970 patients treated at Memorial Sloan Kettering Cancer Center from 1998-2012 by partial or radical nephrectomy for nonmetastatic CC RCC. NLR was calculated by dividing absolute neutrophil count by absolute lymphocyte count; both were obtained from preoperative complete blood count. Uni- and multivariable Cox proportional hazards regression, which included established prognostic variables, were used to test for… More >

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COMMENTARY

Jay D. Raman
Canadian Journal of Urology, Vol.23, No.1, pp. 8155-8155, 2016
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ARTICLE

Todd Yecies, Robert M. Turner II, Matthew C. Ferroni, Bruce L. Jacobs, Benjamin J. Davies
Canadian Journal of Urology, Vol.23, No.1, pp. 8156-8159, 2016
Abstract Introduction: Horseshoe kidney is the most common congenital renal fusion anomaly, with an estimated incidence of 1.7 to 2.5 cases per 1000 live births. In these patients, nephron-sparing surgical management of renal tumors may be complicated by abnormal renal location, aberrant vasculature, and the presence of a renal isthmus. We present the largest known series of patients with renal malignancy in horseshoe kidneys managed by partial or hemi-nephrectomy with associated outcomes.
Materials and methods: A retrospective review of our institution's electronic medical record was conducted to identify consecutive cases over an 11 year period. Pediatric patients and… More >

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ARTICLE

Yasser A. Noureldin^1,2, Ana Stoica¹, Wassim Kassouf¹, Simon Tanguay¹, Franck Bladou¹, Sero Andonian¹
Canadian Journal of Urology, Vol.23, No.1, pp. 8160-8166, 2016
Abstract Introduction: To incorporate the da Vinci Surgical Skills Simulator (dVSSS) into Objective Structured Clinical Examinations (OSCEs) and to assess basic robotic skills of urology Post-Graduate Trainees (PGTs).
Materials and methods: PGTs in post-graduate years (PGY-3 to PGY-5) from two Quebec urology training programs were recruited. During a 20 minute OSCE station, PGTs were asked to fill in a questionnaire and perform two tasks: pick and place, and energy dissection level 1. For each exercise, the norm-referenced method was used to establish a passing score to determine competency. The participant was considered competent in these two basic dVSSS… More >

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COMMENTARY

Costas D. Lallas
Canadian Journal of Urology, Vol.23, No.1, pp. 8167-8167, 2016
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RESIDENT’S CORNER

Muhannad Alsyouf, Mohamed Keheila, Michelle Marinone, Allie Blackburn, Andrea Staack
Canadian Journal of Urology, Vol.23, No.1, pp. 8168-8170, 2016
Abstract Patients undergoing InterStim implantation often have comorbidities, which require magnetic resonance imaging (MRI) for diagnosis. Although MRI of the head has been recently approved for use with the InterStim neurostimulator, imaging of other regions remains controversial. We present a case of Achilles tendinitis diagnosed on MRI of the ankle in a patient with an InterStim device. The neurostimulator was deactivated, and using a transmit/receive extremity coil, the left ankle was imaged without any adverse events. At 9 months post-imaging, the patient continued to have good control of symptoms with InterStim, with no negative effects from More >

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RESIDENT’S CORNER

Munad Khan¹, Dermot O’Kane¹, Justin Du Plessis², Nathan Hoag¹, Nathan Lawrentschuk^1,3,4
Canadian Journal of Urology, Vol.23, No.1, pp. 8171-8175, 2016
Abstract Primary malignant melanoma of the urinary bladder is a rare lesion. We report the case of a 78-year-old male with no previous history of cutaneous melanoma who presented with hematuria. Further investigation with imaging and cystoscopy raised suspicion of a primary bladder and ureteric melanoma, which had subsequently metastasized. This was confirmed with histological assessment and a thorough search for alternative primary lesions. Unfortunately, our patient passed away prior to receiving any oncological treatment for his metastatic melanoma, underscoring both the high mortality of this lesionandtheneedforaconsensusondefnitivetreatment. More >

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RESIDENT’S CORNER

Iryna Makovey, Robert Dolinga, Daniel A. Shoskes
Canadian Journal of Urology, Vol.23, No.1, pp. 8176-8178, 2016
Abstract Psychological factors may play a role in the pathophysiology of chronic prostatitis/chronic pelvic pain syndrome (CP/ CPPS). This case series describes a cohort of 10 men presenting with CP/CPPS whose symptoms began after an extramarital sexual encounter, who strongly believed they had a sexually transmitted infection (STI) despite negative testing, and who have had no improvement with empiric antibiotic treatment. Patients’ clinical presentation and physical exam findings are reviewed. All men were clinically phenotyped with the UPOINT system. Pelvic floor spasm and not infection was prominent in these men. Treatment recommendations are proposed and compliance More >

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HOW I DO IT

Jack Barkin¹, Shelley Burton², Carole Lambert³
Canadian Journal of Urology, Vol.23, No.1, pp. 8179-8183, 2016
Abstract The gonadotropin-releasing hormone (GnRH) receptor antagonist degarelix has several unique characteristics compared to luteinizing hormone-releasing hormone (LHRH) analogs used in the management of prostate cancer. Notable differences of GnRH receptor antagonists include no flare reaction, and a more rapid suppression of testosterone, luteinizing hormone (LH), follicle stimulating hormone (FSH) and prostate-specific antigen (PSA) compared to LHRH analogs. Despite emerging evidence supporting the use of GnRH receptor antagonists over the more widely used LHRH analogs in the management of prostate cancer, physicians may be reluctant to prescribe degarelix. They may be concerned about patient complaints about More >

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PEDIATRIC UROLOGY

John M. Lacy¹, Lauren N. Hendrix¹, Raevti Bole², Enmar Habib³, Cole W. Wootton¹, Ali M. Ziada¹
Canadian Journal of Urology, Vol.23, No.1, pp. 8184-8187, 2016
Abstract Introduction: Hypospadias complications, most notably meatal stenosis, are commonly reported to occur after tubularized incised plate (TIP) hypospadias repair. We focus on a point of technique in TIP repair and its effect on outcome of this possible complication, as well as other commonly reported complications. Meatal stenosis after TIP can be avoided if the urethra and overlying glans are dissected and sutured separately with no attempt at cross suturing whether the urethra ends below, behind, or above the glans sutures. This hypothesis was evaluated by a prospective data collection before and after implementation to evaluate the… More >

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