Open Access

EDITORIAL

Leonard G. Gomella
Canadian Journal of Urology, Vol.24, No.2, pp. 8693-8694, 2017
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LEGENDS IN UROLOGY

Robert H. Whitaker
Canadian Journal of Urology, Vol.24, No.2, pp. 8695-8697, 2017
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REVIEW

Bruno Nahar, Mark L. Gonzalgo
Canadian Journal of Urology, Vol.24, No.2, pp. 8698-8704, 2017
Abstract Introduction: To review oncological and functional outcomes for partial nephrectomy in the setting of T2 tumors.
Materials and methods: We performed a comprehensive literature review on partial nephrectomy for T2 tumors, focusing on major primary series reporting oncological and functional outcomes, as well as complication rates in the last 10 years.
Results: Recent series have reported comparable oncological outcomes between partial nephrectomy and radical nephrectomy for ≥ T2 tumors. However, most of these studies are retrospective in design with small sample sizes. With regard to functional outcomes, partial nephrectomy outperforms radical nephrectomy. However, outcomes are dependent on the… More >

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ARTICLE

Peter N. Tsambarlis¹, Benjamin A. Sherer¹, Karl F. Godlewski¹, Rebecca M. Deal², Jonathan A. Myers², Leslie A. Deane¹
Canadian Journal of Urology, Vol.24, No.2, pp. 8705-8707, 2017
Abstract Introduction: An Institutional Quality and Safety Initiative to reduce postoperative urinary retention (POUR) and improve patient safety indicators (PSIs) was undertaken after a nurse driven protocol for catheter removal lead to an increase in POUR. The aim of this study was to identify the number of risk factors present in patients with POUR while examining the prevalence of those risk factors individually.
Materials and methods: A retrospective review of our institution's surgical database was performed to identify 500 consecutive cases of POUR between July 1, 2013 and July 1, 2014. POUR was defined as the inability to… More >

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ARTICLE

Jack Barkin¹, Roberto Rodriguez-Suarez², Katia Betito²
Canadian Journal of Urology, Vol.24, No.2, pp. 8708-8713, 2017
Abstract Introduction: Natural killer (NK) cells play a significant role in tumor cell immunosurveillance. The association between the activity of NK cells and prostate cancer has previously been demonstrated using conventional research-based tests.
Materials and methods: The aim of the present pilot study was to study the association between NK cell activity (NKA) and prostate cancer using a simple blood test. Subjects that had previously been selected for prostate biopsy underwent a blood test for NKA using an in vitro diagnostic device (IVDD) (NK Vue, ATGen Canada Inc., Laval, QC, Canada) prior to biopsy.
Results: Of the 43 subjects… More >

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ARTICLE

Kyle J. Ericson¹, Hannah C. Wenger², Alexandre M. Rosen³, Kyle J. Kiriluk⁴, Glenn S. Gerber⁵, Gladell P. Paner⁶, Scott E. Eggener⁵
Canadian Journal of Urology, Vol.24, No.2, pp. 8714-8720, 2017
Abstract Introduction: To report the incidence and characteristics of cancer following a diagnosis of atypical small acinar proliferation (ASAP) and comment on current clinical practice recommendations.
Materials and methods: We reviewed patients that underwent prostate biopsy between 2008 and 2013 at a single institution. Men with ASAP without previous cancer were included. Clinicopathologic features including prostate-specific antigen (PSA), presence of ASAP or cancer, tumor volume, number of involved cores, and Gleason score were analyzed in men that received a repeat prostate biopsy.
Results: Of 1450 men, ASAP was found in 75 (5%) patients. Repeat biopsy was performed in 49… More >

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ARTICLE

Gerald O. Ogola¹, Nicolas Delongchamps^2,3, Robert Serfling⁴
Canadian Journal of Urology, Vol.24, No.2, pp. 8721-8727, 2017
Abstract Introduction: To test with actual data a new decision algorithm derived by probability modeling of the number of positive cores, for deciding insignificant versus significant prostate cancer, based on prostate volume, Gleason score, tumor length on biopsy cores, and number of positive cores.
Materials and methods: A dataset of 59 cancer-involved autopsied prostate glands from patients aged 42 to 92 years with prostate volumes of 22 cc to 95 cc was used. An 18 core-systematic biopsy was performed on the first 47 patients, and saturation biopsy protocol of 36 cores was performed on the remainder. Clinically insignificant… More >

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ARTICLE

Claudio Giberti, Fabrizio Gallo, Maurizio Schenone, Emilio Gastaldi, Pierluigi Cortese, Gaetano Ninotta, Davide Becco
Canadian Journal of Urology, Vol.24, No.2, pp. 8728-8733, 2017
Abstract Introduction: To compare oncological and functional results of robot-assisted radical prostatectomy (RARP) and brachytherapy (BT) with a single-center prospective randomized study.
Materials and methods: From January 2012 to January 2014, 165 patients with low risk prostate cancer, prostate volume ≤ 50 g, normal urinary (IPSS ≤ 7 and mean flow rate ≥ 15 mL/sec) and erectile functions (IIEF-5 > 17) were enrolled and randomly assigned to the RARP or BT group. Our end points included the comparison of biochemical recurrence-free survival rates, urinary function (IPSS and EPIC scores) and potency rates (IIEF-5 score) at different time points… More >

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ARTICLE

Thomas Burrows, A. Andrew Ray, Cory Hartsburg
Canadian Journal of Urology, Vol.24, No.2, pp. 8734-8739, 2017
Abstract Introduction: The prostate-specific antigen (PSA) screening test is controversial and can result in both over-diagnosis and over-treatment. Recently, the Canadian Task Force on Preventive Health Care (CTFPHC) has recommended against routine screening for prostate cancer. We sought to determine how the CTFPHC has impacted the practice patterns among family physicians in the North Simcoe Muskoka (NSM) Local Health Integration Network (LHIN).
Materials and methods: We surveyed all 439 family physicians within the NSM LHIN as well as 21 residents of the Family Medical Teaching Unit. Surveys were distributed by either mail or fax. Questions covered three sections:… More >

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ARTICLE

G. Luke Machen, Leah R. Chiles, John Joyce, Kristofer R. Wagner
Canadian Journal of Urology, Vol.24, No.2, pp. 8740-8743, 2017
Abstract Introduction: Although infrequent, when encountered vesicovaginal fistulas (VVF) are a difficult condition for both patients and physicians alike. After the first robotic repair was described in 2005, this has been an increasingly common treatment modality. At our institution between 2009 and 2014, eleven of these patients were evaluated and treated with robotic repair. However, fibrin sealant was used in place of the traditional tissue flap. Included are six patients who had previously undergone operative repair.
Materials and methods: After IRB approval was obtained, a retrospective study was undertaken to identify patients with VVF. Inclusion criteria were operative More >

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ARTICLE

James Furr¹, Ryan Baker¹, Quy Pham¹, Puneet Sindhwani²
Canadian Journal of Urology, Vol.24, No.2, pp. 8744-8748, 2017
Abstract Introduction: Advances in vasectomy technique have minimized patient discomfort; however fear of pain remains a primary concern. The objective is to determine how the anticipation of pain associated with vasectomy compares with patient's actual intraoperative experienced pain levels.
Materials and methods: A cohort of patients undergoing clinic vasectomy was analyzed. Using visual analog pain scale patients were asked to rate their anticipated pain score (APS) pre-procedure and then an experienced pain score (EPS) post-procedure. Patients were also stratified by APS scores (high versus low). Changes in pain score were compared across these groups. Pain scores stratified by… More >

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ARTICLE

Guilherme J. A. Wood, Fabio C. M. Torricelli, Fabio C. Vicentini, Miguel Srougi, Eduardo Mazzucchi
Canadian Journal of Urology, Vol.24, No.2, pp. 8749-8753, 2017
Abstract Introduction: The feasibility and safety of supracostal punctures in supine percutaneous nephrolithotomy (PCNL) are still controversial. In this study we aim to compare success and complication rates from prone and supine PCNL with at least one supracostal puncture.
Material and methods: We reviewed our electronic database for all supracostal PCNLs performed in our institution from February 2008 to September 2013. Patients were enrolled in the study if at least one supracostal puncture was required during surgery. Patients' demographics data, stone characteristics, intra and postoperative data, and success on first postoperative day CT were compared.
Results: A total of… More >

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ARTICLE

Amar P. Patel, Don Bui, John Pattaras, Kenneth Ogan
Canadian Journal of Urology, Vol.24, No.2, pp. 8754-8758, 2017
Abstract Introduction: Interventional radiologist may be hesitant to obtain upper pole access for percutaneous nephrolithotomy (PCNL) due to a higher complication rate. Renal access gained by urologists may achieve higher stone-free rates with similar complication rates. We evaluate our institution's contemporary results of percutaneous renal access in the upper pole for nephrolithotomy by urologists, which we believe both safe and efficacious.
Materials and methods: This retrospective chart review included all PCNL's performed by fellowship-trained endourologists from 2003 to 2014 at a single institution. Inclusion criteria included patients in which renal access was obtained by the urologist via the… More >

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ARTICLE

Jamil S. Syed¹, Cayce B. Nawaf¹, James Rosoff¹, Campbell Bryson¹, Kevin A. Nguyen¹, Alfredo Suarez-Sarmiento¹, Maria Serrano², Adam S. Kibel⁴, Peter Humphrey³, Brian Shuch¹, Adebowale J. Adeniran³
Canadian Journal of Urology, Vol.24, No.2, pp. 8759-8764, 2017
Abstract Introduction: Evidence has demonstrated that tumor size is related to adverse oncologic outcomes in small renal tumors (≤ 4 cm). We evaluated the association of adverse pathologic features (APF) with tumor size and survival in patients with a small renal mass (SRM).
Materials and methods: We retrospectively reviewed the pathologic characteristics of 380 surgically resected SRMs from a single institution. APFs included lymphovascular invasion, coagulative necrosis, sarcomatoid/rhabdoid features, papillary type II histology, and perinephric fat/renal sinus invasion. The number and type of APFs were compared with tumor size. Survival analysis was performed using the Kaplan-Meier method.
Results: There… More >

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PEDIATRIC UROLOGY

Jacob Smith^1,2, Ashay Patel^1,2, Ismael Zamilpa^1,2, Shasha Bai³, Jeffrey Alliston^1,2, Stephen Canon^1,2
Canadian Journal of Urology, Vol.24, No.2, pp. 8765-8769, 2017
Abstract Introduction: Surgical site infection [SSI] is a risk for any surgical procedure, including hypospadias repair. Prophylactic antibiotic therapy for patients having surgery is often effective in preventing SSIs, but with increasing rates of antibiotic resistance, this practice has been questioned. The objectives of this study are 1) to assess the incidence of SSIs in patients following stented, distal hypospadias repair and 2) to observe for any potential difference in the incidence of SSIs for patients with and without preoperative antibiotic utilization in this setting.
Materials and methods: We retrospectively reviewed consecutive patients treated with stented, distal hypospadias… More >

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RESIDENT’S CORNER

Todd G. Manning^1,2, Daniel Christidis^1,2, David Wetherell^1,2, Ruth Cameron-Jeffs³, Nathan Lawrentschuk^1,4,5
Canadian Journal of Urology, Vol.24, No.2, pp. 8770-8772, 2017
Abstract Bilateral obstructing ureteric calculi is a rare cause of acute renal failure. Although urolithiasis in later pregnancy is not uncommon, the development of bilateral obstruction secondary to ureteric calculi in the first trimester is rare and poses difficulty to diagnosis and management. Symptoms of diseases and physiological changes associated with pregnancy can obscure diagnosis of urolithiasis and obstructive uropathy. Advances in minimally invasive endourology afford intervention with reduced risk to fetal health. We present the second case of acute renal failure caused by bilateral obstructing ureteric calculi in a pregnant patient and discuss current management More >

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RESIDENT’S CORNER

Eric Schommer, Julio Gundian, David D. Thiel
Canadian Journal of Urology, Vol.24, No.2, pp. 8773-8775, 2017
Abstract A65-year-old female presented to clinic requesting follow up for a history of right robotic partial nephrectomy done at an outside institution 2 years prior. Initial pathology demonstrated a grade 2/4 3.4 cm clear cell renal cell carcinoma with negative margins. There was no tumor necrosis, sarcomatoid differentiation, or lymphovascular invasion. High quality follow up imaging initially revealed a pseudoaneurysm in the central portion of the right kidney. The patient was sent to interventional radiology for angioembolization. Angiography identifed the abnormality to be a recurrent or residual mass in the renal hilum. MRI confrmed these fndings, More >

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HOW I DO IT

Richard M. Roach
Canadian Journal of Urology, Vol.24, No.2, pp. 8776-8781, 2017
Abstract Men with either chronic or temporary urinary retention symptoms are common patients treated in a urology practice. Both indwelling and intermittent catheterization are widely used to treat this condition. These approaches are associated with significant complications including infection and reduced quality-of-life. Infection is a target for quality improvement and cost reduction strategies in most care settings today.
We use a temporary prostatic stent (TPS) to address these issues in our practice. In this report, we describe our approach to patient selection, sizing, placement and follow up of 214 TPS placed in 56 men with chronic or… More >

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