Open Access

EDITORIAL

Leonard G. Gomella
Canadian Journal of Urology, Vol.24, No.3, pp. 8782-8783, 2017
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LEGENDS IN UROLOGY

Warren T. Snodgrass
Canadian Journal of Urology, Vol.24, No.3, pp. 8784-8787, 2017
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REVIEW

Alvaro Morales
Canadian Journal of Urology, Vol.24, No.3, pp. 8788-8793, 2017
Abstract Introduction: It is 40 years since the initial documentation of the efficacy of bacille Calmette-Guérin (BCG) in the management of non-muscle invasive bladder cancer (NMIBC) and probably an opportune a time as any to retrace the origins of this development and to reflect on the progress that has occurred on the use of immune modifiers in the treatment of NMIBC.
Materials and methods: A PubMed search for publications on the history of BCG was conducted, and those related to the development of the vaccine for protection against tuberculosis as well as those published in the last 40… More >

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COMMENTARY

Mark S. Soloway
Canadian Journal of Urology, Vol.24, No.3, pp. 8794-8794, 2017
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ARTICLE

Ram A. Pathak¹, David D. Thiel¹, Alexander Parker², Michael G. Heckman³, Julia E. Crook³, Nancy N. Diehl³, Andrea Tavlarides², Scott W. Alford¹, Todd C. Igel¹
Canadian Journal of Urology, Vol.24, No.3, pp. 8795-8801, 2017
Abstract Introduction: To compare visual analog scale (VAS) pain scores between patients with a 2-minute versus 10-minute delay of peri-prostatic lidocaine injection prior to transrectal ultrasound-guided prostate biopsies (TRUS-bx).
Materials and methods: Eighty patients who underwent standard 12-core TRUS-bx by a single surgeon were prospectively randomized into four different treatment arms: bibasilar injection with a 2-minute delay, bibasilar injection plus a single apical injection with a 2-minute delay, bibasilar injection with a 10-minute delay, and bibasilar injection plus a single apical injection with a 10-minute delay. Patients were asked to report their level of pain on the VAS… More >

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ARTICLE

Claus G. Roehrborn¹, Jack Barkin², Steven N. Gange³, Neal D. Shore⁴, Jonathan L. Giddens⁵, Damien M. Bolton⁶, Barrett E. Cowan⁷, Anthony L. Cantwell⁸, Kevin T. McVary⁹, Alexis E. Te¹⁰, Shahram S. Gholami¹¹, William G. Moseley¹², Peter T. Chin¹³, William T. Dowling¹⁴, Sheldon J. Freedman¹⁵, Peter F. Incze¹⁶, K. Scott Coffeld¹⁷, Sean Herron¹⁸, Prem Rashid¹⁹, Daniel B. Rukstalis²⁰
Canadian Journal of Urology, Vol.24, No.3, pp. 8802-8813, 2017
Abstract Introduction: To report the five year results of a prospective, multi-center, randomized, blinded sham control trial of the Prostatic Urethral Lift (PUL) in men with bothersome lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH).
Materials and methods: At 19 centers in North America and Australia, 206 subjects ≥50 years old with International Prostate Symptom Score (IPSS) >12, peak flow rate (Qmax) ≤12 mL/s, and prostate volume 30cc-80cc were randomized 2:1 to the PUL procedure or blinded sham control. In PUL permanent UroLift implants are placed to hold open the lateral lobes of the prostate… More >

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ARTICLE

Christopher J. Dru¹, Jennifer T. Anger¹, Colby P. Souders¹, Catherine Bresee², Matthias Weigl³, Elyse Hallett⁴, Ken Catchpole⁵
Canadian Journal of Urology, Vol.24, No.3, pp. 8814-8821, 2017
Abstract Introduction: We sought to apply the principles of human factors research to robotic-assisted radical prostatectomy to understand where training and integration challenges lead to suboptimal and inefficient care.
Materials and methods: Thirty-four robotic-assisted radical prostatectomy and bilateral pelvic lymph node dissections over a 20 week period were observed for flow disruptions (FD) - deviations from optimal care that can compromise safety or efficiency. Other variables - physician experience, trainee involvement, robot model (S versus Si), age, body mass index (BMI), and American Society of Anesthesiologists (ASA) physical status - were used to stratify the data and understand… More >

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ARTICLE

Guila Delouuya^1,2, Carole Lambert^1,2, Jean-Paul Bahary^1,2, Marie-Claude Beauchemin^1,2, Maroie Barkati^1,2, Cynthia Ménard^1,2, Daniel Taussky^1,2
Canadian Journal of Urology, Vol.24, No.3, pp. 8822-8826, 2017
Abstract Introduction: We tested different classification systems in order to separate intermediate-risk prostate cancers into prognostic groups. We then examined which groups were most suited for either prostate seed brachytherapy (PB) or external beam radiotherapy (EBRT).
Materials and methods: We selected patients with D'Amico intermediate-risk prostate cancer who were treated exclusively with either PB or EBRT. Patients were excluded if they had received androgen deprivation therapy in combination with EBRT or a follow up of < 30 months without recurrence. The Kaplan-Meier method was used to compare groups.
Results: Our sample consisted of 475 patients treated from July 2002-September… More >

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ARTICLE

John Roger Bell¹, Kristina L. Penniston¹, Sara L. Best¹, Stephen Y. Nakada^1–3
Canadian Journal of Urology, Vol.24, No.3, pp. 8827-8831, 2017
Abstract Introduction: Several recent trials have reported limited benefit for medical expulsive therapy (MET) in terms of stone passage rates, analgesic requirements, or need for intervention. We evaluated patient attitudes regarding MET after explaining these new findings.
Materials and methods: Over a 12 week period, an investigator-designed survey was offered to sequential patients during routine appointments in our urologic clinic. A brief summary of the conflicting data for MET was provided. Patients then answered questions about their attitudes toward using MET.
Results: Patients (n = 200; 103 M, 97 F) were 56 ± 14 years old (range 20-103… More >

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ARTICLE

Andrew Cohen, Blake Anderson, Glenn Gerber
Canadian Journal of Urology, Vol.24, No.3, pp. 8832-8837, 2017
Abstract Introduction: We aim to determine the optimal method for measuring Hounsfield Units (HU) of calculi for the clinical urologist.
Materials and methods: We present a single institution prospective study from 2014-2015 for 125 consecutive patients. Demographics, baseline characteristics, imaging, and stone analysis were collected. CT scanners and settings were heterogeneous. Hounsfield units were measured by use of ellipsoid tool and free hand outline by two independent urology graders using Philips iSite PACs.
Results: Stone analysis demonstrated 26 pure calcium oxalate (CaOx) stones, 15 pure calcium phosphate (CaP) stones, and 7 uric acid stones, among other mixed types. Excellent… More >

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ARTICLE

Hammouda Sherif, Mostafa Khalil, Rabea Omar
Canadian Journal of Urology, Vol.24, No.3, pp. 8838-8846, 2017
Abstract Introduction: To compare the safety and efficacy of posterior tibial nerve stimulation (PTNS) versus an intradetrusor injection of botulinum toxin type-A (BTX-A) 100 U in the management of refractory idiopathic overactive bladder (OAB).
Materials and methods: We randomized 60 patients with refractory idiopathic OAB to receive an intradetrusor injection of BTX-A 100 U or PTNS. We assessed the patients at baseline, 6 weeks, 3 months, 6 months, and 9 months, and determined their clinical symptoms, overall OAB symptom score, urgency score, quality-of-life score, and urodynamic study parameters.
Results: The two patient groups had similar baseline characteristics. After treatment,… More >

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ARTICLE

Khaled Madbouly¹, Ahmed Isa², Mohamad Habous³, Raed Almannie⁴, Basim Abu-Rafea², Saleh Binsaleh⁴
Canadian Journal of Urology, Vol.24, No.3, pp. 8847-8852, 2017
Abstract Introduction: Pregnancy rates after intrauterine insemination (IUI) varies greatly. We aimed to identify pre and post processing semen analysis parameters that may be predictive of successful pregnancy in couples undergoing IUI.
Materials and methods: A retrospective study of the records of all couples underwent IUI for a 2 year period at our infertility center. Different characteristics of female subjects, pre and post processing semen parameters and treatment parameters were compared statistically.
Results: Thirty-two clinical pregnancies followed 526 IUI cycles in 294 couples, for a clinical pregnancy rate of 6.1% per cycle and a 10.9% per couple. The mean… More >

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PEDIATRIC UROLOGY

Zenon Pogorelić^1,2, Tomislava Brković², Dražen Budimir¹, Jakov Todorić¹, Đurđica Košuljandić³, Ana Jerončić⁴, Mihovil Biočić¹, Marijan Saraga^2,3
Canadian Journal of Urology, Vol.24, No.3, pp. 8853-8858, 2017
Abstract Introduction: The aim of this study was to determine the efficacy and potential complications of double-J ureteric stents in the treatment of primary hydronephrosis in pediatric patients.
Materials and methods: A retrospective case-records review of 133 patients (45 girls and 88 boys) treated because of primary hydronephrosis with double-J ureteric stents, in Department of Pediatric Surgery, Split University Hospital, between December 1997 and December 2014, was performed. Success of treatment, results of follow up investigations and complications were recorded. Patients were followed up clinically and radiologically for a minimum of 2 years following stent insertion.
Results: In all, 133… More >

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HOW I DO IT

Lance Patrick Walsh
Canadian Journal of Urology, Vol.24, No.3, pp. 8859-8864, 2017
Abstract Benign prostatic hypertrophy (BPH) affects an estimated 60% of men over the age of 50 and 90% of men over the age of 80. The prostatic urethral lift (PUL) is a safe and effective office-based procedure that is used worldwide for the treatment of BPH in men who are dissatisfied with medications due to side effects or lack of efficacy or don’t want to have a transurethral resection of the prostate due to the side effects and invasiveness of the procedure. In 2012 Barkin et al, published the standard technique for the delivery of the More >

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RESIDENT’S CORNER

Emma Sumner, Behram Cenk Acar, Matthew R. Acker
Canadian Journal of Urology, Vol.24, No.3, pp. 8865-8867, 2017
Abstract Oncocytic tumors arising from the adrenal gland are rare. Oncocytic adrenal neoplasms (OAN) may mimic adrenocortical carcinoma (ACC) at presentation, and can only be defnitively diagnosed histologically. Most OANs are benign, and carry a favorable prognosis. We report on an 83-year-old female who, while being investigated for anemia and weight loss, was found to have a 23 cm adrenal mass concerning for ACC. Adrenalectomy and histopathology confrmed a malignant OAN, based on theLin-Weiss-Biscegliacriteria.Wereportonthelargest non-functional, malignant OAN cited in the literature to date. OAN’s, though rare, can be considered in the differential diagnosis of large adrenal More >

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RESIDENT’S CORNER

Ryan Fitzpatrick¹, Nicholas R. Paterson¹, Eric C. Belanger², Arleigh McCurdy³, James Watterson¹
Canadian Journal of Urology, Vol.24, No.3, pp. 8868-8870, 2017
Abstract Amyloidosis is a protein folding disorder characterized by the deposition of fibrillar proteins into solid organs or tissues. Primary localized amyloidosis of the bladder is very rare and can mimic bladder cancer in its presentation with hematuria, lower urinary tract symptoms or a mass on imaging. A case of localized amyloidosis of the bladder in a 48-year-old man with painless gross hematuria and evidence of bladder mass on ultrasound is presented. Amyloidosis is a rare but important non-malignant process of the bladder. We present a review of the literature and suggestions for management of this More >

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