Open Access

EDITORIAL

Timothy D. Averch
Canadian Journal of Urology, Vol.25, No.1, pp. 9148-9148, 2018
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LEGENDS IN UROLOGY

Per-Anders Abrahamsson
Canadian Journal of Urology, Vol.25, No.1, pp. 9149-9151, 2018
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LETTER

Jerry G. Blaivas, Jeffrey P. Weiss
Canadian Journal of Urology, Vol.25, No.1, pp. 9152-9153, 2018
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REVIEW

Todd Yecies, Timothy D. Averch, Michelle J. Semins
Canadian Journal of Urology, Vol.25, No.1, pp. 9154-9160, 2018
Abstract Introduction: The risks of exposure to medical ionizing radiation are of increasing concern both among medical professionals and the general public. Patients with nephrolithiasis are exposed to high levels of ionizing radiation through both diagnostic and therapeutic modalities. Endourologists who perform a high volume of fluoroscopy-guided procedures are also exposed to significant quantities of ionizing radiation. The combination of judicious use of radiation-based imaging modalities, application of new imaging techniques such as ultra-low-dose computed tomography (CT) scans, and modification of current technologies, such as increased use of ultrasound and pulsed fluoroscopy, offers the potential to significantly… More >

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ARTICLE

Quentin Manach¹, Olivier Cussenot², Morgan Rouprêt¹, Xavier Gamé³, Emmanuel Chartier-Kastler¹, Christine Reus¹, Philippe Camparo⁴, Eva Compérat², Véronique Phé¹
Canadian Journal of Urology, Vol.25, No.1, pp. 9161-9167, 2018
Abstract Introduction: To determine whether the validated tumor biomarkers of luminal and basal subtypes of bladder cancer, established in non neuro-urological patients, are applicable to a neuro-urological population.
Materials and methods: We collected bladder cancer samples from neuro-urological patients (n = 20) and non-neurological controls (n = 40). The expression levels of GATA3 and CK5/6 were analyzed using immunohistochemistry on tissue microarray sections. We also evaluated the correlation between previously identified biomarker expression, gender, age, tumor stage (non-muscle-invasive bladder cancer [NMIBC] vs. muscle-invasive bladder cancer [MIBC]), squamous-cell differentiation, and luminal/basal subtypes using Pearson’s correlation coefficient (r).
Results: The mean… More >

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ARTICLE

Samuel G. Antoine, Alexander C. Small, James M. McKiernan, Ojas Shah
Canadian Journal of Urology, Vol.25, No.1, pp. 9168-9178, 2018
Abstract Introduction: Surgical subspecialty societies release clinical practice guidelines (CPGs) to provide topic-specific recommendations to healthcare providers. We hypothesize that there may be significant differences in statement strength and evidence quality both within the American Urological Association (AUA) guidelines and compared to those published by the American Academy of Orthopedic Surgeons (AAOS) and the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS).
Materials and methods: CPGs issued through 2017 were extracted from AUAnet.org. Statements were characterized by evidence basis, strength, and evidence quality. CPGs were compared among urologic subspecialties and to those from the AAOS and AAO-HNS. Analysis… More >

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ARTICLE

Joshua S. Jue^1,2, Tulay Koru-Sengul^3,4, Kevin J. Moore^2,3, Feng Miao², Mahmoud Alameddine¹, Bruno Nahar¹, Sanoj Punnen¹, Dipen J. Parekh^1,4, Chad R. Ritch¹, Mark L. Gonzalgo^1,4
Canadian Journal of Urology, Vol.25, No.1, pp. 9179-9185, 2018
Abstract Introduction: To investigate the impact of perioperative factors on overall survival among patients with histologic variants of bladder cancer treated with radical cystectomy.
Materials and methods: The National Cancer Data Base (NCDB) was utilized to identify patients diagnosed with muscle-invasive bladder cancer (cT2–T4, N0, M0) from 2004 to 2013. Variant histology bladder cancers—including non-mucinous adenocarcinoma, mucinous/signet ring adenocarcinoma, micropapillary urothelial carcinoma, small cell carcinoma, and squamous cell carcinoma—were compared to urothelial carcinoma with respect to overall survival. Adjusted hazard ratios (aHR) and 95% confidence intervals (CI) were calculated using a multivariable Cox regression model to examine factors… More >

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ARTICLE

Eric J. Kirshenbaum^1,2, Robert H. Blackwell^1,2, Belinda Li¹, Anai N. Kothari^2,3, Paul C. Kuo^2,3, Robert C. Flanigan¹, Alex Gorbonos¹, Gopal N. Gupta^1,2
Canadian Journal of Urology, Vol.25, No.1, pp. 9186-9192, 2018
Abstract Introduction: The purpose of this article is to assess the incidence of pulmonary aspiration following major urologic surgery, identify predictors of an aspiration event, and evaluate subsequent clinical outcomes.
Materials and methods: The Healthcare Cost and Utilization Project State Inpatient Database for California (2007–2011) was used to identify patients undergoing cystectomy, prostatectomy, partial nephrectomy, and radical nephrectomy. Aspiration events were identified within 30 days post-surgery. The primary outcome was 30-day mortality; secondary outcomes included total length of hospital stay, discharge location, and diagnoses of acute renal failure, pneumonia, or sepsis. Descriptive statistics were performed. A multivariable logistic… More >

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ARTICLE

Jay G. Fuletra¹, Anastasiya Kamenko², Frederick Ramsey³, Daniel D. Eun², Adam C. Reese²
Canadian Journal of Urology, Vol.25, No.1, pp. 9193-9198, 2018
Abstract Introduction: Prior studies suggest that among men with low-grade prostate cancer, African American (AA) men produce less prostate-specific antigen (PSA) than Caucasians. We investigated racial differences in PSA, PSA density (PSAD), and tumor volume among men with prostate cancer, regardless of tumor grade. If present, these differences would suggest that AA men may benefit from different screening, surveillance, and treatment regimens compared to Caucasians.
Materials and methods: We identified men from our institutional prostate cancer database who underwent radical prostatectomy between 2012 and 2015. Clinicopathologic parameters were compared by race. Multivariable linear regression was then performed to… More >

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ARTICLE

Bryan D. Hinck¹, Ricardo Miyaoka¹, James E. Lingeman², Dean G. Assimos³, Brian R. Matlaga⁴, Rocky Pramanik⁵, John Asplin⁵, Benjamin Cohen¹, Manoj Monga¹
Canadian Journal of Urology, Vol.25, No.1, pp. 9199-9204, 2018
Abstract Introduction: This study aims to determine whether markers of kidney injury correlate with urinary oxalate excretion. If such a relationship exists, these biomarkers could serve as early predictors of oxalate nephropathy. Gastric bypass surgery for obesity is known to be associated with postoperative hyperoxaluria, which can lead to urolithiasis and renal damage.
Materials and methods: Patients were recruited from four large academic medical centers at least six months after undergoing gastric bypass surgery. Participants provided a spot urine sample for analysis of three established biomarkers of kidney injury: 8-iso-Prostaglandin F_2α, N-acetyl-β-D-glucosaminidase, and neutrophil gelatinase-associated lipocalin. In addition, 24-hour… More >

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ARTICLE

Ahmed Mohey, Mohamed Alhefnawy, Mostafa Mahmoud, Rabea Gomaa, Tarek Soliman, Shabieb Ahmed, Yasser A. Noureldin
Canadian Journal of Urology, Vol.25, No.1, pp. 9205-9209, 2018
Abstract Introduction: This study aims to assess the conversion rate during fluoroless ureteroscopy (URS) and evaluate its feasibility, safety, and efficacy as a definitive management approach for distal ureteral calculi.
Materials and methods: Between May 2013 and August 2015, patients with radio-opaque distal ureteral stones ≤ 1 cm in size were randomized to undergo either fluoroless-URS or standard URS. Exclusion criteria included prior ureteral surgery, ureteral kinking or stricture, single kidney, additional proximal ureteral or renal stones, uncontrolled coagulopathy, and/or congenital urinary tract anomalies. Patient demographics, stone characteristics, operative data, stone-free status, and complications were compared between the… More >

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RESIDENT’S CORNER

Nicholas H. Chakiryan¹, Phil W. Raess², Kevin Turner², Jason C. Hedges¹, Jen-Jane Liu¹
Canadian Journal of Urology, Vol.25, No.1, pp. 9210-9213, 2018
Abstract Malignant Leydig cell tumor is a rare entity that has been previously described as rapidly progressive and uniformly fatal. We present the case of a malignant Leydig cell tumor that presented 14 years after orchiectomy with an isolated retroperitoneal metastasis. Our patient underwent a retroperitoneal lymph node dissection and has been free of recurrence or progression at 12 months of follow up. Additionally, we describe the symptomatic hormone dysfunction experienced by our patient as a result of his tumor. More >

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RESIDENT’S CORNER

Brian J. McArdle, Patricia Vidal, Sarah P. Psutka, Courtney M.P. Hollowell
Canadian Journal of Urology, Vol.25, No.1, pp. 9214-9216, 2018
Abstract It is rare to see an adult presenting with exstrophy of the bladder. Malignant conversion in exstrophy occurs in 4%, with adenocarcinoma as the most common histopathology. We report the first case of metastatic high grade urothelial carcinoma with squamous and sarcomatoid differentiation arising from undiagnosed, closed bladder exstrophy in a female at advanced age with associated bilateral deep vein thrombosis and clot retention. The patient developed clinical progression of disease despite neoadjuvant gemcitabine-cisplatin and salvage (or palliative) radiotherapy. To the best of our knowledge, this is the first reported case of a primary urothelial More >

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RESIDENT’S CORNER

Wesley Baas, Blake O’Connor, Ahmed El-Zawahry
Canadian Journal of Urology, Vol.25, No.1, pp. 9217-9219, 2018
Abstract A 57-year-old African American male presented with vague abdominal pain and bilateral flank pain. The patient was found to have bilateral hydronephrosis and significant renal function impairment secondary to pelvic lipomatosis. Pelvic lipomatosis represents a clinically-diagnosed unique cause of ureteral obstruction and subsequent renal impairment. We present a case report of newly diagnosed pelvic lipomatosis, the clinical and imaging characteristics for diagnosis, and its conservative management with serial ureteral stent exchanges. More >

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