Open Access

BOOK REVIEW

Richard J. Wassersug, John Robinson, R. Psych, Lauren Walker
Canadian Journal of Urology, Vol.25, No.6, pp. 9568-9568, 2018
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EDITORIAL

Leonard G. Gomella
Canadian Journal of Urology, Vol.25, No.6, pp. 9569-9569, 2018
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LEGENDS IN UROLOGY

Laurent Boccon-Gibod
Canadian Journal of Urology, Vol.25, No.6, pp. 9570-9572, 2018
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ARTICLE

Daniel C. Edwards¹, David B. Cahn², Madhu Reddy³, Dana Kivlin⁴, Aseem Malhotra⁵, Tianyu Li⁶, David Y.T. Chen², Rosalia Viterbo², Robert G. Uzzo², Richard E. Greenberg², Marc C. Smaldone², Paul Curcillo⁷, Alexander Kutikov²
Canadian Journal of Urology, Vol.25, No.6, pp. 9573-9578, 2018
Abstract Introduction: Postoperative incisional hernias (PIH) are an established complication of abdominal surgery, with rates after radical cystectomy (RC) poorly defined. The objective of this analysis is to compare rates and risk factors of PIH after open (ORC) and robotic-assisted (RARC) cystectomy at a tertiary-care referral center.
Materials and methods: We performed a retrospective review of patients undergoing ORC and RARC from 2000-2015 with pre- and postoperative cross-sectional imaging available. Images were evaluated for anthropometric measurements and the presence of postoperative radiographic PIH (RPIH). Patient demographics, type of urinary diversion, and postoperative hernia repair (PHR) were also assessed.
Results:… More >

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ARTICLE

Amr Mahran^1,2, Laura Bukavina^1,2, Kirtishri Mishra^1,2, Christina Buzzy^1,2, Morgan L Fish¹, Aidan Bobrow¹, Lee Ponsky^1,2,3
Canadian Journal of Urology, Vol.25, No.6, pp. 9579-9584, 2018
Abstract Introduction: The vast majority of bladder cancer is non-muscle invasive with transurethral resection (TURBT) as the gold standard for surgical treatment. There is a high recurrence of bladder cancer post-surgery, which adds to the frustration in current urologic practice. Current standard of care to further reduce bladder cancer recurrence is instillation of intravesical chemotherapy (ICT), a practice that is not routinely followed. Several studies point to similar effects with normal saline or water irrigation alone. Our objective is to review the current available literature and provide practicing urologists with an alternative to ICT.
Materials and methods: A… More >

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ARTICLE

Kevan M. Sternberg¹, Andrew Pham¹, Theodore Cisu¹, Marissa L. Kildow², Kristina L. Penniston²
Canadian Journal of Urology, Vol.25, No.6, pp. 9585-9590, 2018
Abstract Introduction: Renal colic is commonly seen in the emergency department (ED), where the focus is on diagnosis and symptom control. Educational materials are sometimes provided upon discharge; however, no standard content has been established. We characterized the educational materials given to patients reporting to EDs in different regions across the U.S. for symptomatic kidney stones, specifically evaluating disease-specific information, symptom management, prevention strategies including dietary recommendations (DRs), and patient follow up plans.
Materials and methods: Generic discharge instructions for patients presenting to EDs with renal colic were obtained from community hospitals and academic medical centers between October… More >

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ARTICLE

Mark Broadwin¹, Alex J. Vanni²
Canadian Journal of Urology, Vol.25, No.6, pp. 9591-9595, 2018
Abstract Introduction: There is no standardized treatment algorithm for isolated fossa navicularis strictures and treatment modality often falls to surgeon preference. We evaluated the outcomes of a standardized algorithm for fossa navicularis strictures based on stricture etiology, lumen size, and glans size to minimize the number of patients requiring a two-stage urethral reconstruction.
Materials and methods: We retrospectively reviewed a prospectively maintained urethral reconstruction database by a single surgeon from 2011-2018. A treatment algorithm was applied and patients underwent one of three treatment modalities: a two-stage buccal mucosa graft (BMG), a single-stage dorsal inlay BMG, or a single-stage… More >

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ARTICLE

Karen M. Doersch¹, G. Luke Machen², Kim H. Thai², John Sung², Marawan M. El Tayeb²
Canadian Journal of Urology, Vol.25, No.6, pp. 9596-9600, 2018
Abstract Introduction: Stent placement is a common procedure for addressing obstructive uropathy. However, lack of operating room (OR) availability can substantially delay this procedure. In this study, we sought to assess the feasibility, safety, and efficacy of this procedure in a clinical setting using nitrous oxide (N₂O) and local anesthesia.
Materials and methods: Patients included in this study included those who were determined to need management of urinary obstruction with a JJ (“double J”) stent and had their procedure performed in the clinic procedure suite with N₂O anesthesia.
Results: We present a case series of 565 patients undergoing ureteral stent… More >

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ARTICLE

Rachel A. Moses, Annah J. Vollstedt, Vernon M. Pais Jr.
Canadian Journal of Urology, Vol.25, No.6, pp. 9601-9605, 2018
Abstract Introduction: Though widely performed, the safety of non-intravenous contrast (NIVC) urography in patients with documented intravenous, iodinated contrast allergic like reactions (ICA) is unclear. The purpose of this study was to determine the risk of “allergic-like” reaction (ALR) events in patients with ICA undergoing NIVC urography.
Materials and methods: Patients undergoing contrast urography at a single institution were identified between 2011-2014. Patient charts were reviewed for documented ICA prior to index surgery, preoperative allergy prophylaxis with steroid or antihistamine, and acute allergic reactions identified by ICD codes within 24 hours of surgery.
Results: A total of 2,650 patients… More >

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ARTICLE

Takeshi Yamasaki, Satoshi Tamada, Minoru Kato, Taiyo Otoshi, Hisao Tanaka, Taro Iguchi, Tatsuya Nakatani
Canadian Journal of Urology, Vol.25, No.6, pp. 9606-9613, 2018
Abstract Introduction: Recently, the use of indocyanine green (ICG) with near infrared fluorescence (NIRF) imaging has emerged as an alternative technique for the real-time delineation of resection margins during partial nephrectomy (PN). We aimed to assess the feasibility of using NIRF imaging with ICG during laparoscopic partial nephrectomy (LPN) to delineate the margin between normal renal parenchyma and renal cortical tumors.
Materials and methods: A retrospective comparison of real-time tumor margin identification and operative outcomes was conducted for 83 patients who underwent LPN with NIRF imaging (IMAGE1 system) and 74 patients who did not.
Results: Tumor margins were identified… More >

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RESIDENT’S CORNER

Ericka Sohlberg, Andrew Sun, Rustin Massoudi, Kris Prado, Eila Skinner
Canadian Journal of Urology, Vol.25, No.6, pp. 9614-9616, 2018
Abstract While renal angiomyolipomas (AMLs) generally remain small and asymptomatic, larger AMLs are more common in tuberous sclerosis patients. Giant AMLs over 20 cm are a rare entity and little is known about their management. We present a unique case of a 48-year-old woman with tuberous sclerosis and a 39 cm AML arising from a solitary kidney, after undergoing nephrectomy for a prior AML. Giant renal AMLs can occur in patients with tuberous sclerosis and resection should be considered even for large tumors. Renal sparing is often difficult and patients should be counseled about potential need More >

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RESIDENT’S CORNER

Ali Syed, Joon Yau Leong, Seth Teplitsky, William Li, Akhil Das
Canadian Journal of Urology, Vol.25, No.6, pp. 9617-9619, 2018
Abstract We report a rare complication of rectourethral fistula formation 6 weeks after a 70-year-old man underwent an uneventful HoLEP procedure. Cystourethrogram confrmed the diagnosis and the patient was managed conservatively with chronic indwelling catheter placement for 6 weeks. After this, his symptoms resolved completely and a repeat cystourethrogram showed marked resolution of the fstulous tract. The cause of the fstula formation is believed to be due to a delayed thermal or infectious reaction. Post-procedure follow up is necessary in all patients to monitor for complications that donotarise immediately after surgery. More >

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RESIDENT’S CORNER

Theodore R. Saitz¹, Anil A. Thomas²
Canadian Journal of Urology, Vol.25, No.6, pp. 9620-9622, 2018
Abstract A healthy 35-year-old male presented for vasectomy after fathering two children. Due to difficulty palpating the left vas, the patient was taken to the operating room for scrotal exploration and vasectomy. The left vas was absent; however, a 1.2 cm pearly nodule was identified in the scrotum along its suspected course. This nodule was excised, found to contain thick white pasty fluid, and confirmed vas deferens by pathology. The patient was found to have normal kidneys on renal ultrasound and was indeed a carrier for cystic fibrosis gene mutations. We herein discuss management and implications More >

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HOW I DO IT

Jaasmit Khurana¹, Vivian Ip¹, Gerald Todd², Rakesh V. Sondekoppam¹
Canadian Journal of Urology, Vol.25, No.6, pp. 9623-9626, 2018
Abstract Pain control following major abdominal surgery remains a significant barrier to patient comfort. Although thoracic epidurals have been used to provide analgesia for these surgeries, the transversus abdominis plane (TAP) block is gaining popularity. The TAP catheter insertion method has transformed over the past two decades from a blinded technique to one conducted primarily under ultrasound guidance by anesthesiologists. Recently, however, interest has increased on the potential for direct surgical insertion of catheters into the TAP plane following flank incisions due to anatomical considerations. Proposed advantages include a reduction in operating time, requirement of minimal More >

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