Open Access

EDITORIAL

Leonard G. Gomella
Canadian Journal of Urology, Vol.27, No.1, pp. 10067-10067, 2020
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LEGENDS IN UROLOGY

Richard E. Hautmann
Canadian Journal of Urology, Vol.27, No.1, pp. 10068-10071, 2020
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ARTICLE

Peter Gilling¹, Neil Barber², Mohamed Bidair³, Paul Anderson⁴, Mark Sutton⁵, Tev Aho⁶, Eugene Kramolowsky⁷, Andrew Thomas⁸, Barrett Cowan⁹, Ronald P. Kaufman, Jr.¹⁰, Andrew Trainer¹¹, Andrew Arther¹¹, Gopal Badlani¹², Mark Plante¹³, Mihir Desai¹⁴, Leo Doumanian¹⁴, Alexis E. Te¹⁵, Mark DeGuenther¹⁶, Claus Roehrborn¹⁷
Canadian Journal of Urology, Vol.27, No.1, pp. 10072-10079, 2020
Abstract Introduction: To compare 3-year efficacy and safety after prostate resection with Aquablation therapy or transurethral resection of the prostate (TURP) for the treatment of lower urinary tract symptoms related to benign prostate hyperplasia (BPH).
Materials and methods: One hundred and eighty-one patients assigned to either Aquablation therapy or TURP were followed for 3 years postoperatively. Patients and follow-up assessors were blinded to treatment. Assessments included International Prostate Symptom Score (IPSS), Male Sexual Health Questionnaire (MSHQ-EjD), International Index of Erectile Function (IIEF) and uroflow.
Results: Over 3 years of treatment, improvements in IPSS scores were statistically similar across groups.… More >

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ARTICLE

Whitney N. Stanton¹, E. David Crawford², Paul B. Arangua³, Francisco G. La Rosa¹, Adrie van Bokhoven¹, M. Scott Lucia¹, Wendy L. Poage⁴, Alan Partin⁵, Paul Maroni³, Priya N. Werahera¹
Canadian Journal of Urology, Vol.27, No.1, pp. 10080-10085, 2020
Abstract Introduction: To identify patients at risk of high-grade prostate cancer using prostate cancer biomarkers.
Materials and methods: A total of 601 men were screened for prostate cancer in 2012, 2015, and 2016 using prostate cancer biomarkers: prostate health index (phi), 4KScore, and SelectMDx. The first two are blood tests that incorporate several PSA isoforms; SelectMDx measures mRNA levels of homeobox C6 and distal-less homeobox 1 in post-digital rectal examination urine samples. The performance of each biomarker was evaluated using cut-off values based on published literature. Gleason Grade Group (GG) ≥ 2 is considered as high-grade prostate cancer.
Results:… More >

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COMMENTARY

Judd W. Moul
Canadian Journal of Urology, Vol.27, No.1, pp. 10086-10086, 2020
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ARTICLE

Alexander J. Skokan¹, Ryan W. Dobbs¹, Andrew M. Harris², Christopher D. Tessier³, Kamran P. Sajadi³, Ruchika Talwar¹, Ian Berger¹, Thomas J. Guzzo¹, Justin B. Ziemba¹
Canadian Journal of Urology, Vol.27, No.1, pp. 10087-10092, 2020
Abstract Introduction: A shared professional culture focused on patient safety is critical to delivering high-quality care. There is a need for objective metrics to help identify target areas for improvement in patient safety culture. The Medical Office Survey on Patient Safety Culture (SOPS) was developed and validated by the United States Agency for Healthcare Research and Quality to measure patient safety culture in the ambulatory setting. In this study we report on safety culture and practices in six academic urology clinics utilizing this validated questionnaire.
Materials and methods: The SOPS was administered to all staff in ambulatory urology… More >

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ARTICLE

Jim K. Shen, Kevin G. Chan, Jonathan N. Warner
Canadian Journal of Urology, Vol.27, No.1, pp. 10093-10098, 2020
Abstract Introduction: To assess the use, complications, and outcomes of continent cutaneous ileocecal cystoplasty (CCIC) for the management of refractory bladder neck contractures and/or urinary incontinence after prostate cancer therapy.
Materials and methods: An institutional review board approved database was reviewed for patients who underwent CCIC from January 1, 2003 to December 31, 2018. Preoperative, perioperative and postoperative factors were assessed, including complications and outcomes.
Results: Thirteen patients were identified. Indications for CCIC included refractory bladder neck contracture (n = 3), urinary incontinence (n = 5), or both (n = 5). Median age was 69. Median follow-up was 78.1… More >

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ARTICLE

Mark Mann¹, Brian P. Calio¹, James Ryan Mark¹, Raju Chelluri², Erich Hufnagel³, Adam Reese⁴, Costas D. Lallas¹, Edouard J. Trabulsi¹, Thenappan Chandrasekar¹, Patrick J. Shenot¹, Ethan Halpern⁵, Leonard G. Gomella¹
Canadian Journal of Urology, Vol.27, No.1, pp. 10099-10104, 2020
Abstract Introduction: To assess whether standard American Urological Association (AUA) and other recommendations for prostate biopsy prophylaxis provide sufficient coverage of common urinary organisms responsible for post biopsy infections by comparing local antibiograms in Philadelphia-area hospitals.
Materials and methods: De-identified culture results derived from antibiograms were collected from six academic and community hospitals in the Philadelphia region. Analysis specifically focused on four major bacterial causes of urinary tract infection following prostate biopsy (Escherichia coli (E. coli), Klebsiella pneumoniae, Proteus mirabilis and Enterococcus faecalis) along with commonly recommended antibiotics including fluoroquinolones (FQ’s), trimethoprim/sulfamethoxazole, ceftriaxone, and gentamicin.
Results: Bacterial sensitivities to… More >

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COMMENTARY

Eric H. Kim, Gerald L. Andriole
Canadian Journal of Urology, Vol.27, No.1, pp. 10105-10105, 2020
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ARTICLE

Robert A. Petrossian¹, Danuta Dynda¹, Kristin Delfino¹, Ahmed El-Zawahry³, Kevin T. McVary²
Canadian Journal of Urology, Vol.27, No.1, pp. 10106-10117, 2020
Abstract Introduction: The role of organized sleep in overall health and quality-of-life (QoL) is critical. Nocturia necessarily disrupts the normal sleep cycle and negatively impacts one’s health, work productivity, and QoL. We investigated, for the first time in an exploratory pilot, the effectiveness of mirabegron for improving sleep disturbance and nocturia.
Materials and methods: This was a prospective, open-label 12-week trial evaluating the efficacy of mirabegron in 34 men and women with disordered sleep and lower urinary tract symptoms (LUTS). Subjects received mirabegron 25 mg daily for 4 weeks, then increased to 50 mg. Subjects completed the Patient-Reported… More >

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ARTICLE

Charles C. Peyton¹, Ali Hajiran¹, Kevin Morgan², Mounsif Azizi¹, Dominic Tang¹, Juan Chipollini¹, Scott M. Gilbert¹, Michael Poch¹, Wade J. Sexton¹, Philippe E. Spiess¹
Canadian Journal of Urology, Vol.27, No.1, pp. 10118-10124, 2020
Abstract Introduction: To describe the incidence, contemporary management, risk factors and outcomes of urinary leak following open and robotic partial nephrectomy at a tertiary care, comprehensive cancer center.
Materials and methods: We reviewed 975 patients who underwent partial nephrectomy at Moffitt Cancer Center from January 2009 to May 2017. Patient demographic, perioperative and follow-up data were recorded and compared, stratified for postoperative urine leak. Fisher’s exact and Wilcoxon sum-rank testing were performed for categorical and continuous variables as indicated.
Results: Twenty-three of 975 (2.3%) patients experienced a urine leak after partial nephrectomy. Median nephrometry score for urine leak patients… More >

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ARTICLE

Robert J. Evans¹, Tyler Overholt¹, Marc Colaco¹, Stephen J. Walker^1,2
Canadian Journal of Urology, Vol.27, No.1, pp. 10125-10129, 2020
Abstract Introduction: Botulinum toxin A (BTX-A) is currently used as a fourth-line therapeutic option for interstitial cystitis/bladder pain syndrome (IC/BPS) management. The purpose of this study was to determine if BTX-A injection can mitigate pain and if injection location (i.e., trigone-including versus trigone-sparing injection template) impacts treatment efficacy and/or treatment complications profile.
Materials and methods: Female IC/BPS patients refractory to conservative management strategies were prospectively enrolled and asked to complete a baseline history and physical exam, post-void residual (PVR) urine volume determination, O’Leary Sant (OLS) questionnaire, and Pelvic Pain and Urgency/Frequency Symptom Scale (PUF) questionnaire. Participants were randomly… More >

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ARTICLE

Joshua Palka, Zaid Farooq, Barrett G. Anderson
Canadian Journal of Urology, Vol.27, No.1, pp. 10130-10134, 2020
Abstract Introduction: Initial management of obstructing ureteral stones with concomitant urinary tract infection (UTI) includes prompt renal decompression and antibiotics. Some urologists theorize that performing retrograde pyelography (RGP) at the time of ureteral stent placement may cause pyelovenous backflow of bacteria thereby worsening clinical outcomes. We compared outcomes in patients with infected ureteral stones who underwent RGP versus no RGP prior to stent placement.
Materials and methods: A retrospective chart review was conducted involving patients who presented between 2015 and 2017 with an obstructing ureteral stone and associated UTI. Computed tomography scans were evaluated for stone size and… More >

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RESIDENT’S CORNER

Alexandra L. Tabakin, Nicholas J. Farber, Joseph Barone
Canadian Journal of Urology, Vol.27, No.1, pp. 10135-10137, 2020
Abstract Testicular torsion is a common pediatric emergency. Predisposing factors and other risk factors for testicular torsion have not been fully elucidated. This case report highlights teenage brothers who each experienced rightsided testicular torsion at nearly the same age, just 1 year apart. Because of their parents’ urgency in seeking medical attention, the affected testicles in both patients were salvaged. We also review the current literature in regards to etiology, inheritance, and patient and parental education. More >

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RESIDENT’S CORNER

Kelly R. Pekala¹, Oluwaseun Orikogbo², Liam C. Macleod¹, Louis D’Agostino¹
Canadian Journal of Urology, Vol.27, No.1, pp. 10138-10141, 2020
Abstract Renal artery aneurysms can present with gross hematuria and are potentially life-threatening in cases of rupture. We report a case of a young male with no prior genitourinary history who presents to an emergency department with sudden onset gross hematuria, clot retention, and right-sided flank pain. On evaluation, he was found to have a renal artery aneurysm bleeding into his collecting system and underwent renal artery embolization and rapid resolution of his hematuria. Renal vascular pathology should be considered in the differential diagnosis and timely diagnosis of this condition is imperative as surgical interventions have More >

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