Open Access

EDITORIAL

Leonard G. Gomella
Canadian Journal of Urology, Vol.27, No.3, pp. 10199-10200, 2020
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LEGENDS IN UROLOGY

Alan J. Wein
Canadian Journal of Urology, Vol.27, No.3, pp. 10201-10204, 2020
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REVIEW

Vipin Tyagi¹, Ajay Kumar Sharma², Mahendra Bhandari³
Canadian Journal of Urology, Vol.27, No.3, pp. 10205-10212, 2020
Abstract Introduction: The novel coronavirus disease 2019 (COVID-19) pandemic has afflicted > 3.3 million people around the world since December 2019. Though more than 1000 publications have appeared in scientific journals addressing a plethora of questions, there is a considerable hiatus in understanding the behavior and natural history of the virus and its impact on urology. Also, a modified approach is the need of the hour in taking care of patients, as urologists should safeguard their teams, families, and patients.
Material and methods: The authors have used guidelines from the USA, Canada, UK, Europe, and India for making… More >

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ARTICLE

Ronald F. Tutrone¹, William Schiff²
Canadian Journal of Urology, Vol.27, No.3, pp. 10213-10219, 2020
Abstract Introduction: To report the early postoperative patient experience, including symptom response, catheterization, recovery and satisfaction, following treatment with two minimally invasive surgical therapies (MIST) for benign prostatic hyperplasia (BPH): mechanical disobstruction with UroLift prostatic urethral lift (PUL) and tissue ablation with steam injection (Rezum).
Materials and methods: Patient reported outcomes of 53 non-retention patients from two U.S. sites who underwent PUL (n = 30) or Rezum (n = 23) were collected within 2 months post-treatment. There were no exclusion criteria for baseline symptoms, prostate size, or BPH medical therapy. Patients completed questionnaires which assessed postoperative BPH symptoms… More >

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ARTICLE

Ishaq Al Salmi¹, Terence Menezes¹, Mohamed EL-Khodary¹, Sandra Monteiro², Ehsan A. Haider¹, Abdullah Alabousi¹
Canadian Journal of Urology, Vol.27, No.3, pp. 10220-10227, 2020
Abstract Introduction: The aim of this study was to evaluate the value of dynamic contrast enhanced (DCE) imaging in multi-parametric prostate MRI (mpMRI) for the detection and staging of prostate cancer in comparison with T2W and DWI images alone in biparametric MRI (bpMRI) in treatment-naïve patients.
Materials and methods: One hundred consecutive patients who underwent a prostate MRI at our institution from June-August 2017, as well as a systematic ultrasound-guided prostate biopsy or prostatectomy, were included. Strictly following PI-RADS v2, the MRI studies were independently interpreted by a body radiologist and a body-imaging fellow on two different occasions… More >

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ARTICLE

Gregory P. Murphy¹, Kushan D. Radadia¹, Jonathan Weese¹, Cooper R. Benson², Niraj Badhiwala¹, Alethea Paradis¹, Joel Vetter¹, Steven B. Brandes²
Canadian Journal of Urology, Vol.27, No.3, pp. 10228-10232, 2020
Abstract Introduction: To evaluate flexible pediatric cystoscopy (FPC) as an adjunctive procedure to retrograde urethrography (RUG) and voiding cystourethrography (VCUG) in the preoperative setting for male urethral strictures. Since imaging interpretation of stricture length and caliber can be difficult at times, we sought to evaluate diagnostic utility of FPC to predict reconstructive surgery.
Materials and methods: Reconstructive urology databases at Washington University and Columbia University were queried from 2010-2017. A total of 185 anterior urethroplasty patients met inclusion criteria. All surgeries were performed by a single surgeon. There were 102 patients that underwent preoperative FPC (7.5 Fr in… More >

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ARTICLE

Sutchin R. Patel¹, Michael W. Witthaus², Erdal S. Erturk², Ronald Rabinowitz², Stephen Y. Nakada¹
Canadian Journal of Urology, Vol.27, No.3, pp. 10233-10237, 2020
Abstract Introduction: The development of renal stones in space would not only impact the health of an astronaut but could critically affect the success of the mission.
Materials and methods: We reviewed the medical literature, texts, and multimedia sources regarding the careers of Dr. Abraham Cockett and Dr. Peggy Whitson and their contributions to the study of urolithiasis in space, as well as the studies in between both of their careers that helped to further characterize the risks of stone formation in space.
Results: Dr. Abraham T. K. Cockett (1928-2011) was Professor and Chair of the Department of Urology… More >

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ARTICLE

Kinan Bachour¹, Michael E. Rezaee², Amanda R. Swanton², Vernon M. Pais, Jr.^1,2
Canadian Journal of Urology, Vol.27, No.3, pp. 10238-10243, 2020
Abstract Introduction: To investigate the relationship between socioeconomic factors, specifically insurance status, and kidney stones using a nationally representative cohort.
Materials and methods: A retrospective secondary data analysis of National Health and Nutrition Examination Survey (NHANES) data from 2007 to 2014 was performed. Using univariate statistics and multiple logistic regressions, we examined the relationship between socioeconomic factors and kidney stone history.
Results: The weighted national prevalence of nephrolithiasis between ages 20 and 64 was 7.7% of a population of over 95.3 million. Fifty-three percent of the total population was female. The mean age was 42 years and the mean… More >

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ARTICLE

Keara English¹, Richard Maiman², Melissa Laudano², Nitya Abraham²
Canadian Journal of Urology, Vol.27, No.3, pp. 10244-10249, 2020
Abstract Introduction: Given the invasive nature of urodynamics and its unclear impact on altering patient management, we aimed to determine whether performing a urodynamic study (UDS) resulted in a change in either patient diagnosis or treatment offered in women with uncomplicated urinary incontinence.
Materials and methods: A retrospective review was performed of all female patients who underwent UDS for urinary incontinence at our practice between January 2014 and 2017. Patients with neurogenic lower urinary tract dysfunction, incomplete emptying, urinary retention, or prior anti-incontinence surgery were excluded. We compared the ICD-10 diagnosis and primary treatment offered in the absence… More >

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ARTICLE

Thenappan Chandrasekar^1,*, Lydia Glick², Daniella Wong², Timothy M. Han², Joon Yau Leong², Misung Yi³, James R. Mark¹, Mark J. Mann¹, Edouard J. Trabulsi¹, Costas D. Lallas¹
Canadian Journal of Urology, Vol.27, No.3, pp. 10250-10256, 2020
Abstract Introduction: To evaluate the impact of an “opt-in” non-narcotic postoperative pain regimen on narcotic utilization and patient-reported pain scores.
Materials and methods: A prospective, non-blinded pre- and post-interventional trial was conducted, including a lead-in period for baseline evaluation. The intervention group received a new pain protocol prioritizing non-narcotic medications, an “opt-in” requirement for opiates, and standardized patient education. Study outcomes included opiate prescription and utilization (measured in Morphine Equivalent Doses) and reported pain scores on postoperative day (POD) 1, discharge, and follow-up.
Results: At discharge, 70% fewer patients were prescribed any opioids (ARR: -0.7; p < 0.001); the… More >

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ARTICLE

Tyler L. Overholt¹, Robert J. Evans¹, Bruce A. Lessey³, Catherine A. Matthews¹, Katherine N. Hines¹, Gopal Badlani¹, Stephen J. Walker^1,2
Canadian Journal of Urology, Vol.27, No.3, pp. 10257-10262, 2020
Abstract Introduction: Interstitial cystitis/bladder pain syndrome (IC/BPS) and endometriosis are coexistent diagnoses in 48%-65% of women with chronic pelvic pain (CPP), suggesting that dual screening may be warranted. To further investigate the clinical relationship and risk factors between these two conditions, we performed a retrospective review of our large IC/BPS patient data registry.
Materials and methods: We evaluated IC/BPS patients who were prospectively enrolled into our registry who completed validated questionnaires and underwent therapeutic hydrodistension, during which anesthetic bladder capacity (BC) and Hunner’s lesion (HL) status were recorded. Demographic/medical history were reviewed. IC/BPS patients with co-occurring endometriosis diagnosis… More >

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HOW I DO IT

Rabun Jones, Ryan W. Dobbs, Whitney R. Halgrimson, Hari T. Vigneswaran, Ikenna Madueke, Jessica Wilson, Michael R. Abern, Simone Crivellaro
Canadian Journal of Urology, Vol.27, No.3, pp. 10263-10269, 2020
Abstract The da Vinci single port (SP) robotic system (Intuitive Surgical, Sunnyvale, CA, USA) is a recently approved robotic platform designed with several modifications to the previously available multi-port robotic systems. This article describes the technique performed utilizing the SP robotic system for radical robotic-assisted laparoscopic prostatectomy (RALP) with or without bilateral pelvic lymph node dissection from a single institution. In this report we describe our step-by-step approach, technical modifications from the multi-port technique and initial results for performing single port roboticassisted laparoscopic prostatectomy (SP-RALP). We describe our initial experience and technique with the SP robotic More >

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RESIDENT’S CORNER

Clarissa M. Gurbani¹, Vincent Khor², Jeffrey J. Leow¹, Melissa H.W. Tay³, Yew-Lam Chong¹
Canadian Journal of Urology, Vol.27, No.3, pp. 10270-10272, 2020
Abstract Wunderlich syndrome (WS) is a rare triad of flank pain, flank mass and hypovolemic shock and is classically attributed to angiomyolipomata or neoplasms. Treatment is guided by clinical severity: conservative, selective arterial embolization, or nephrectomy. We report an atypical case of a 69-year old man with a pre-existing 9 cm left renal tumor who developed WS secondary to anticoagulation and simple cyst rupture from his contralateral kidney, complicated by abdominal compartment syndrome with hemodynamic instability despite inotropic support and robust resuscitation. Early recognition and source control via radical nephrectomy were essential in securing a positive More >

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