Home / Journals / CJU / Vol.27, No.4, 2020
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  • Open AccessOpen Access

    EDITORIAL

    The Wisdom of Wayne Gretzky: Lessons For Urologic Practice

    Kevin R. Loughlin
    Canadian Journal of Urology, Vol.27, No.4, pp. 10273-10274, 2020
    Abstract This article has no abstract. More >

  • Open AccessOpen Access

    LEGENDS IN UROLOGY

    LEGENDS IN UROLOGY

    Arturo Mendoza-Valdés
    Canadian Journal of Urology, Vol.27, No.4, pp. 10275-10277, 2020
    Abstract This article has no abstract. More >

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    ARTICLE

    Utility of the Aortic-Lesion-AttenuationDifference (ALAD) and Peak Early-Phase Enhancement Ratio (PEER) to differentiate benign from malignant renal masses

    Amanda E. Kahn1, Steven J. Lomax1, Essa M. Bajalia1, Colleen T. Ball2, David D. Thiel1
    Canadian Journal of Urology, Vol.27, No.4, pp. 10278-10284, 2020
    Abstract Introduction: To evaluate the utility of the Aorta-Lesion-Attenuation-Difference (ALAD) and Peak Early-phase Enhancement Ratio (PEER) on contrast-enhanced computed tomography (CT) to differentiate between the appearances of chromophobe renal cell carcinoma, clear cell renal cell carcinoma, and oncocytoma.
    Materials and methods: ALAD and PEER values were retrospectively measured by a reviewer from 119 patients with surgically resected renal masses (chromophobe renal cell carcinoma n = 29, clear cell renal cell carcinoma n = 28, and oncocytoma n = 62). The ALAD value is expressed as: ALAD = Hounsfield Units aorta – Hounsfield Units mass. PEER is expressed as… More >

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    ARTICLE

    Analysis of guideline recommended use of renal mass biopsy and association with treatment

    Joaquin Michel1, Andrew T. Lenis1, Patrick M. Lec1, Vishnukam Golla1, David C. Johnson2, Kiran Gollapudi3, Jeremy Blumberg3, Brian M. Shuch1,4, Karim Chamie1,4
    Canadian Journal of Urology, Vol.27, No.4, pp. 10285-10293, 2020
    Abstract Introduction: Renal mass biopsy (RMB) may not be indicated when the results are unlikely to impact management, such as in young and/or healthy patients and in elderly and/or frail patients. We analyzed the utility of RMB in three patient cohorts stratified by age-adjusted Charlson comorbidity index score (ACCI).
    Materials and methods: We identified patients with cT1a renal tumors in the National Cancer Database from 2004-2014. We combined age and Charlson-Deyo scores to identify young and/or healthy patients (“healthy-ACCI”), elderly and/or frail patients (“frail-ACCI”), and a reference cohort. We performed multivariable logistic regression to identify predictors of RMB… More >

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    ARTICLE

    Intermittent catheterization and urinary tract infection in multiple sclerosis patients

    Lauren E. Corona1, Nadia R. Sion2, Anne P. Cameron1, Paholo G. Barboglio Romo1, John T. Stoffel1
    Canadian Journal of Urology, Vol.27, No.4, pp. 10294-10299, 2020
    Abstract Introduction: We sought to investigate whether starting clean intermittent catheterization (CIC) for multiple sclerosis (MS) patients with lower urinary tract symptoms (LUTS) and elevated post-void residual (PVR) would improve urinary quality of life (QoL) and decrease risk of urinary tract infection (UTI).
    Materials and methods: We retrospectively reviewed an institutional database for MS patients with PVR > 100 mL and obstructive LUTS. Patients were categorized by subsequent choice of treatment: CIC versus medical treatment. Outcomes compared over 1-year follow up included incidence of UTI, urinary QoL, emergency room visits, and adherence to therapy.
    Results: Between 2014 and 2017,… More >

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    ARTICLE

    The current state of continence in Canada: a population representative epidemiological survey

    Christina Shaw1, Jacky Cahill2, Adrian Wagg1,2
    Canadian Journal of Urology, Vol.27, No.4, pp. 10300-10305, 2020
    Abstract Introduction: Data on the prevalence of lower urinary tract symptoms (LUTS) and urinary incontinence (UI) in Canada are dated. This study aims to describe the current prevalence of LUTS and UI, to assess the state of knowledge of these conditions, the treatment for them and the treatment experience of symptomatic persons.
    Materials and methods: A nationally representative adult (≥ 18 years) sample was surveyed using a questionnaire based on the EPIC study. The margin of error associated with this probability-based sample was +/-3.1%, 19 times out of 20.
    Results: Of the 1000 people contacted (52% female, 48% male),… More >

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    ARTICLE

    Defining hypogonadism in male partners of couples with unexplained infertility

    J.C. Trussell1, Ava Delu1, Robert J. Kiltz2, Vladimir A. Kuznetsov1
    Canadian Journal of Urology, Vol.27, No.4, pp. 10306-10311, 2020
    Abstract Introduction: Men with unexplained infertility (UI) should undergo an initial hormonal evaluation including serum FSH and total testosterone (TT). Unfortunately, there is no consensus regarding which TT cut point should be used to define hypogonadism in such men. To determine the best definition for hypogonadism, three different, literature-based TT cut points were used to assess associations between TT and semen parameters. The hypothesis was that the lowest TT cut point would associate with poorest sperm parameters.
    Materials and methods: We performed an IRB-approved retrospective chart review of 247 consecutive males presenting for evaluation of male factor infertility.… More >

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    ARTICLE

    Time for a mandatory urology rotation? Adequacy of urological exposure during medical school – a survey of graduates of the University of the West Indies, Trinidad and Tobago

    Satyendra Persaud1,4, Belinda Morrison2, Kurt A. McCammon3, K Sadho4, C Gosine4
    Canadian Journal of Urology, Vol.27, No.4, pp. 10312-10315, 2020
    Abstract Introduction: To objectively assess the self-reported adequacy and utility of exposure of our students to urology during their training.
    Materials and methods: A questionnaire was sent to the University of the West Indies graduating class of 2018, now functioning as medical interns. A questionnaire was designed to collect information regarding respondent demographics, perceptions of their urology exposure during their medical school training, as well as their attitudes towards the specialty. The survey was also designed to capture respondents’ comfort levels with commonly encountered urological scenarios and investigations. The survey was distributed in February 2019 using the online… More >

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    COMMENTARY

    The paucity of urology undergraduate education in medical schools - global challenges and opportunities

    Grannum R. Sant
    Canadian Journal of Urology, Vol.27, No.4, pp. 10316-10316, 2020
    Abstract This article has no abstract. More >

  • Open AccessOpen Access

    ARTICLE

    Semi-rigid ureteroscope as a dilator in renal stone ureteroscopic treatment

    Amy M. Reed1, Eric C. Umbreit2, James K. Aden1, Christopher L. Allam1
    Canadian Journal of Urology, Vol.27, No.4, pp. 10317-10321, 2020
    Abstract Introduction: To determine the efficacy and safety of using the semi-rigid ureteroscope as the only ureteral dilator for primary ureteroscopy (URS) in the treatment of renal stones.
    Materials and methods: A retrospective review of primary URS for renal stone disease was performed on consecutive patients treated by a single provider from 2013 to 2017. Utilizing wire placement under fluoroscopic guidance and direct visual ureteroscopic dilation with a semi-rigid ureteroscope, primary outcome was successful completion of stone treatment. In addition, perioperative safety was evaluated.
    Results: A total of 126 consecutive cases of primary URS using the semi-rigid ureteroscope as… More >

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    HOW I DO IT

    How I Do It: The Optilume drug-coated balloon for urethral strictures

    Dean S. Elterman1, Karl Coutinho2, Judith C. Hagedorn3
    Canadian Journal of Urology, Vol.27, No.4, pp. 10322-10328, 2020
    Abstract Urethral stricture disease can be difficult to treat and stricture recurrence is common. The management of stricture disease has evolved and urethroplasty can achieve a high rate of lasting urethral patency. Nevertheless, endoscopic treatments still seem to have sub-optimal outcomes with high stricture recurrence rates. The Optilume drug-coated balloon represents a step forward in the endoscopic management of urethral strictures. The drug-coated balloon may offer an intermediate step prior to repeated dilations, urethrostomies, or urethroplasty. This treatment modality is a promising alternative to current endoscopic management and an option for patients that are poor surgical More >

  • Open AccessOpen Access

    PEDIATRIC UROLOGY

    Surgical management of pediatric renal masses: surgeon subspecialty practice patterns

    Patrick J. Hensley, Amanda F. Saltzman, Ali M. Ziada
    Canadian Journal of Urology, Vol.27, No.4, pp. 10329-10335, 2020
    Abstract Introduction: Management of pediatric renal masses has lagged behind adult paradigms adopting minimally invasive surgery (MIS) and nephron-sparing surgery (NSS). This study investigated national practice patterns between pediatric urologists (PU) and pediatric surgeons (PS) in pediatric renal malignancy.
    Materials and methods: The Pediatric National Surgical Quality Improvement Program database was queried for CPT codes for radical/partial nephrectomy from 2012-2017 performed for renal malignancy. Patients were grouped by specialty and operative approach.
    Results: PU managed 175 (17%) patients while PS managed 811 (77%). PU were more likely to use MIS (14% versus 5%, p < 0.001) and NSS (33%… More >

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    RESIDENT’S CORNER

    Female urethral condyloma acuminata mimicking urethral caruncle

    Nathan Cheng, Gina Kirkpatrick, Debra L. Fromer
    Canadian Journal of Urology, Vol.27, No.4, pp. 10336-10338, 2020
    Abstract Condyloma acuminata are epidermal lesions caused by the human papillomavirus (HPV) most commonly affecting the anogenital region. Urethral involvement is uncommon, and may mimic other urethral lesions. In this case report, a 62-year-old patient presents with what was believed to be a urethral caruncle and underwent successful resection with the final pathologic diagnosis of urethral condyloma. The clinical features and diagnosis are reviewed. This condition should be considered in the differential diagnosis of females with known HPV or those who are deemed higher risk with unprotected sexual encounters. More >

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    RESIDENT’S CORNER

    Vanishing bile duct syndrome associated with pazopanib after progression on pembrolizumab

    Ying Yan Zhong1, Luke McLean2, Andrew Buckle1,2, Shankar Siva2, Ben Tran2
    Canadian Journal of Urology, Vol.27, No.4, pp. 10339-10341, 2020
    Abstract Pazopanib, a tyrosine kinase inhibitor, has been a standard first-line treatment for metastatic renal cell carcinoma (mRCC). Recent trials combining pazopanib with programmed cell death protein 1 (PD-1) inhibitors, including pembrolizumab, have shown excessive hepatotoxicity. We report a case of fatal hepatotoxicity from vanishing bile duct syndrome (VBDS) associated with pazopanib treatment, in a patient previously exposed to pembrolizumab. This is the first report of pazopanibinduced VBDS. We postulate whether prior exposure to pembrolizumab predisposed towards pazopanib-induction of VBDS, and discuss potential risks of sequential PD-1 inhibitor followed by pazopanib in mRCC, due to prolonged More >

  • Open AccessOpen Access

    RESIDENT’S CORNER

    The use of nephrostomy tubes in optimizing surgical conditions for a patient with xanthogranulomatous pyelonephritis

    Jordan L. Allen, Marcus O. Erdman, Joseph Y. Clark
    Canadian Journal of Urology, Vol.27, No.4, pp. 10342-10345, 2020
    Abstract Xanthogranulomatous pyelonephritis is a rare variant of pyelonephritis that often requires radical surgery. We report a case of a 51-year-old female patient who was managed with prolonged placement of nephrostomy tubes prior to surgery. This case illustrates the importance of surgical optimization of a poor operative candidate and the use of nephrostomy tubes as a temporizing management strategy. More >

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