Open Access

EDITORIAL

Kevin R. Loughlin
Canadian Journal of Urology, Vol.27, No.4, pp. 10273-10274, 2020
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LEGENDS IN UROLOGY

Arturo Mendoza-Valdés
Canadian Journal of Urology, Vol.27, No.4, pp. 10275-10277, 2020
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ARTICLE

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

Joaquin Michel¹, Andrew T. Lenis¹, Patrick M. Lec¹, Vishnukam Golla¹, David C. Johnson², Kiran Gollapudi³, Jeremy Blumberg³, Brian M. Shuch^1,4, Karim Chamie^1,4
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

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

Christina Shaw¹, Jacky Cahill², Adrian Wagg^1,2
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

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

Satyendra Persaud^1,4, 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

Grannum R. Sant
Canadian Journal of Urology, Vol.27, No.4, pp. 10316-10316, 2020
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ARTICLE

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

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 >

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PEDIATRIC UROLOGY

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

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

Ying Yan Zhong¹, Luke McLean², Andrew Buckle^1,2, 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 >

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RESIDENT’S CORNER

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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