Open Access

EDITORIAL

Leonard G. Gomella
Canadian Journal of Urology, Vol.27, No.6, pp. 10424-10425, 2020
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LEGENDS IN UROLOGY

Maurizio Brausi
Canadian Journal of Urology, Vol.27, No.6, pp. 10426-10430, 2020
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ARTICLE

Justin B. Ziemba¹, Christopher D. Tessier², Andrew M. Harris³
Canadian Journal of Urology, Vol.27, No.6, pp. 10431-10436, 2020
Abstract Introduction: To assess the perception of patient safety culture and the infrastructure to support patient safety (PS) education within American and Canadian urological residency programs.
Materials and methods: A needs assessment was developed by experts in patient safety. The survey contained items about prior PS education, perceived value of learning PS, components of an ideal PS curriculum, and desired resources to facilitate PS education. Select items from the validated AHRQ Survey on Patient Safety Culture (SOPS) were also included. The survey was distributed electronically (12/2018-2/2019) to all urology residents (RES) and program directors (PD) of urological residency… More >

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ARTICLE

Benjamin M. Dropkin¹, Jeremiah D. Dallmer², Leah P. Chisholm², Niels V. Johnsen¹, Roger R. Dmochowski¹, Douglas F. Milam¹, Melissa R. Kaufman¹
Canadian Journal of Urology, Vol.27, No.6, pp. 10437-10442, 2020
Abstract Introduction: We sought to explore whether patients discharged without antibiotics after artificial urinary sphincter (AUS) insertion were more likely to require device explantation for infection or erosion compared to patients discharged with antibiotics at our institution and compared to patients in other large, contemporary series.
Materials and methods: AUS insertions performed at our institution between 2013 and 2017 were retrospectively reviewed to determine demographics, comorbidities, and perioperative and medium-term outcomes. Patients were grouped based on 1) known risk factors for infectious complications or erosion and 2) postoperative antibiotic prescription status. Patients were placed in Group 1 if… More >

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COMMENTARY

Jack M. Zuckerman
Canadian Journal of Urology, Vol.27, No.6, pp. 10443-10443, 2020
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ARTICLE

Tyler J. Maiers¹, David J. Abramowitz¹, Raymond Pominville¹, Ajay A. Myneni², Katia Noyes^2,3, John J. Bodkin III^1,4
Canadian Journal of Urology, Vol.27, No.6, pp. 10444-10449, 2020
Abstract Introduction: Genitourinary foreign body (FB) insertion is a rare occurrence. Commonly reported reasons for insertion include autoeroticism and intoxication; however, psychiatric illness is thought to contribute in most cases. In the incarcerated population, malingering plays a prominent role. We examined clinical patient characteristics and management patterns for cases of genitourinary FB insertion and sought to identify risk factors for recidivism.
Materials and methods: A retrospective review was performed of all patients presenting to a tertiary trauma center with a genitourinary FB between January 2001-June 2019. Patient demographics, presentation, workup, and management were reviewed. Bivariate and multivariate statistical… More >

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ARTICLE

Amihay Nevo¹, Jonathan P. Moore¹, Mitchell R. Humphreys¹, Saif Salih¹, Mira A. Keddis², Kyle M. Rose¹, Scott S. Cheney¹, Karen L. Stern¹
Canadian Journal of Urology, Vol.27, No.6, pp. 10450-10455, 2020
Abstract Introduction: Bladder stones have historically been associated with urinary stasis secondary to bladder outlet obstruction (BOO). Recent studies indicate that the role of BOO in bladder stone formation is minor. We evaluate the role of urinary lithogenic factors in bladder stone formation by comparing the compositions of bladder stones and kidney stones in patients with multi-site urinary calculi.
Materials and methods: We identified patients who were treated for concomitant bladder stones and kidney stones between 2008-2019 and had both stone compositions available. Patients with bladder stone size < 10 mm, urinary foreign bodies, encrusted stents, or tumors… More >

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ARTICLE

Jacob Lucas¹, Ryan Barlotta¹, Matthew Brennan¹, Pak Leung², Amir S. Patel¹, Robert G. Uzzo¹, Jay Simhan¹
Canadian Journal of Urology, Vol.27, No.6, pp. 10456-10460, 2020
Abstract Introduction: Evidence suggests overutilization of procedural intervention for renal traumas. The objective of this study was to assess clinical factors associated with procedural intervention for patients presenting to the emergency department (ED) with isolated renal trauma.
Materials and methods: A United States statewide trauma registry was queried for trauma patients presenting to level I or II trauma centers with isolated renal injuries (Grades I–V) from 2000-2013. Patient demographics, mechanism, American Association for the Surgery of Trauma (AAST) grade, trauma center level designation, presenting ED vital signs, Glasgow Coma Scale (GCS), intubation status, and blood product transfusion were assessed.
… More >

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ARTICLE

Omar M. Dawood¹, Daniel J. Sadowski², Steve Scaife³, Nicholas N. Tadros¹, Robert H. Blackwell¹
Canadian Journal of Urology, Vol.27, No.6, pp. 10461-10465, 2020
Abstract Introduction: Erectile dysfunction is common after radical cystectomy; however, research on sexual dysfunction after this procedure is relatively scarce. Our goal was to evaluate the incidence of penile prosthesis implantation after radical cystectomy, with a focus on rural/urban disparity.
Materials and methods: We used the SEER-Medicare database to identify patients with bladder cancer diagnosed between 1991-2009 who had a radical cystectomy (ICD-9 codes 57.7, 57.71, 57.79). The outcome was placement of a penile implant (ICD-9 codes 64.95 and 64.97). Covariates extracted included rural county status, age, race, ethnicity, marital status, geographic region, socioeconomic status, Charlson comorbidity, pathologic… More >

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ARTICLE

Neha R. Malhotra^1,2, Anthony J. Schaeffer^1,2, Austen D. Slade³, Patrick C. Cartwright^1,2, Glen A. Lau^1,2
Canadian Journal of Urology, Vol.27, No.6, pp. 10466-10470, 2020
Abstract Introduction: Urethrocutaneous fistulae are the most common complication after hypospadias repair. We sought to compare outcomes of proximal versus distal urethrocutaneous fistula repair and hypothesized that patients with proximal fistulae would have lower rates of success than those with distal fistulae. We also aimed to evaluate factors that affected these outcomes.
Material and methods: Current procedural terminology codes were used to identify patients undergoing urethrocutaneous fistula repair after hypospadias surgery between 2014 and 2017 at an academic, pediatric urology referral center. Characteristics for each initial hypospadias repair and each fistula repair were noted, including location of meatus,… More >

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ARTICLE

Daniel Marchalik^1,2, Charlotte Goldman¹, Jordan Alger¹, Ariel Rodriguez³, Andrew Catomeris³, John H. Lynch¹, Jamie Padmore², Mihriye Mete², Ross Krasnow¹
Canadian Journal of Urology, Vol.27, No.6, pp. 10471-10479, 2020
Abstract Introduction: Surgical trainees experience high rates of depression and suicidal ideation (SI). However, there remain a gap in knowledge on the drivers of depression and SI in trainees, especially within the field of urology.
Materials and methods: We conducted a national study of urology trainees using a 50-item questionnaire in May 2018. The survey included demographic, depression (Patient Health Questionnaire-9 (PHQ-9)), burnout (Maslach Burnout Inventory (MBI)), and quality of life (QoL) questions.
Results: Overall, 37 (17.6%) endorsed depression; 24 residents endorsed SI (11%). SI was higher in those with depression (p < 0.001). Burnout was also higher among… More >

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HOW I DO IT

Lydia Glick¹, Thenappan Chandrasekar¹, Scott G. Hubosky¹, Seth Teplitsky², Mihir Shah³, Joon Yau Leong¹, Geoffrey Ouma⁴, James R. Mark¹
Canadian Journal of Urology, Vol.27, No.6, pp. 10480-10487, 2020
Abstract Appropriate perioperative management of antithrombotic medications is critical; for every patient, the risk of bleeding must be balanced against individual risk of thrombosis. There has been a rapid influx of new antithrombotic therapies in the past 5 years, yet there is a lack of clear and concise guidelines on the management of anticoagulant and antiplatelet therapy during urologic surgery. Here we describe our approach to perioperative antithrombotic counseling, including the timing of stopping and restarting these medications. These practice guidelines have been developed in consultation with the Vascular Medicine service at our institution as well More >

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HOW I DO IT

Jordan Allen, Necole M. Streeper
Canadian Journal of Urology, Vol.27, No.6, pp. 10488-10491, 2020
Abstract Obesity is a known risk factor for recurrent nephrolithiasis and it can be challenging to provide safe surgical intervention in the super obese population. Despite high weight limits on surgical beds, these often do not take into account positioning the patient on the end of the bed for dorsal lithotomy, which can risk an unsteady bed. In addition, depending on patient habitus the leg stirrups may not accommodate. There is limited literature that discusses the technical approach for positioning super obese patients in dorsal lithotomy when the weight limit approaches or exceeds the capacity of More >

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COMMENTARY

Kaylee Luck, Vernon M. Pais Jr.
Canadian Journal of Urology, Vol.27, No.6, pp. 10492-10492, 2020
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RESIDENT’S CORNER

Lael Stieglitz, Vernon M. Pais Jr.
Canadian Journal of Urology, Vol.27, No.6, pp. 10493-10495, 2020
Abstract Erdheim-Chester disease (ECD) is a rare systemic histiocytosis with urologic manifestations in a majority of affected patients. An important manifestation is a pronounced retroperitoneal fibrosis with reported dense inflammatory rind surrounding the kidneys. We report a case of a patient with large stone burden necessitating percutaneous nephrolithotomy and the implications related to his Erdheim-Chester-related retroperitoneal fibrotic changes. Foreknowledge of these implications may inform perioperative counseling and surgical planning to maximize opportunity for successful outcomes. More >

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RESIDENT’S CORNER

Christopher Dall^1,2, Kenneth Lim^1,2, George Khludenev³, Krishnan Venkatesan^1,2
Canadian Journal of Urology, Vol.27, No.6, pp. 10496-10499, 2020
Abstract Acute vasitis, or inflammation of the vas deferens, is a rare condition that classically presents with unilateral groin pain radiating into the scrotum and a bulge or induration along the inguinal canal. As a result, it mimics and is often mistaken for more common pathologies such as inguinal hernia, epididymo-orchitis or testicular torsion. A misdiagnosis may lead to unnecessary surgery and morbidity. Here, we present a case of acute vasitis which was originally diagnosed as an incarcerated inguinal hernia. Finally, we review the imaging findings, which can often be subtle and misinterpreted or missed. More >

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