Open Access

BOOK REVIEW

Marc Goldstein
Canadian Journal of Urology, Vol.31, No.5, pp. 11971-11971, 2024
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EDITORIAL

Kevin R. Loughlin
Canadian Journal of Urology, Vol.31, No.5, pp. 11972-11973, 2024
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LEGENDS IN UROLOGY

Peter R. Carroll
Canadian Journal of Urology, Vol.31, No.5, pp. 11974-11976, 2024
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REVIEW

Jean-Baptiste Lattouf¹, Jenny J. Ko², Margot K. Davis³, Christian Constance⁴, Geoffrey T. Gotto⁵
Canadian Journal of Urology, Vol.31, No.5, pp. 11977-11985, 2024
Abstract Introduction: Niraparib, a PARP1/2 inhibitor, is newly approved in combination with abiraterone acetate (AA) plus prednisone or prednisolone (niraparib/AA+P) for the treatment of adult patients with BRCA-mutated, treatment-naïve metastatic castration resistant prostate cancer (mCRPC). Detailed guidance beyond the prescribing information may be helpful in managing the side effect profile and dosing practicalities of this combination therapy.
Materials and methods: A panel of specialists convened to design management algorithms for four common niraparib/ AA+P treatment-related adverse events (AEs) in mCRPC; anemia, thrombocytopenia, hypertension, and nausea. The algorithms build on Health Canada-approved prescribing information to highlight practical considerations related… More >

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ARTICLE

James Wysock^1,*, Jesse Persily^1,*, Angela Tong², Eli Rapoport¹, Ben Zaslavsky¹, Majlinda Tafa¹, Herbert Lepor¹
Canadian Journal of Urology, Vol.31, No.5, pp. 11986-11991, 2024
Abstract Introduction: Local disease recurrence following focal therapy (FT) for prostate cancer may be due to failure to eradicate focal disease or development of disease in the untreated prostate (in- and out-of-field recurrences). Several studies suggest in-field contrast enhancement (CE) on post treatment multi-parametric (mp) MRI between 6-12 months following FT indicates residual disease. The present study assesses the incidence and oncologic implications of early CE observed following primary partial gland cryoablation (PPGCA).
Material and methods: The surveillance protocol for men enrolled in our prospective outcomes study following PPGCA included mpMRI at 6-12 months, 2 years, 3.5 years,… More >

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ARTICLE

Kennedy E. Okhawere¹, Ralph Grauer¹, Indu Saini¹, Iretiayo T. Joel¹, Alp Tuna Beksac², Oluwatoyin Ayo-Farai¹, Rutul Patel¹, Talia G. Korn¹, Kirolos N. Meilika¹, Najimdin Pedro¹, Ketan K. Badani¹
Canadian Journal of Urology, Vol.31, No.5, pp. 11992-12003, 2024
Abstract Introduction: We aim to identify factors associated with surgical refusal and non-surgical candidacy in clinical stage I kidney masses and to evaluate their impact on overall survival (OS).
Materials and methods: We conducted a retrospective cohort study using the National Cancer Database of patients with clinical stage I kidney cancer between 2004 and 2017. Logistic regression was used to determine baseline sociodemographic-, clinical-, and treatment facility-related factors associated with surgical refusal and non-surgical candidacy. Patients were 1.1 propensity score-matched and Cox regression analysis evaluated the impact of surgical refusal and non-surgical candidacy on OS.
Results: Compared to those… More >

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ARTICLE

Daniel Steffens^1,2,3, Cherry Koh^1,2,3,4, Nicholas Hirst^1,2, Ruby Cole^1,2, Michael J. Solomon^1,2,3,4, Lisa Nguyen-Lal⁵
Canadian Journal of Urology, Vol.31, No.5, pp. 12004-12012, 2024
Abstract Introduction: The evidence on the effectiveness of prehabilitation in patients undergoing bladder cancer surgery remains lacking. Thus, the aim of this study is to determine the effectiveness of prehabilitation on reducing postoperative morbidity and length of hospital stay in patients undergoing bladder cancer surgery.
Materials and methods: This systematic review included randomized controlled trials investigating the effect of prehabilitation on postoperative outcomes in patients undergoing bladder cancer surgery. A comprehensive search was conducted, with two reviewers independently screening articles and extracting data. The Cochrane Collaboration’s tool was used to assess risk of bias, and GRADE to rate… More >

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ARTICLE

Yash B. Shah, Anushka Ghosh, Aaron Hochberg, James R. Mark, Costas D. Lallas, Mihir S. Shah
Canadian Journal of Urology, Vol.31, No.5, pp. 12013-12018, 2024
Abstract Introduction: Patients seek support from online resources when facing a troubling urologic cancer diagnosis. Physician-written resources exceed the recommended 6-8th grade reading level, creating confusion and driving patients towards unregulated online materials like AI chatbots. We aim to compare the readability and quality of patient education on ChatGPT against Epic and Urology Care Foundation (UCF).
Materials and methods: We analyzed prostate, bladder, and kidney cancer content from ChatGPT, Epic, and UCF. We further studied readability-adjusted responses using specific AI prompting (ChatGPT-a) and Epic material designated as Easy to Read. Blinded reviewers completed descriptive textual analysis, readability analysis… More >

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HOW I DO IT

Braden Rolig¹, James A. Brown²
Canadian Journal of Urology, Vol.31, No.5, pp. 12019-12021, 2024
Abstract The Hem-o-lok Weck clip is part of a polymer locking ligation system often employed for hemostasis in surgical practices. Its use is routine in a wide array of surgical subspecialties. Surgeons have limited options in removing these clips when they are aberrantly positioned.
Herein, we describe a novel, cost-effective approach for removing a Hem-o-lok clip using standard robotic instruments. This simple approach will allow surgeons to remove a Hem-o-lok clip precisely and quickly if it is not adequately placed.
During a routine robotic-assisted laparoscopic prostatectomy a Hem-o-lok Weck clip was noted to be in juxtaposition to… More >

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HOW I DO IT

Bilal Chughtai¹, Alia Codelia-Anjum¹, Dean S. Elterman², Nirmala Pillalamarri¹, Vincent Lucente³
Canadian Journal of Urology, Vol.31, No.5, pp. 12022-12025, 2024
Abstract Pelvic organ prolapse (POP) is a common condition that significantly impairs a woman's quality of life. Currently a range of interventions from non-surgical to surgical options exist, all with their unique advantages and disadvantages. Among these, the EnPlace system stands out as a truly minimally invasive transvaginal percutaneous device designed to repair apical POP by bilaterally anchoring sutures to the sacrospinous ligaments. Readers will familiarize themselves with the EnPlace, relevant historical studies, and the technique for EnPlace transvaginal percutaneous sacrospinous ligament fixation for hysteropexy or colposuspension. More >

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RESIDENT’S CORNER

Matthew Buell, Brian Hu
Canadian Journal of Urology, Vol.31, No.5, pp. 12026-12029, 2024
Abstract Radical cystectomy is a preferred treatment for muscle invasive bladder cancer. Despite known complications, rapid onset, severe hyperkalemia necessitating abortion of surgery has not been reported. In this case report, a patient with end stage renal disease (ESRD) undergoing attempted cystectomy developed severe intraoperative hyperkalemia and acidosis that led to abortion of surgery and transfer to the medical intensive care unit for emergent hemodialysis. The multifactorial etiology was related to respiratory acidosis, ESRD, patient positioning, clipping of ureters, and body habitus, as well as an idiopathic element. Knowledge of hyperkalemia etiologies can assist in diagnosis More >

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