Ksenia Chezar¹, Geoffrey Gotto², Shaun Medlicott¹, Kiril Trpkov¹

Canadian Journal of Urology, Vol.25, No.3, pp. 9360-9362, 2018

Abstract The presence of urothelial epithelial metaplasia in a seminal vesicle is an exceptionally rare finding. We describe a unique case of urothelial metaplasia of the seminal vesicle and ejaculatory duct, found in a radical prostatectomy specimen from a patient with complex urogenital anatomy. A 70-year-old patient with organ confined (pT2) prostatic adenocarcinoma (Gleason score 3+4 = 7) had a right-sided Hutch diverticulum and a left crossed-fused renal ectopia. Although the histogenesis of urothelial metaplasia in the seminal vesicle remains unclear, in the patient presented herein it likely developed as a consequence of the previously unrecognized More >

Bradley A. Morganstern¹, Samantha Scaccia¹, Wayland Wu¹, Alex K. Williamson², Lane S. Palmer¹

Canadian Journal of Urology, Vol.25, No.3, pp. 9357-9359, 2018

Abstract Embryonal rhabdomyosarcoma is a rare cancer that often requires multimodality therapy to treat; however, these therapies can cause changes in the biology of the tumor. Several reports have documented pathologic changes but only recently have genetic changes been mapped. We present case of two separate synchronous primary rhabdomyosarcomas in a 17-month-old patient and discuss the pathophysiology and genetic changes that occur with treatment. We hypothesize that a genetic feld defect arising in development of the urogenital sinus caused the tumors, but that treatment modalities may have caused genetic alterations changing clinical behavior of the tumors More >

Vladimir Mouraviev¹, Michael McDonald²

Canadian Journal of Urology, Vol.25, No.3, pp. 9349-9356, 2018

Abstract Introduction: The changing face of current infection phenotypes — from planktonic to biofilm type — has increasingly implicated bacterial biofilms in recurrent infections. To date, no specific medical treatment exists that can effectively target biofilms within the human host. Similarly, the identification of biofilms has traditionally relied on tissue sample analysis using electron microscopy or DNA identification via polymerase chain reaction (PCR) and sequencing. Standard culture and sensitivity tests are not capable of detecting the presence of biofilms.
Materials and methods: Two types or "levels" of molecular microbial diagnostic testing were performed as described below. In both… More >

Avinash Chenam¹, Nora Ruel², Sumanta Pal³, John Barlog¹, Clayton Lau¹, Timothy Wilson¹, Bertram Yuh¹

Canadian Journal of Urology, Vol.25, No.3, pp. 9340-9348, 2018

Abstract Introduction: Extended lymph node dissection (ELND) compared to limited lymph node dissection (LLND) at the time of prostatectomy improves staging and lymph node (LN) yield. The effect on biochemical recurrence (BCR) and survival is less well understood. We sought to evaluate the benefit of robotic ELND and LLND with respect to BCR.
Materials and methods: Between 2008-2012, 584 consecutive men with intermediate or high-risk clinically localized adenocarcinoma of the prostate underwent robotic-assisted radical prostatectomy (RARP) with concomitant LLND (n = 326) or ELND (n = 258). Survival estimates were made using the Kaplan-Meier method. Log-rank statistic was… More >

Michael A. Avallone, Peter N. Dietrich, Shanta T. Shepherd, Mona Lalehzari, R. Corey O’Connor, Michael L. Guralnick

Canadian Journal of Urology, Vol.25, No.3, pp. 9334-9339, 2018

Abstract Introduction: Classic surgical teaching advocates for closure of the mesenteric defect (MD) after bowel anastomosis, but the necessity is controversial. We sought to evaluate the necessity of MD closure at the time of harvest of ileum for genitourinary reconstructive surgery (GURS) by analyzing the incidence of early and late gastrointestinal adverse events (GIAE) in patients with and without MD closure.
Materials and methods: A retrospective review was conducted on patients undergoing urologic reconstruction with ileum to identify incidence of ileus, small bowel obstruction (SBO), gastrointestinal (GI) fistula, and stoma complications. Patient and procedure variables were analyzed to… More >

Bradley A. Erickson¹, Brennan A. Tesdahl¹, Maria A. Voznesensky¹, Benjamin N. Breyer², Bryan B. Voelzke³, Nejd F. Alsikafi⁴, Alex J. Vanni⁵, Joshua A. Broghammer⁶, Jill C. Buckley⁷, Jeremy B. Myers⁸, William O. Brant⁸, Lee C. Zhao⁹, Thomas G. Smith III¹⁰, Brian L. Swick¹, Laila Dahmoush¹

Canadian Journal of Urology, Vol.25, No.3, pp. 9328-9333, 2018

Abstract Introduction: Given the poor understanding of the pathophysiology of genital lichen sclerosus (GLS) and a lack of accepted definitive diagnostic criteria, we proposed to survey pathologists regarding their understanding of GLS. We hypothesized that significant disagreement about GLS will exist.
Materials and methods: All urologists participating in the Trauma and Urologic Reconstruction Network of Surgeons identified genitourinary pathologists (GUP) and dermatopathologists (DP) at their respective institutions who were then invited to participate in an online survey regarding their experience with diagnosing GLS, GLS pathophysiology, and its relationship to urethral stricture disease.
Results: There were 23 (12 DP, 11… More >

S. Johar Raza¹, Perry Xu¹, Justin Barnes², Robert Fisher¹, Allison May¹, Oussama Darwish¹, Brian Dang¹, Prajakta Adsul¹, Carl A. Freeman³, Sameer A. Siddiqui¹

Canadian Journal of Urology, Vol.25, No.3, pp. 9323-9327, 2018

Abstract Introduction: Conservative management of penetrating renal trauma is emerging, with data originating from centers with variable levels of trauma care. This study reviews the outcomes of renal salvage after penetrating trauma at a level I trauma center.
Materials and methods: An institutional review board approved trauma registry at Saint Louis University Hospital was retrospectively analyzed for patients with penetrating renal trauma from 2009 to 2014. Patients were divided into nephrectomy group (NG) or non-nephrectomy group (non-NG), and compared. A multi-variable analysis was performed to determine predictors of nephrectomy, with cross-validation to evaluate the performance of the multi-variable… More >

Veeru Kasivisvanathan^1,2,3, Muddassar Hussain⁴

Canadian Journal of Urology, Vol.25, No.3, pp. 9317-9322, 2018

Abstract Introduction: The purpose of this analysis was to compare Aquablation to transurethral resection of the prostate (TURP) with respect to efficacy and safety at 1 year for the treatment of lower urinary tract symptoms related to benign prostatic hyperplasia (BPH) in the United States (U.S.) cohort from the Waterjet Ablation Therapy for Endoscopic Resection of prostate tissue (WATER) study.
Materials and methods: WATER is a double-blinded, multicenter prospective randomized controlled trial for patients with moderate-to-severe lower urinary tract symptoms related to BPH. Men were randomized to TURP or Aquablation. The efficacy and safety outcomes at 1 year… More >

Karen L. Stern, Manoj Monga

Canadian Journal of Urology, Vol.25, No.3, pp. 9313-9316, 2018

Abstract Introduction: The Moses technology of the holmium laser has been shown to decrease retropulsion in the ureter and procedural time in kidney stones during laser lithotripsy. Theoretically, these improvements could lead to cost savings for the patient.
Materials and methods: All patients with total laser energy data recorded who underwent ureteroscopy with laser lithotripsy by a single surgeon at a tertiary care center were included. Total lasing time was calculated from the total laser energy. Sub-analyses were done on stone size and stone composition. The procedure time using Moses technology was projected to be approximately 35% less… More >

Jessica C. Lloyd, Juan Guzman-Negron, Howard B. Goldman

Canadian Journal of Urology, Vol.25, No.3, pp. 9307-9312, 2018

Abstract Introduction: Robotic surgical procedures have become more common in female pelvic reconstruction. Purported benefits of robotic assisted pelvic floor reconstruction (RAPFR) procedures include shorter hospital stay, faster recovery, lower blood loss, and decreased postoperative pain. Following RAPFR procedures, the current accepted practice is discharge after a one-night hospitalization. We assessed whether same day discharge (SDD) affects the short term safety of and patient satisfaction with robotic assisted pelvic floor reconstructive procedures, relative to those who remain hospitalized overnight.
Materials and methods: We retrospectively reviewed the charts of women who underwent RAPFR procedures between October 2015 and October… More >