Kassem Faraj¹, Yu-Hui H. Chang², Kyle M. Rose¹, Elizabeth B. Habermann³, David A. Etzioni⁴, Gail Blodgett¹, Erik P. Castle¹, Mitchell R. Humphreys¹, Mark D. Tyson II¹

Canadian Journal of Urology, Vol.26, No.5, pp. 9922-9930, 2019

Abstract Introduction: Mitomycin-C (MMC) and thiotepa are intravesical agents effective in reducing the recurrence of low-grade noninvasive bladder cancer when instilled perioperatively. No studies have compared these agents as a single-dose perioperative instillation. This study tests whether there is a difference in recurrence-free survival in patients with low-grade noninvasive bladder cancer who received intravesical MMC versus thiotepa.
Materials and methods: A retrospective review was performed of patients who underwent cystoscopic excision of a bladder mass identified as a small, low-grade, treatment-naïve, noninvasive, wild-type urothelial carcinoma of the bladder and who received either intravesical thiotepa (30 mg/15 cc) or… More >

Anand V. Badri¹, Nikhil Waingankar², Kristin Edwards³, Alexander Kutikov¹, Rosaleen B. Parsons³, David Y. Chen¹, Marc C. Smaldone¹, Rosalia Viterbo¹, Richard E. Greenberg¹, Robert G. Uzzo¹

Canadian Journal of Urology, Vol.26, No.5, pp. 9916-9921, 2019

Abstract Introduction: Current radiographic guidelines suggest unenhanced renal lesions < 20 Hounsfield Units (HU) are overwhelmingly benign, requiring no further evaluation. We evaluate our experience with papillary renal cell carcinoma (pRCC) presenting with low pre-contrast attenuation and the relationship of attenuation with histologic pRCC subtype.
Materials and methods: We reviewed our institutional kidney cancer database for patients with pT1 or pT2 pRCC between 2003-2017. Tumors were categorized by papillary subtype by expert uropathologists. Preoperative CT images were analyzed at six regional tumor locations. Low, presumably benign, unenhanced median attenuation was defined as ≤ 20 HU. We calculated the… More >

Mehrdad Alemozaffar¹, Kenneth Ogan¹, Christopher P. Filson¹, Dattatraya Patil¹, Grace Lee², Daniel J. Canter³, Gordon Hong⁴, Viraj A. Master¹

Canadian Journal of Urology, Vol.26, No.5, pp. 9908-9915, 2019

Abstract Introduction: The use of an electrocautery device (monopolar loop) for patients undergoing transurethral resection of bladder tumors (TURBT) is standard of care. The aim of this study is to establish non-inferiority of complication rates for a bipolar energy device, the PK PlasmaButton (PK Button), when compared to the monopolar loop.
Materials and methods: Seventy-eight subjects (41 monopolar loop and 37 PK Button), were enrolled in a single-center, prospective, randomized study with cystoscopically detected bladder tumors that were judged endoscopically resectable with only one trip into the operating room. Intra and postoperative data on complication rates, operative time,… More >

Leonard G. Gomella

Canadian Journal of Urology, Vol.26, No.5, pp. 9905-9905, 2019

Abstract This article has no abstract. More >

Daniel L. Pelzman, Michelle J. Semins

Canadian Journal of Urology, Vol.26, No.6, pp. 10061-10063, 2019

Abstract Renal pseudoaneurysm following ureteroscopy is a rare cause of hematuria usually diagnosed and treated with angiography and embolization. Here we present a case of a small pseudoaneurysm causing intermittent flank pain and gross hematuria associated with clot retention initially diagnosed during ureteroscopy and subsequently treated with a combined endourologic and endovascular approach. More >

Ahmad N. Alzubaidi¹, Kenneth G. Nepple¹, Annah Vollstedt¹, Laila Dahmoush³, Deqin Ma³, Michael D. Henry^1,2,3,4, James A. Brown^1,4

Canadian Journal of Urology, Vol.26, No.6, pp. 10054-10060, 2019

Abstract Introduction: Dystroglycan (DG) is a cell surface receptor for extracellular matrix proteins involved in tissue mechanical stability and matrix organization. Initial work has demonstrated that alpha-DG expression is decreased in many types of adenocarcinoma, including prostate, and potentially associated with the development of metastatic disease. However, the consistency between prostate and lymph node alpha-DG staining has not been previously reported. Additionally, identification of an immunohistochemical marker associated with prostate cancer grade, stage, need for adjuvant or salvage therapy, and mortality would have potential clinical value.
Materials and methods: Node-positive, margin-negative radical prostatectomy specimens from a single institution… More >

Jordan Hill¹, Mike Paulden², Christopher McCabe², Scott A. North³, Peter Venner³, Nawaid Usmani¹

Canadian Journal of Urology, Vol.26, No.6, pp. 10045-10053, 2019

Abstract Introduction: Enzalutamide (Enza) is an effective treatmentformetastaticcastrate-resistantprostatecancer (mCPRC). However, Enza is not cost-effective (CE) at willingness to pay (WTP) thresholds from $0-$125 000/quality adjusted life years (QALYs) and is therefore a strain on valuable health care dollars. Metformin (Met) isinexpensive(~$8.00/month)andisthoughttoimprove prostate cancer specifc and overall survival compared to thosenottakingMet.Wehypothesizedthattheremustbe an added effect Met could provide that would make Enza CEtherebyalleviatingthisfnancialstrainongovernment health care budgets.
Materials and methods: We constructed a Markov model and performed a threshold analysis to narrow in on the added effect needed to make such a combination therapy cost-effective at various WTP thresholds.
Results:… More >

Emilie Dardenne¹, Quentin Manach¹, Pietro Grande^1,2, Riccardo Campi^1,3, Florie Gomez¹, Benjamin Granger⁴, Vincent Misrai⁵, Marc-Olivier Bitker¹, Pierre Mozer¹, Morgan Roupret¹

Canadian Journal of Urology, Vol.26, No.6, pp. 10039-10044, 2019

Abstract Introduction: To investigate the mid-term results of penile prosthesis (PP) implantation in patients with erectile dysfunction (ED) from a “real-life” historic cohort in a French academic center.
Materials and methods: All patients receiving an inflatable PP between 2004 and 2014 in our institution were included in this study. ED was assessed preoperatively using the IIEF-5 questionnaire. Postoperative satisfaction with the PP was assessed using the EDITS questionnaire at each follow-up visit. Postoperative complications were classed according to the Clavien classification. Surgical and functional outcomes were recorded prospectively.
Results: Seventy-six men received a PP during the 10-year study period.… More >

Alexis Wang¹, Charles F. Polotti², Shu Wang¹, Sammy Elsamra^2,*, Mohummad Minhaj Siddiqui^1,*

Canadian Journal of Urology, Vol.26, No.6, pp. 10033-10038, 2019

Abstract Introduction: Robotic cystectomy with intracorporeal urinary diversion (RCID) is a technically challenging procedure. It is understood that this approach has a learning curve; however, limited studies have characterized this learning curve. The cumulative sum (CUSUM) method plots the learning curve. The aim of this study was to use the CUSUM approach to investigate the number of cases required to reach a consistent, desired performance level for RCID.
Materials and methods: A retrospective study of the first 27 and 28 RCID cases performed by two new fellowship-trained faculty at two separate institutions from November 2014 to January 2018… More >

Zenon Pogorelic^1,2, Christopher Neumann², Miro Jukic¹

Canadian Journal of Urology, Vol.26, No.6, pp. 10026-10032, 2019

Abstract Introduction: The aim of this study was to investigate demographic and clinical characteristics and outcomes of the treatments of the patients with an unusual presentation of testicular torsion (TT) and to clarify their peculiarities.
Material and methods: From January 1999 until December 2017, the case records of 149 patients who underwent surgery for TT were retrospectively reviewed. Out of that number, 25 patients were identified with unusual presentation of an acute scrotum (14 patients who presented with abdominal pain only, and 11 who presented with testicular torsion in the inguinal canal).
Results: The median age of all children… More >