Adam B. Althaus, Ostap Dovirak, Peter Chang, Kimberly N. Taylor, Thomas D. O’Halloran, Andrew A. Wagner

Canadian Journal of Urology, Vol.22, No.5, pp. 7984-7989, 2015

Abstract Introduction: Continuation of antiplatelet medications through major urologic surgery may increase the risk of intraoperative and postoperative bleeding complications. However, withdrawal of antiplatelet therapy may place some patients at high risk of serious cardiovascular or cerebrovascular complications. We assess the feasibility of performing robotic partial nephrectomy (RPN) in patients maintained on aspirin or dual antiplatelet therapy with aspirin and clopidogrel.
Material and methods: Perioperative data was collected prospectively on 230 subjects undergoing RPN enrolled in an IRB approved quality of life study. We analyzed subjects who were maintained on either aspirin alone or both aspirin and clopidogrel… More >

Frank T. D’Arcy¹, Nathan Lawrentschuk^1,2,3, Rustom P. Manecksha^1,4, David R. Webb¹

Canadian Journal of Urology, Vol.22, No.5, pp. 7978-7983, 2015

Abstract Introduction: Percutaneous nephrolithotomy (PCNL) was described in the 1980s and revolutionized the treatment of stone disease. The crucial component to this surgery is satisfactory track creation. We examine how the development and production in the 1980s of a single stage dilator (SSD) subsequently modified for pediatric PCNL has become the ideal access tool for mini percutaneous nephrolithotomy (mPCNL) today.
Materials and methods: The conception, production, scientific and clinical development of the original SSD is described. The pitfalls of track dilation in general according to method of dilation are also discussed and outlined.
Results: This study provides evidence clarifying More >

Seyed Saeid Dianat¹, H. Ballentine Carter^2,4, Edward M. Schaeffer^2,4, Ulrike M. Hamper^1,2, Jonathan I. Epstein^2,3,4, Katarzyna J. Macura^1,2,4

Canadian Journal of Urology, Vol.22, No.5, pp. 7965-7972, 2015

Abstract Introduction: Purpose of this pilot study was to correlate quantitative parameters derived from the multiparametric magnetic resonance imaging (MP-MRI) of the prostate with results from MRI guided transrectal ultrasound (MRI/TRUS) fusion prostate biopsy in men with suspected prostate cancer.
Materials and methods: Thirty-nine consecutive patients who had 3.0T MP-MRI and subsequent MRI/TRUS fusion prostate biopsy were included and 73 MRI-identified targets were sampled by 177 cores. The pre-biopsy MP-MRI consisted of T2-weighted, diffusion weighted (DWI), and dynamic contrast enhanced (DCE) images. The association of quantitative MRI measurements with biopsy histopathology findings was assessed by Mann-Whitney U-test and… More >

Ilan J. Safr^1,2, Adam B. Shrewsberry^1,2, Isabella M. Issa³, Kenneth Ogan^1,2, Chad W. M. Ritenour^1,2, Jerry Sullivan^1,2, Muta M. Issa^1,2

Canadian Journal of Urology, Vol.22, No.5, pp. 7959-7964, 2015

Abstract Introduction: The study objective was to determine the impact of remote monitoring and supervision (RMS) in integrated endourology suites (IES) on residents achieving endoscopic training milestones.
Materials and methods: Twenty-one urology residents evaluated RMS in IES using a 25-question survey. IES provided audio-visual communication for faculty to supervise residents remotely. Questionnaire used a linear visual scale of 1-10 to assess acceptability (8 questions), impact on training (10 questions), supervision level (1 question), and pre- and post-training milestone self-assessments (6 questions). Improvements in Patient Care Milestone #7 (upper/lower tract endoscopic procedures) and Patient Care Milestone #9 (office-based procedures)… More >

Jerry G. Blaivas^1,2,3, Johnson F. Tsui^2,4, Gabriel Mekel^2,5, Matthew S. Benedon², Belinda Li⁶, Fara M. Friedman³, James M. Weinberger^2,7, Jeremy Weedon³, Jeffrey P. Weiss^2,3

Canadian Journal of Urology, Vol.22, No.5, pp. 7952-7958, 2015

Abstract Introduction: To develop and validate a lower urinary tract symptom score (LUTSS) as a measure of lower urinary tract symptom (LUTS) severity and a treatment outcome tool in adults.
Materials and methods: An expert panel was convened to develop the LUTSS questionnaire. Content validity was achieved by obtaining subject and expert feedback from two prospective drafts. Subjects were divided into three groups: normal, LUTS and overactive bladder (OAB). Questionnaire was administered on two separate occasions within 1-2 weeks. Test-retest reliability, internal consistency, discriminant validity, criterion validity and responsiveness to change were also assessed.
Results: The questionnaire contains 14… More >

Alfredo Harb-De la Rosa, Matthew Acker, Raj A. Kumar, Murugesan Manoharan

Canadian Journal of Urology, Vol.22, No.5, pp. 7947-7951, 2015

Abstract Introduction: Bladder cancer is the sixth most common cancer in the Western world. Patients with bladder cancer require close monitoring, which may include frequent cystoscopy and urine cytology. Such monitoring results in significant health care cost. The application of epigenetics may allow for a risk adapted approach and more cost-effective method of monitoring. A number of epigenetic changes have been described for many cancer sites, including the urinary bladder. In this review, we discuss the use of epigenetics in bladder cancer and the potential diagnostic and therapeutic applications.
Materials and methods: A comprehensive search of the English… More >

Simon Ouellet, Claudio Jeldres, Hugo Simard, Robert Sabbagh, Michel Carmel

Canadian Journal of Urology, Vol.22, No.6, pp. 8112-8114, 2015

Abstract Orthotopic ileal neobladder has been frequently performed as urinary diversion after cystectomy over the last decades. We report an unusual complication of very large calculi in a Studer ileal neobladder. Due to its size, open cystolithotomy was performed. More >

Shuvro De, Michael J. Belsante, Timothy J. Tausch, Jay Simhan

Canadian Journal of Urology, Vol.22, No.6, pp. 8108-8111, 2015

Abstract Fournier’s gangrene is an uncommon necrotizing infection affecting the genital and perineal area. Penile involvement in particular is rare owing to its rich vascular supply. In this report, we document a case of Fournier’s gangrene involving penile and urethral tissue requiring multiple debridements resulting in significant penile deformity and a non-healing wound. Eventually, the patient underwent penectomy and perineal urethrostomy creation. In this case, penectomy and perineal urethrostomy provide a functional outcome for highly refractory and complex patients with Fournier’s gangrene involving penile tissue. More >

Andrew J. Davidiuk, David D. Thiel

Canadian Journal of Urology, Vol.22, No.6, pp. 8105-8107, 2015

Abstract Spontaneous retroperitoneal hematoma (SRH) is a rare, potentially lethal entity that can arise from a variety of etiologies. We present a case of SRH secondary to hemorrhage from the right inferior adrenal artery in a 22-year-old woman. The patient presented to the emergency room with significant right flank pain, and computed tomography (CT) demonstrated a large, right-sided retroperitoneal hematoma with no identifiable etiology. Renal angiography revealed active extravasation from the right inferior adrenal artery. The patient was definitively treated with endovascular coiling of the ruptured artery, and long-term follow-up demonstrated resolution of the retroperitoneal hematoma. More >

Tim A. Ludwig^1,*, Philip Reiss^1,*, Marco Wieland², Andreas Becker¹, Margit Fisch¹, Felix K. Chun¹, Roland Dahlem¹

Canadian Journal of Urology, Vol.22, No.6, pp. 8100-8104, 2015

Abstract Introduction: The aim was to perform a feasibility study of the new artificial sphincter device ARTUS in human cadavers. ARTUS is a new electro-mechanical device, which may prevent urethral damage due to a new working principle which is to perform only sequential pressure on successive parts of the urethra.
Material and methods: The implantation of the ARTUS device was performed in six cadavers (3 males, 3 females) with different body mass indices. Subsequently the basic operation data (operation time, cuff size, length of wires, complication) were assessed.
Results: The implantation of the ARTUS device is performed easily by… More >