Michael J. Manyak

Canadian Journal of Urology, Vol.14, Suppl.6, pp. 32-38, 2007

Abstract Rapid advances in imaging technology have whetted our collective appetites for practical clinical applications to assist the physician and patient in therapeutic decisions. Current limitations of imaging technology are being addressed by the convergence of technology in materials science, the computer industry, and biology which have led to improvements of diagnostic imaging. Refinements in image acquisition, fusion of images, and outcomes data now suggest use for image-guided therapy. Novel imaging agents and technologies appear to provide improved capabilities to detect malignant lymph nodes. Future applications of optical coherence tomography, electron paramagnetic resonance imaging, nanotechnology, and More >

Gary W. Bong, Thomas E. Keane

Canadian Journal of Urology, Vol.14, Suppl.6, pp. 2-9, 2007

Abstract Despite excellent success rates with radical prostatectomy and radiotherapy for the treatment of prostate cancer, a significant number of patients will experience a rise in their serum prostate specific antigen (PSA) level. A variety of salvage options in this scenario have been investigated and the choice to pursue surveillance, single therapy or combination therapy depends on clinical assessment of risk and location of tumor recurrence. After radical prostatectomy, for example, patients with low risk local disease may not require secondary therapy or may benefit from salvage radiotherapy. Those with higher risk disease, based on PSA More >

Lester S. Borden Jr., Paul M. Kozlowski, Christopher R. Porter, John M. Corman

Canadian Journal of Urology, Vol.14, No.2, pp. 3499-3501, 2007

Abstract Introduction: Robotic-assisted laparoscopic radical prostatectomy (RLRP) is playing an increasing role in the surgical management of prostate cancer. The benefits of minimally invasive surgery, enhanced surgeon familiarity with the instrumentation, and increased patient demand has led to the popularity of this surgical technique. There are, however, shortcomings specifically associated with this technology. Notably, instrumentation failure associated with robotic procedures represents a new and unique problem in urological surgery. We examine the rate of mechanical failure of the da Vinci robotic system and its impact on our prostate cancer program.
Materials and methods: We reviewed our prospective, institutional… More >

Ronald S. Boris, Sanjeev A. Kaul, Richard C. Sarle, Hans J. Stricker

Canadian Journal of Urology, Vol.14, No.3, pp. 3566-3570, 2007

Abstract Objective: To compare perioperative, functional and oncological outcomes of a single surgeon's experience with retropubic (RRP), perineal (RPP), and robotic assisted (RARP) radical prostatectomy.
Methods: Results from 150 radical prostatectomies performed by a single surgeon were compared. The groups consisted of the last 50 consecutive RRP (group 1) and RPP patients (group 2) and his first 50 RARP patients (group 3). He had significant experience in RRP and RPP and extensive training prior to performing RARP. The data was obtained from record review and patient survey. Patient demographics, operative parameters, pathological characteristics, complications, and functional outcomes… More >

Gabriel P. Haas

Canadian Journal of Urology, Vol.14, No.3, pp. 3534-3534, 2007

Abstract This article has no abstract. More >

Danny M. Rabah

Canadian Journal of Urology, Vol.14, No.4, pp. 3640-3642, 2007

Abstract The traditional treatment of choice for urachal carcinoma has been either an open radical cystectomy or the more recently accepted extended partial cystectomy and umbilectomy. Recently a laparoscopic technique has been reported. We report for the first time a robot-assisted technique for an extended partial cystectomy with en bloc umbilectomy for the management of urachal carcinoma in a 49-year-old man. More >

Rajesh G. Laungani, Sanjeev Kaul, Fred Muhletaler, Ketan K. Badani, James Peabody, Mani Menon

Canadian Journal of Urology, Vol.14, No.4, pp. 3635-3639, 2007

Abstract Objective: Several investigators have noted that previous inguinal hernia repair with or without the use of prosthetic mesh might be a relative contraindication for open or laparoscopic radical prostatectomy due to the presence of adhesions and the difficulty of tissue dissection. We aimed to evaluate the impact of previous hernia repair on the performance and feasibility of robotic prostatectomy.
Materials and methods: We performed a retrospective analysis of 354 patients who underwent robotic prostatectomy at our institution. The three patient groups were: 292 patients who had no prior hernia repair (group 1), 50 patients who had prior… More >

Frederick P. Mendiola, Kevin C. Zorn, Ofer N. Gofrit, Albert A. Mikhail, Marcelo A. Orvieto, Lambda P. Msezane, Gary D. Steinberg

Canadian Journal of Urology, Vol.14, No.4, pp. 3628-3634, 2007

Abstract Introduction: Radical cystectomy (RC) with urinary diversion remains as one of the more complex urological procedures despite considerable progress in surgical technique. Increasing patient age, along with associated age-related comorbidities, may portend a poor outcome in those undergoing such complicated surgical procedures. Herein, we report our experience with radical cystectomy in the elderly population.
Methods: We retrospectively reviewed our RC results from 1995 to 2003. Patients ≥80 years old were included in this analysis. Perioperative outcomes, as well as overall and disease-free survival were evaluated.
Results: A total of 517 patients underwent RC with urinary diversion during… More >

Lambda P. Msezane, Ofer N. Gofrit, Shang Lin, Arieh L. Shalhav, Gregory P. Zagaja, Kevin C. Zorn

Canadian Journal of Urology, Vol.14, No.5, pp. 3697-3701, 2007

Abstract Introduction: Pre-operative prediction of pathological stage represents the cornerstone of prostate cancer management. Patient counseling is routinely based on pre-operative PSA, Gleason score and clinical stage. In this study, we evaluated whether prostate weight (PW) is an independent predictor of extracapsular extension (ECE) and positive surgical margin (PSM).
Methods: Between February 2003 and November 2006, 709 men underwent robotic-assisted laparoscopic radical prostatectomy (RLRP). Pre-operative parameters (patient age, pre-operative PSA, biopsy Gleason score, clinical stage) as well as pathological data (prostate weight, pathological stage) were prospectively gathered after internal-review board (IRB) approval. Evaluation of the influence of… More >

Khurshid A. Guru^1,4, Gregory E. Wilding^3,6, Pamela Piacente¹, Jannah Thompson⁴, Wei Deng⁶, Hyung L. Kim^1,4, James Mohler^1,4, Kathleen O’Leary^2,5

Canadian Journal of Urology, Vol.14, No.6, pp. 3753-3756, 2007

Abstract Introduction: To date, no study has compared postoperative pain and requirement for pain medications in open versus robot-assisted radical cystectomy. Patient reported pain and opiate use were reviewed retrospectively using prospectively collected data from postoperative day one to day of discharge.
Materials and methods: Twenty consecutive robot-assisted radical cystectomy patients were compared to the prior 20 patients who underwent open radical cystectomy. Data was collected prospectively to determine opiate requirements and pain scores in each group. Daily opiate use was converted to morphine sulfate equivalents (MSE) to facilitate comparison. A Likert pain perception scale was used to… More >