Solomon L. Woldu, Trushar Patel, Edan Y. Shapiro, Ari M. Bergman, Ketan K. Badani

Canadian Journal of Urology, Vol.20, No.6, pp. 7079-7083, 2013

Abstract Introduction: There are many concerns expressed by urologists performing robotic assisted laparoscopic prostatectomy (RALP) regarding management of the dorsal vein complex (DVC). We sought to examine the influence of delayed DVC ligation versus standard DVC ligation on the apical surgical margin status and other key surgical parameters following RALP.
Materials and methods: The Columbia University Urologic Oncology Database was retrospectively reviewed to identify patients who underwent RALP between 2008-2011. Operative records were analyzed to determine whether the DVC was ligated in the 'standard' or 'delayed' manner. The standard group had the DVC ligated prior to the apical… More >

Roger F. Valdivieso, Pierre-Alain Hueber, Kevin C. Zorn

Canadian Journal of Urology, Vol.20, No.6, pp. 7073-7078, 2013

Abstract The introduction of the “da Vinci Robotic Surgical System” (Intuitive Surgical, Sunnyvale, CA, USA) has been an important step toward a minimally invasive approach to radical prostatectomy. Technological peculiarities, such as three-dimensional vision, wristed instrumentation with seven degrees of freedom of motion, lack of tremor, 10x magnification, and a comfortable seated position for the surgeon, have added value to the procedure for both the surgeon and the patient. In this article, we describe the 9-step surgical technique for robot-assisted radical prostatectomy (RARP) that is currently used in our institution (University of Montreal Hospital Center (CHUM) More >

Austin D. DeRosa¹, Kevin G. Baldie¹, Adeboye O. Osunkoya², John G. Pattaras^1,3

Canadian Journal of Urology, Vol.20, No.6, pp. 7070-7072, 2013

Abstract Hemangiopericytomas are rare mesenchymal lesions arising from pericytes within the walls of capillaries. They often have an unpredictable course. We present a case of a large retroperitoneal hemangiopericytoma in a 65-year-old woman who initially presented with upper gastrointestinal discomfort. Following exptirpative surgery, pathology was consistent with hemangiopericytoma of low malignant potential. Widespread metastasis was discovered on follow up imaging, 17 months following surgery. To our knowledge, this is the first case report demonstrating a primary retroperitoneal hemangioperictoma with confirmed metastases. More >

Zulfiqar Butt¹, Jack Slatnik², Eric P. Estey¹

Canadian Journal of Urology, Vol.20, No.6, pp. 7067-7069, 2013

Abstract Angiomyofibroblastoma (AMF) is a rare benign tumor of the female genital tract. Three cases of AMF-like tumors of the male genital tract have been reported in the literature. We present the first documented case of an AMF-like soft tissue tumor of the male pelvis excised with robotic assisted laparoscopic surgery. More >

Robert J. Hartman, Jr.¹, Brian T. Helfand², William W. Lin²

Canadian Journal of Urology, Vol.20, No.6, pp. 7064-7066, 2013

Abstract Retroperitoneal fibrosis (RPF) is a rarely occurring disease process characterized by the development of fibrous plaques that encase retroperitoneal organs and major vessels. The most common sequelae is obstructive uropathy secondary to ureteral compression. Ureterolysis with intraperitoneal transposition and omental wrapping has historically been a popularized means to relieve ureteral obstruction. We present the case of a 47-year-old man with bilateral hydronephrosis secondary to RPF. Due to insufficient length of omentum, we report the first documented use of SurgiWrap to wrap the ureters to minimize the future possibility of recurrent/continued fibrosis, compression, and ureteral obstruction. More >

Samantha Low¹, Maleeha Azim¹, Elaine Wan², Vimal Hariharan²

Canadian Journal of Urology, Vol.20, No.6, pp. 7060-7063, 2013

Abstract Simple renal cysts are most commonly found in the elderly, male population. The majority of simple renal cysts remain untreated, except on the rare occasion when they become complicated with hemorrhage, infection, or rupture.
We present the case of a 31-year-old female with a simple renal cyst which was initially treated as acute pyelonephritis. A high clinical suspicion led to the diagnosis of an infected renal cyst, which was treated with antibiotic therapy and radiological drainage. There were minimal complications, and the patient made an uneventful recovery. More >

Daniel A. Pérez-Fentes¹, Francisco Gude², Miguel Blanco¹, Rosa Novoa¹, Camilo García Freire¹

Canadian Journal of Urology, Vol.20, No.6, pp. 7050-7059, 2013

Abstract Introduction: The aim of this study is to identify surgical, patient- and stone-related factors predictive of clinical success and complications after percutaneous nephrolithotomy (PCNL).
Materials and methods: We prospectively studied 100 consecutive PCNL procedures. Univariate and multiple regression models were used in order to identify which variables could act as independent predictors of PCNL outcomes. Success was defined as complete absence of fragments in a non-contrast CT. The Clavien-modified grading system was used to classify the complications.
Results: Univariate analysis showed that patients rendered stone-free had a significantly lower stone burden, shorter operating times, single stones and non-struvite… More >

Jen-Jane Liu, David P. Guo, Harcharan Gill

Canadian Journal of Urology, Vol.20, No.6, pp. 7046-7049, 2013

Abstract Introduction: We reviewed the consultation patterns for difficult urethral catheter placement in tertiary care hospitals and developed a treatment algorithm for this common request.
Materials and methods: We identified all urethral catheter consults obtained by urology residents at three tertiary care hospitals from October 2009 through October 2010. Only consults for inability to place urethral catheter by the referring team were included; hematuria or clot retention were excluded. Patient age, date of consultation, consulting service, prior urologic history, initial number of attempts, and final outcome were recorded.
Results: Eighty-one consults were recorded. Seventy-seven (96%) were male; the median… More >

Cynthia P. Leung¹, Adam P. Klausner¹, Joseph R. Habibi¹, Ashley B. King¹, Adam S. Feldman²

Canadian Journal of Urology, Vol.20, No.6, pp. 7042-7045, 2013

Abstract Introduction: Audience response systems (ARS) have not been used to gauge knowledge transfer and retention in the setting of large medical conferences. In this study, we explore the utility of an ARS as an educational tool in the setting of a large urology conference.
Materials and methods: At the 2011 joint meeting of the Mid-Atlantic and New England sections of the American Urological Association, conference attendees were able to use a web-based and cell-phone accessed ARS. At the meeting, six ARS questions were asked during five point-counterpoint debate topics covering areas of prostate cancer, incontinence, pediatrics, stone… More >

Tin C. Ngo¹, Michael P. Hurley², Alan E. Thong¹, Seung Hyun Jeon³, John T. Leppert^1,4, Benjamin I. Chung¹

Canadian Journal of Urology, Vol.20, No.6, pp. 7035-7041, 2013

Abstract Introduction: To identify factors associated with the development of chronic kidney disease (CKD) after nephrectomy and to create a clinical model to predict CKD after nephrectomy for kidney cancer for clinical use.
Materials and methods: We identified 144 patients who had normal renal function (eGFR > 60) prior to undergoing nephrectomy for kidney cancer. Selected cases occurred between 2007 and 2010 and had at least 30 days follow up. Sixty-six percent (n = 95) underwent radical nephrectomy and 62.5% (n = 90) developed CKD (stage 3 or higher) postoperatively. We used univariable analysis to screen for predictors… More >