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  • Open Access

    ARTICLE

    Variability of transrectal ultrasound-guided prostate biopsy prophylactic measures

    Joel H. Hillelsohn1, Brian Duty2, Michael L. Blute Jr.1, Zhamshid Okhunov3, Mahyar Kashan1, Robert Moldwin1, Richard N. Ashley1

    Canadian Journal of Urology, Vol.19, No.6, pp. 6573-6577, 2012

    Abstract Introduction: To assess the variability of pre-prostate biopsy prophylaxis among American urologists.
    Materials and methods: A survey was electronically mailed to 3355 urologists around the country. Urologists were surveyed on their antibiotic prophylaxis choice, the route and duration of antimicrobial prophylaxis. Additionally they were questioned about their knowledge of local antimicrobial resistance and if rectal enemas were routinely used.
    Results: There were 679 (21%) responses to the survey. The survey revealed differences in pre-prostate biopsy prophylaxis among urologists. Ten different classes of antibiotics were used orally, 4 classes intramuscular, 5 classes intravenous, and there was also 14 different More >

  • Open Access

    ARTICLE

    Perineural invasion on prostate biopsy does not predict adverse pathological outcome

    Malik Elharram1, David Margel2, Antonio Finelli2, John Trachtenberg2, Andrew Evans3, Theodorus H. van der Kwast3, Joan M. Sweet2, Neil Fleshner2

    Canadian Journal of Urology, Vol.19, No.6, pp. 6567-6572, 2012

    Abstract Introduction: The clinical significance of perineural invasion (PNI) on prostate needle biopsy is controversial. The aim of this present study is to determine the role of PNI on prostate biopsy in predicting adverse findings at radical prostatectomy in a recent cohort of screen detected prostate cancer.
    Materials and methods: We analyzed 470 patients diagnosed with prostate cancer from a prospectively maintained database at Princess Margaret Hospital. Out of the 470 patients diagnosed with prostate cancer, 139 underwent radical prostatectomy. Pathological specimens were examined, and perineural invasion was identified as carcinoma tracking along or around a nerve in… More >

  • Open Access

    COMMENTARY

    Endoscopic biopsy of upper tract tumors: why bother?

    Francis X. Keeley Jr

    Canadian Journal of Urology, Vol.19, No.6, pp. 6566-6566, 2012

    Abstract This article has no abstract. More >

  • Open Access

    ARTICLE

    Ureteroscopic biopsy of upper tract urothelial carcinoma using a novel ureteroscopic biopsy forceps

    Shaun E. L. Wason1, John D. Seigne1, Alan R. Schned2, Vernon M. Pais Jr1

    Canadian Journal of Urology, Vol.19, No.6, pp. 6560-6565, 2012

    Abstract Introduction: We sought to assess the adequacy of surgical specimens obtained utilizing the BIGopsy (Cook Medical, Bloomington, IN, USA) biopsy forceps both ex vivo and in vivo and compare them to traditional 3Fr biopsy forceps in patients with suspected upper tract urothelial carcinoma.
    Materials and methods: Patients undergoing nephroureterectomy for suspected upper tract transitional cell carcinoma were recruited. Surgical specimens, immediately after extirpation were examined and alternatively biopsied ex vivo with the BIGopsy and 3Fr biopsy forceps. We then retrospectively reviewed our most recent experience with ureteroscopic biopsy. The biopsy device, size, depth, grade, stage, pathologic diagnosis… More >

  • Open Access

    ARTICLE

    Obesometric factors associated with increased skin-to-stone distances in renal stone patients

    Christopher B. Allard1, Anatoly Shuster2, Jehonathan H. Pinthus3, Forough Farrokhyar4, A. Raees1, Michael Patlas2, Edward D. Matsumoto1, J. Paul Whelan1

    Canadian Journal of Urology, Vol.19, No.6, pp. 6554-6559, 2012

    Abstract Introduction: Obese patients are at increased risk for renal stones as well as treatment failures due to increased skin-to-stone distances (SSD) and harder stone compositions. We investigated the relationships between obesometric parameters (body mass index [BMI], body fat distribution and obesity-related hormone levels) with SSD and stone hardness.
    Materials and methods: We prospectively enrolled patients undergoing stone interventions at our institution. Computed tomography (CT) scans were analyzed; adipose tissue was identified according to Hounsfield units (HU) and separated into subcutaneous (SAT) and visceral (VAT) components. The pixels were averaged at three levels to calculate fat distribution: %VAT… More >

  • Open Access

    ARTICLE

    Erectile dysfunction in patients with traumatic urethral strictures treated with anastomotic urethroplasty: a single-factor analysis

    Chen-Ye Tang, Qiang Fu, Ren-Jie Cui, Xian-Jun Sun

    Canadian Journal of Urology, Vol.19, No.6, pp. 6548-6553, 2012

    Abstract Introduction: To investigate factors correlated with erectile dysfunction (ED) in patients with traumatic urethral strictures undergoing end-to-end anastomotic urethroplasty (AU).
    Materials and methods: Between January 2010 and January 2011, 41 patients with urethral strictures resulting from pelvic fracture urethral distraction defects underwent end-to-end AU. The abridged International Index of Erectile Function (IIEF-5) was used to subjectively assess erectile function at admission and 2 weeks postoperatively.
    Results: Pre- and post-injury IIEF-5 scores differed significantly (23.54 ± 1.45 versus 10.02 ± 3.57; p < 0.0001), but pre- and postoperative scores did not (10.02 ± 3.57 versus 9.29 ± 4.14; p… More >

  • Open Access

    ARTICLE

    The digital rectal examination (DRE) remains important – outcomes from a contemporary cohort of men undergoing an initial 12-18 core prostate needle biopsy

    Ricardo Palmerola1, Paul Smith2, Vanessa Elliot2, Carl T. Reese2, Frank B. Mahon2, Lewis E. Harpster2, Nikolina Icitovic1, Jay D. Raman2,3

    Canadian Journal of Urology, Vol.19, No.6, pp. 6542-6547, 2012

    Abstract Introduction: Indications for prostate needle biopsy (PNB) include elevated serum prostate-specific antigen (PSA) and/or abnormal digital rectal examination (DRE). We evaluated a contemporary cohort of men undergoing PNB to determine cancer detection rates when stratified by DRE status.
    Materials and methods: The charts of 806 men who underwent a PNB were reviewed. Serum PSA was categorized as normal or abnormal according to age-specific criteria. A normal DRE was defined as a smooth, age-appropriate, asymmetric, or uniformly enlarged prostate. An abnormal DRE was defined by either a nodule or induration. Sensitivity, specificity, and predictive values were determined for… More >

  • Open Access

    REVIEW

    Salvage therapy for locally recurrent prostate cancer after radiation

    David M. Marcus1,5, Daniel J. Canter2,5, Ashesh B. Jani1,2,5, Ryan W. Dobbs2, David M. Schuster3, Bradley C. Carthon4,5, Peter J. Rossi1,2,5

    Canadian Journal of Urology, Vol.19, No.6, pp. 6534-6541, 2012

    Abstract Introduction: External beam radiotherapy (EBRT) is widely utilized as primary therapy for clinically localized prostate cancer. For patients who develop locally recurrent disease after EBRT, local salvage therapy may be indicated. The primary modalities for local salvage treatment in this setting include radical prostatectomy, cryotherapy, and brachytherapy. To date, there is little data describing outcomes and toxicity associated with each of these salvage modalities.
    Materials and methods: A review of the literature was performed to identify studies of local salvage therapy for patients who had failed primary EBRT for localized prostate cancer. We focused on prospective trials… More >

  • Open Access

    LEGENDS IN UROLOGY

    LEGENDS IN UROLOGY

    John J. Mulcahy

    Canadian Journal of Urology, Vol.19, No.6, pp. 6531-6533, 2012

    Abstract This article has no abstract. More >

  • Open Access

    EDITORIAL

    Circumcision: A Spiritual, Medical or Criminal Act?

    Leonard G. Gomella

    Canadian Journal of Urology, Vol.19, No.6, pp. 6530-6530, 2012

    Abstract This article has no abstract. More >

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