Laurence H. Klotz, Richard Choo, Gerard Morton, Cyril Danjoux

Canadian Journal of Urology, Vol.9, Suppl.1, pp. 2-7, 2002

Abstract The optimal management of clinically localized prostate cancer remains unresolved. Management options range from a conservative approach to definitive treatment. While evidence suggests that expectant management yields similar 10-year survival rates and quality-adjusted life years compared to definitive treatment, this approach alone will deprive some patients with potentially curable disease of the opportunity for curative therapy. Effective management of localized prostate cancer requires differentiation between patients with biologically aggressive disease, in whom curative therapy is strongly warranted, and those with indolent malignancy, in whom conservative management would be equally efficacious. A comparison of surveillance studies… More >

Roanne Segal¹, Eric Winquist², Himu Lukka³, Joseph L. Chin⁴, Michael Brundage⁵, B. R. Markman⁶

Canadian Journal of Urology, Vol.9, No.5, pp. 1625-1633, 2002

Abstract Background and purpose: To examine the role of adjuvant chemotherapy in the treatment of patients with deep muscle-invasive transitional cell carcinoma (TCC) of the bladder who have undergone cystectomy.
Materials and methods: A systematic review of the published literature was combined with a consensus process, involving the interpretation of evidence within the context of conventional practice, to develop an evidence-based practice guideline for use in Ontario.
Results: Five randomized controlled trials (RCTs) comparing adjuvant chemotherapy with observation were found that reported data on survival. Sample sizes of the trials were small, and each of the trials evaluated a cisplatin-based… More >

Laurence H. Klotz

Canadian Journal of Urology, Vol.9, No.5, pp. 1623-1623, 2002

Abstract This article has no abstract. More >

Darrel E. Drachenberg¹, David G. Bell²

Canadian Journal of Urology, Vol.9, No.4, pp. 1602-1606, 2002

Abstract Background: The treatment of localized prostate cancer has increased over the past decade in large part due to enhanced screening efforts with prostate specific antigen (PSA) and has resulted in a dramatic increase in the number of radical retropubic prostatectomies being performed in recent years. It is estimated that between 5% and 10% of men who are candidates for radical surgical treatment for localized prostate cancer will have concomitant inguinal hernia. Given the well described complications of untreated inguinal hernias we propose that simultaneous repair be undertaken along with radical retropubic prostatectomy for preoperatively defined hernias More >

Marc David¹, Luis Souhami¹, Armen Aprikian²

Canadian Journal of Urology, Vol.9, No.4, pp. 1599-1601, 2002

Abstract A case of post renal acute renal failure secondary to radiation therapy for prostate cancer is described. Severe bladder inflammatory reaction, leading to bilateral ureteric obstruction, occurred after a moderate dose of radiotherapy (6400 cGy in 35 fractions). At a follow-up time of 8 years, the patient has fully recovered and remains disease-free. To our knowledge, this complication has never been described previously. Given the thrust in prostate cancer treatment toward dose escalation this complication could become more frequent. More >

Brian Blew¹, Blair Carpenter², Michael P. Leonard³

Canadian Journal of Urology, Vol.9, No.4, pp. 1595-1598, 2002

Abstract Purpose: Nephrogenic rests (NR) are clusters of cells similar to renal blastema. NR are frequently seen in kidneys with Wilms' tumor (WT) and are seen with higher frequency in nephrectomy specimens from obstructed and/or multicystic dysplastic kidneys (MCDK) compared to autopsy series of normal kidneys. The significance of NR and their role in tumorigenesis is largely unknown. We report the findings of two cases with NR associated with ureteral ectopy/obstruction and review the relevant literature.
Materials and methods: Two cases of upper pole heminephrectomy associated with ectopic upper pole ureter and resultant hydronephrosis were found to have… More >

Fred Saad, Robert Sabbagh, Michael McCormack, François Peloquin

Canadian Journal of Urology, Vol.9, No.4, pp. 1592-1594, 2002

Abstract Purpose: To compare patient reported pain during TRUS guided biopsies using intrarectal lidocaine gel versus lubricating gel.
Materials and methods: From May 2000 to May 2001, 360 men undergoing transrectal prostate biopsy were enrolled in this study. Patients were randomized into two groups. In group 1, 180 patients received 10 cc of 2% intrarectal lidocaine gel (Xylocaine® 2% jelly, Astra Pharma Inc.) 5 to 10 minutes before the procedure and in group 2, 180 patients received 10 cc of lubricating gel. No other sedation or analgesia was given. Pain level immediately after the last biopsy was assessed More >

Ragnar Asplund^1,2

Canadian Journal of Urology, Vol.9, No.4, pp. 1588-1591, 2002

Abstract Objective: To assess the temporal trend in surgical treatment of benign hypertrophy of the prostate in Sweden, particularly the possible influence of nocturia on the probability to be treated by a transurethral resection operation of the prostate (TURP).
Materials and methods: There were 2501 elderly men recruited by a questionnaire from a group of pensioners (n=4035; response rate 62%). Their age was 73.3 (6.4) years. The questionnaire included questions on their health and diseases, drugs, sleep habits and the number of nocturnal voiding episodes. Data on deaths from July 1, 1992 to December 31, 1997 were obtained.
Results:… More >

Canadian Urological Association Guidelines Committee

Canadian Journal of Urology, Vol.9, No.4, pp. 1583-1587, 2002

Abstract Erectile dysfunction has undergone dramatic advances in diagnosis and therapeutics over the past decade. Increasing numbers of men are currently seeking medical help for their sexual concerns, often from primary health care providers.
The Canadian Urological Association (CUA), Guidelines Committee is charged with the responsibility of creating practice guidelines for urologic conditions with the goal of improving physician knowledge and enhancing patient care. These Erectile Dysfunction Guidelines highlight the evolving use of a minimally invasive patient self­directed goal oriented approach to evaluation and treatment using oral agents as first-line therapy based on efficacy, side effect More >

Joseph L. Chin, Stephen E. Pautler

Canadian Journal of Urology, Vol.9, No.4, pp. 1576-1582, 2002

Abstract The diagnostic rate of small, "incidental" tumors which are amenable to local excision or ablation has increased significantly due to widespread use of non-invasive body imaging tests. The role of nephron-sparing tumor­ablative surgery has expanded beyond the traditional circumstances of neoplasms in solitary/functionally solitary kidneys or tumors present bilaterally. Due to technologic advances, possible therapeutic options now include open surgery, laparoscopic, percutaneous and extraciorporeal approaches, in addition to surveillance in some cases. This review will concentrate on the new energy sources available for tumor ablation rather than the different surgical approaches, with a detailed review More >