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Canadian Journal of Urology

Albert S Lee, Diana K Bowen, Seth Vatsky, Stephen A Zderic, Gregory E Tasian
We report successful percutaneous nephrolithotomy (PCNL) in an 8-week-old, 4.12 kg infant with a combined stone burden of > 2 cm in a solitary kidney. The patient was born with thoracolumbar myelomeningocele and had developed recurrent urinary tract infections. Her size precluded retrograde intrarenal surgery and shockwave lithotripsy would be unlikely to clear the stone burden. Stone analysis revealed hydroxyapatite and carbonate apatite stones, and metabolic work up revealed hypercalciuria for which chlorothiazide was started...
June 2018: Canadian Journal of Urology
Ksenia Chezar, Geoffrey Gotto, Shaun Medlicott, Kiril Trpkov
The presence of urothelial epithelial metaplasia in a seminal vesicle is an exceptionally rare finding. We describe a unique case of urothelial metaplasia of the seminal vesicle and ejaculatory duct, found in a radical prostatectomy specimen from a patient with complex urogenital anatomy. A 70-year-old patient with organ confined (pT2) prostatic adenocarcinoma (Gleason score 3+4 = 7) had a right-sided Hutch diverticulum and a left crossed-fused renal ectopia. Although the histogenesis of urothelial metaplasia in the seminal vesicle remains unclear, in the patient presented herein it likely developed as a consequence of the previously unrecognized malformation...
June 2018: Canadian Journal of Urology
Bradley A Morganstern, Samantha Scaccia, Wayland Wu, Alex K Williamson, Lane S Palmer
Embryonal rhabdomyosarcoma is a rare cancer that often requires multimodality therapy to treat; however, these therapies can cause changes in the biology of the tumor. Several reports have documented pathologic changes but only recently have genetic changes been mapped. We present case of two separate synchronous primary rhabdomyosarcomas in a 17-month-old patient and discuss the pathophysiology and genetic changes that occur with treatment. We hypothesize that a genetic field defect arising in development of the urogenital sinus caused the tumors, but that treatment modalities may have caused genetic alterations changing clinical behavior of the tumors and responses to treatment...
June 2018: Canadian Journal of Urology
Vladimir Mouraviev, Michael McDonald
INTRODUCTION: The changing face of current infection phenotypes from planktonic to biofilm type has been developed implicating bacterial biofilms in recurrent infection. To date, no specific medical treatment exists to specifically target biofilms in the human host. Similarly, the identification of a biofilm has relied upon the analysis of tissue samples with electron microscopy or DNA identification with polymerase chain reaction (PCR) and sequencing. Standard culture and sensitivity test is not able to detect a presence of biofilms...
June 2018: Canadian Journal of Urology
Avinash Chenam, Nora Ruel, Sumanta Pal, John Barlog, Clayton Lau, Timothy Wilson, Bertram Yuh
INTRODUCTION: Extended lymph node dissection (ELND) compared to limited lymph node dissection (LLND) at time of prostatectomy improves staging and lymph node (LN) yield. The effect on biochemical recurrence (BCR) and survival is less well understood. We sought to evaluate the benefit of robotic ELND and LLND with respect to BCR. MATERIALS AND METHODS: Between 2008-2012, 584 consecutive men with intermediate or high risk clinically localized adenocarcinoma of the prostate underwent robotic assisted radical prostatectomy (RARP) with concomitant LLND (n = 326) or ELND (n = 258)...
June 2018: Canadian Journal of Urology
Michael A Avallone, Peter N Dietrich, Shanta T Shepherd, Mona Lalehzari, R Corey O'Connor, Michael L Guralnick
INTRODUCTION: Classic surgical teaching advocates for closure of the mesenteric defect (MD) after bowel anastomosis but the necessity is controversial. We sought to evaluate the necessity of MD closure at the time of harvest of ileum for genitourinary reconstructive surgery (GURS) by analyzing the incidence of early and late gastrointestinal adverse events (GIAE) in patients with and without MD closure. MATERIALS AND METHODS: A retrospective review was conducted on patients undergoing urologic reconstruction with ileum to identify incidence of ileus, small bowel obstruction (SBO), gastrointestinal (GI) fistula and stoma complications...
June 2018: Canadian Journal of Urology
Bradley A Erickson, Brennan A Tesdahl, Maria A Voznesensky, Benjamin N Breyer, Bryan B Voelzke, Nejd F Alsikafi, Alex J Vanni, Joshua A Broghammer, Jill C Buckley, Jeremy B Myers, William O Brant, Lee C Zhao, Thomas G Smith Iii, Brian L Swick, Laila Dahmoush
INTRODUCTION: Given the poor understanding of the pathophysiology of genital lichen sclerosus (GLS) and a lack of accepted definitive diagnostic criteria, we proposed to survey pathologists regarding their understanding of GLS. We hypothesized that significant disagreement about GLS will exist. MATERIALS AND METHODS: All urologists participating in the Trauma and Urologic Reconstruction Network of Surgeons identified genitourinary (GUP) and dermatopathologists (DP) at their respective institutions who were then invited to participate in an online survey regarding their experience with diagnosing GLS, GLS pathophysiology and its relationship to urethral stricture disease...
June 2018: Canadian Journal of Urology
S Johar Raza, Perry Xu, Justin Barnes, Robert Fisher, Allison May, Oussama Darwish, Brian Dang, Prajakta Adsul, Carl A Freeman, Sameer A Siddiqui
INTRODUCTION: Conservative management of penetrating renal trauma is emerging, with data originating from centers with variable level of trauma care. This study reviews the outcomes of renal salvage after penetrating trauma at a level I trauma center. MATERIALS AND METHODS: An institutional review board approved trauma registry at Saint Louis University Hospital was retrospectively analyzed, for patients with penetrating renal trauma from 2009 to 2014. Patients were divided into nephrectomy group (NG) or non-nephrectomy group (non-NG), and compared...
June 2018: Canadian Journal of Urology
Veeru Kasivisvanathan, Muddassar Hussain
INTRODUCTION: The purpose of this analysis was to compare Aquablation to transurethral resection of the prostate (TURP) with respect to efficacy and safety at 1 year for the treatment of lower urinary tract symptoms related to benign prostatic hyperplasia (BPH) in the United States (U.S.) cohort from the Waterjet Ablation Therapy for Endoscopic Resection of prostate tissue (WATER) study. MATERIALS AND METHODS: WATER is a double-blinded, multicenter prospective randomized controlled trial for patients with moderate-to-severe lower urinary tract symptoms related to BPH...
June 2018: Canadian Journal of Urology
Karen L Stern, Manoj Monga
INTRODUCTION: The Moses technology of the holmium laser has been shown to decrease retropulsion in the ureter and procedural time in kidney stones during laser lithotripsy. Theoretically, these improvements could lead to cost savings for the patient. MATERIALS AND METHODS: All patients with total laser energy data recorded who underwent ureteroscopy with laser lithotripsy by a single surgeon at a tertiary care center were included. Total lasing time was calculated from the total laser energy...
June 2018: Canadian Journal of Urology
Jessica C Lloyd, Juan Guzman-Negron, Howard B Goldman
INTRODUCTION: Robotic surgical procedures have become more common in female pelvic reconstruction. Purported benefits of robotic assisted pelvic floor reconstruction (RAPFR) procedures include shorter hospital stay, faster recovery, lower blood loss, and decreased postoperative pain. Following RAPFR procedures, the current accepted practice is discharge after a one-night hospitalization. We assessed whether same day discharge (SDD) affects the short term safety of and patient satisfaction with robotic assisted pelvic floor reconstructive procedures, relative to those who remain hospitalized overnight...
June 2018: Canadian Journal of Urology
Khushabu Kasabwala, Gilbert J Wise
INTRODUCTION: Each year, varicella-zoster virus (VZV) affects nearly one million people in the United States, often in the form of herpes zoster, or shingles. The urologic system is a rare but often debilitating target. This paper reviews the epidemiology, symptomatology, diagnosis, and management of VZV as it relates to urologic practice. MATERIALS AND METHODS: We performed a PubMed search using the query "herpes zoster" and "varicella-zoster virus" combined with multiple urological terms...
June 2018: Canadian Journal of Urology
Diane K Newman, Eric S Rovner, Alan J Wein
No abstract text is available yet for this article.
June 2018: Canadian Journal of Urology
Robert M Weiss
No abstract text is available yet for this article.
June 2018: Canadian Journal of Urology
José Ignacio Nolazco
No abstract text is available yet for this article.
June 2018: Canadian Journal of Urology
Hong Truong
No abstract text is available yet for this article.
June 2018: Canadian Journal of Urology
Juan Montoya, Eric Gross, Lawrence Karsh
Hydrogel spacer placement between the prostate and rectum in men scheduled to undergo prostate radiotherapy is an emerging technique well suited for urologists. The hydrogel spacer reduces rectal injury during radiotherapy by displacing the rectum away from the high dose region. Following radiotherapy the hydrogel spacer then liquifies, is absorbed, and then clears via renal filtration in approximately 6 months. Herein we describe the appropriate patients eligible for this procedure, and the application technique we use in our clinic...
April 2018: Canadian Journal of Urology
Sonja C Murchison, Mildred B Martens, Pauline Truong, Abraham Alexander
Radiation induced malignancy (RIM) after treatment for prostate cancer is well documented after external beam irradiation, but less so in the setting of brachytherapy. We report a case of mucinous adenocarcinoma of the prostate, consistent with a RIM, which developed 12 years after low dose rate brachytherapy for low risk prostate adenocarcinoma. Diagnostic and therapeutic considerations of RIM are discussed. As long term survivors are followed in the community by primary care physicians and urologists, awareness of RIM as a potential late effect of brachytherapy is important to ensure that cases are diagnosed and managed appropriately...
April 2018: Canadian Journal of Urology
Vikram K Sabarwal, Cayde Ritchie, Kareem Rayn, Baris Turkbey, Peter Pinto
Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) identifies prostate cancer on the basis of multiparametric MRI (mpMRI). As an assessment tool, it correctly predicts clinically significant cancer in the vast majority of cases. In this light, we report a rare patient, for whom a PI-RADS 5 lesion vanished over the course of 13 months.
April 2018: Canadian Journal of Urology
Taha A Abdel-Meguid, Hisham A Mosli, Hasan Farsi, Ahmad Alsayyad, Abdulmalik Tayib, Moataz Sait, Ahmad Abdelsalam
INTRODUCTION: To evaluate the efficacy and safety of intraprostatic injections of onabotulinumtoxinA (onaBoNT-A) to treat refractory chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). MATERIALS AND METHODS: Prospective two-group controlled study. Treatment group included adult men with refractory category-III nonbacterial CP/CPPS who underwent transurethral intraprostatic injections of onaBoNT-A (200 U). Control group included comparable patients who underwent cystoscopy only...
April 2018: Canadian Journal of Urology
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