Open Access

BOOK REVIEW

Yoichi Arai, Osamu Ogawa
Canadian Journal of Urology, Vol.26, No.2, pp. 9686-9686, 2019
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EDITORIAL

Leonard G. Gomella
Canadian Journal of Urology, Vol.26, No.2, pp. 9687-9689, 2019
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LEGENDS IN UROLOGY

David A. Bloom
Canadian Journal of Urology, Vol.26, No.2, pp. 9690-9693, 2019
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ARTICLE

Joon Yau Leong, Brian Calio, Mihir Shah, Patrick Sullivan, Edouard J. Trabulsi, Leonard G. Gomella, Costas D. Lallas
Canadian Journal of Urology, Vol.26, No.2, pp. 9694-9698, 2019
Abstract Introduction: An important aspect of overlapping surgery is to determine the “critical portion” of an operation. Currently, there are no guidelines that standardize the critical portions of common urologic procedures. We sought to determine the relationship between the critical portions of common urologic operations as defined by the primary surgeon compared to the trainee at a single academic medical center.
Materials and methods: In an open-ended survey of the Urology Department at Thomas Jefferson University, attending surgeons and urology residents were asked to list five of their most commonly performed surgeries and subsequently identify what they defined… More >

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ARTICLE

Jamil S. Syed¹, Kevin A. Nguyen¹, Alfie Suarez-Sariemento¹, Cynthia Leung¹, Marianne Casilla-Lennon¹, Jay D. Raman², Brian Shuch^1,3
Canadian Journal of Urology, Vol.26, No.2, pp. 9699-9707, 2019
Abstract Introduction: Approximately 7% of patients with localized upper tract urothelial cancer (UTUC) are treated without definitive therapy. Understanding outcomes and alternative therapy would aid in counseling older patients with comorbidities.
Materials and methods: We utilized the National Cancer Database to identify patients with localized UTUC managed non-surgically between 2004 and 2013. Patient demographics, comorbidity, tumor grade, and chemotherapy and radiation utilization were recorded. Survival analyses were performed with the Kaplan-Meier method and a Cox proportional hazard regression model.
Results: We identified 3157 (10.9%) patients with localized UTUC who did not receive definitive surgery. Median age was 79 years,… More >

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ARTICLE

Andrew Salner¹, Ilene Staff², Rene I. Jahiel¹, Keith M. Bellizzi³, Alison Champagne², Joseph Tortora², Alison G. Wong³, Tara McLaughlin⁴, Joseph Wagner⁴
Canadian Journal of Urology, Vol.26, No.2, pp. 9708-9714, 2019
Abstract Introduction: We compared the return-to-work interval (RTWI) after radical retro-pubic prostatectomy (RRP) and robot-assisted laparoscopic prostatectomy (RALP) in men being treated for early-stage prostate cancer.
Materials and methods: We mailed a 28-item questionnaire to a random sample of 2,696 patients who either had RRP from 1995 to 2004 or RALP from 2004 to 2011.
Results: We received analyzable questionnaires from 315 patients; 178 had RALP and 137 had RRP. The median RTWI was shorter in the RALP group than in the RRP group (3 versus 4 weeks, p = .016). The percent of subjects who had not returned More >

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ARTICLE

Kellan F. Clark¹, Matthew Risendal¹, Sharon Hill², Samuel Deem³
Canadian Journal of Urology, Vol.26, No.2, pp. 9715-9719, 2019
Abstract Introduction: The TNM staging system is used globally as the standard for interpreting the extent of cancer. Currently, T3a renal cell carcinoma is classified as tumor extending into the perinephric fat or renal vein. Prognostic outcomes may vary among renal cell carcinomas with renal vein involvement (RVI) versus those with perinephric fat involvement (PFI).
Materials and methods: We reviewed the medical records of all patients who underwent radical or partial nephrectomy at our institution by a single group of urologists between 2000 and 2014. After identifying those patients with T3a renal cell carcinoma, we further analyzed their… More >

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ARTICLE

Jacqueline Zillioux¹, David Rapp¹, Luriel Smith-Harrison², Matthew Wang¹, Raymond Costabile¹
Canadian Journal of Urology, Vol.26, No.2, pp. 9720-9725, 2019
Abstract Introduction: To evaluate complications following urinary diversion for non-malignant conditions.
Materials and methods: We performed a retrospective review of patients undergoing urinary diversion for benign indications between 2000 and 2017. Data collected including patient demographic and clinical characteristics, surgical characteristics, and complications. Complications were graded using Clavien-Dindo classification and were categorized as early versus delayed (≤ versus > 90 day postoperatively). Logistic regression assessed for predictors of developing any postoperative complication.
Results: A total of 68 patients were identified for study analysis with median follow up of 24 (7-72) months. Sixty-eight percent and 25% of patients underwent diversion… More >

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ARTICLE

Ashley M. Shumate¹, Grayson Roth², Colleen T. Ball², Kaitlynn Custer², David D. Thiel¹
Canadian Journal of Urology, Vol.26, No.2, pp. 9726-9732, 2019
Abstract Introduction: To prospectively analyze the association of clinical and operative variables on patient length of hospital stay (LOS) following robotic-assisted partial nephrectomy (RAPN) and develop an accurate clinical-based scoring system to predict prolonged LOS following RAPN.
Materials and methods: We analyzed 304 consecutive RAPNs performed by a single surgeon. Prolonged LOS was defined as greater than 3 days of hospitalization postoperatively. Preoperative clinical factors and operative variables were analyzed for association with LOS. After adjusting for multiple testing, p ≤ 0.004 was considered statistically significant.
Results: LOS was 1 day in 17 (5.6%) patients, 2 days in 136… More >

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ARTICLE

Karen L. Stern¹, Donald Fedrigon III¹, Christopher J. Loftus², Manoj Monga¹
Canadian Journal of Urology, Vol.26, No.2, pp. 9733-9735, 2019
Abstract Introduction: Studies indicate that with a safety wire in the ureter, an increased amount of force is necessary to advance ureteral access sheaths up to the proximal ureter. Theoretically, the compression of the ureter with the wire could lead to an increase in number and severity of ureteral injuries secondary to placement of a sheath. This prospective study aims to evaluate if there is a correlation between the use of a safety wire and ureteral injury from sheath placement by evaluating the location of the wire in relation to the injury after ureteroscopy.
Materials and Methods: Fifty-nine… More >

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RESIDENT’S CORNER

Humberto Vigil¹, Sender Herschorn¹, Ron Kodama¹, Jon Barrett²
Canadian Journal of Urology, Vol.26, No.2, pp. 9736-9739, 2019
Abstract The incidence of placenta accreta spectrum is on the rise. The most serious entity within this spectrum is percreta: extension beyond the uterus. The bladder is most commonly involved in these cases and is especially relevant for the urologist. Important sequelae include hemorrhage, massive transfusion, maternal mortality and urinary tract injury. Approaching this disorder as well as associated urinary tract involvement in a standardized and multi-disciplinary fashion significantly improves outcomes and reduces morbidity. Herein, we present a case of complete placenta percreta involving the bladder that was successfully managed with minimal obstetrical and genitourinary morbidity. More >

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RESIDENT’S CORNER

Eric C. Wendel, Raunak D. Patel, Daniel J. Canter
Canadian Journal of Urology, Vol.26, No.2, pp. 9740-9742, 2019
Abstract The outcome of nephron-sparing surgical management of small renal masses is generally favorable, specifically in terms of long term renal function, overall survival, and oncologic outcomes. Given the overall prognosis and renal function preservation, transplantation of kidneys with small renal masses has increasingly been accepted as a donor option for renal transplantation. We present a case of an incidental renal mass on preoperative donor transplant evaluation and subsequent ex-vivo donor partial nephrectomy at the time of renal transplantation. More >

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RESIDENT’S CORNER

Abhinav V. Reddy^1,2, Matthew N. Mills^1,3, Stanley L. Liauw⁴, Sujith Baliga⁵, Charles R. Kersh⁶
Canadian Journal of Urology, Vol.26, No.2, pp. 9743-9745, 2019
Abstract Renal cell carcinoma (RCC) is usually treated with surgery, with or without systemic therapy. For select patients, stereotactic body radiation therapy (SBRT) may be a suitable alternative. Although many reports exist on the successful use of SBRT, very few have described long term outcomes with regard to disease progression and renal function. We report a rare case of a single patient with primary, metastatic, and locally recurrent renal cell carcinoma who was successfully treated with SBRT. The patient has been disease-free for 8 years since treatment, with stable renal function even after two courses of More >

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