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Canadian Journal of Urology

Millard Henry, Cameron Britton, Caitlin Coco, Vipulkumar S Dadhania, Gennady Slobodov
Primary spindle cell sarcoma of the prostate is exceedingly rare and accounts for 0.1% of all prostatic cancers. Typically, the disease course is rapid and portends a short and dismal prognosis. We report a case of prostatic stromal sarcoma (PSS) which likely lay dormant for several years after a transurethral resection of the prostate. This case is unique in that this cancer did not display the rapid growth of PSS in prior reports. Our patient received a cystoprostatectomy and an ileal conduit. This article describes a rare presentation of a rare tumor and a brief review of the literature...
February 2019: Canadian Journal of Urology
Jessica Costales, Muhannad Alsyouf, Phillip Napolitan, Sharon Wang, Brian Hu
Corynebacterium urealyticum is an organism associated with a rare chronic urinary tract infection, which can lead to calcification of the urinary tract and promote rapid lithogenesis. This case illustrates the serious complications that can arise from chronic infection with C. urealyticum, which include rapid progression of luminal and parenchymal urinary tract calcification and concomitant renal failure. This case and a review of the literature demonstrate the need for an increased awareness of this organism with early identification, aggressive management, and test of cure that may help avoid the sequela of these infections...
February 2019: Canadian Journal of Urology
W Jordan Brockway, Andrew J Bradsher, Jessica E Hook, Ashay S Patel, Ismael Zamilpa, Stephen J Canon
INTRODUCTION: 2-octyl cyanoacrylate (OC) has been shown to be a viable option for usage following standard circumcision but data on its utilization following hypospadias repair is limited. Both OC and a standard waterproof transparent dressing (WD) are used following hypospadias repair at our children's hospital. Our hypothesis is that patients with distal hypospadias repair using OC for surgical dressing have similar outcomes as compared to patients with WD. MATERIALS AND METHODS: A retrospective study was performed evaluating all patients with distal hypospadias repair during a 2 year period...
February 2019: Canadian Journal of Urology
Carlos A Batagello, Hugo D Barone Dos Santos, Andrew H Nguyen, Luay Alshara, Jianbo Li, Giovanni Scala Marchini, Fabio C Vicentini, Fabio César Miranda Torricelli, Alexandre Danilovic, Jessica Goulart Pereira, Emily Rose, Miguel Srougi, Willian C Nahas, Eduardo Mazzucchi, Manoj Monga
INTRODUCTION: The optimal patient positioning for percutaneous nephrolithotomy (PCNL) based on the complexity of stone burden is not yet defined. Thus, we aimed to evaluate the intraoperative parameters, effectiveness and complications of patients undergoing PCNL between the endoscopic-guided prone split-leg PCNL (ePSL) and the supine PCNL by stratifying patients according to Guy's stone score (GSS). MATERIALS AND METHODS: A retrospective chart review was conducted of patients undergoing PCNL at two high-volume tertiary referral centers...
February 2019: Canadian Journal of Urology
Nicholas J Farber, Nadiya Chuchvara, Parth K Modi, Joshua Sterling, Sammy E Elsamra
INTRODUCTION: To assess whether urologists are able to accurately estimate the cost of commonly used endourologic disposable devices. MATERIALS AND METHODS: An anonymous questionnaire was presented to resident and attending urologists in one academic healthcare system. Respondents estimated the cost of 15 disposable devices commonly used in ureteroscopy. Twenty-five surgeons (9 resident and 16 attending urologists) participated for a response rate of 96.2%. Respondents' cost estimates were compared to actual institutional costs and considered accurate if the absolute percentage error was within 20%...
February 2019: Canadian Journal of Urology
Hatim Thaker, Saum Ghodoussipour, Mateen Saffarian, Akbar Ashrafi, Gus Miranda, Jie Cai, Anne K Schuckman, Monish Aron, Mihir Desai, Inderbir S Gill, Siamak Daneshmand, Hooman Djaladat
INTRODUCTION: To evaluate the reasons leading to an extended hospital stay (EHS) in patients undergoing radical cystectomy (RC) with postoperative enhanced recovery after surgery (ERAS) protocol. MATERIALS AND METHODS: A total of 509 patients underwent RC and urinary diversion with ERAS between May 2012 and March 2017. The protocol includes no bowel preparation, early feeding, predominantly non-narcotic pain control and µ opioid antagonists. Non-consenting/lost to follow up patients, and those with non-urothelial carcinoma were excluded...
February 2019: Canadian Journal of Urology
Félix Couture, Stefano Polesello, Côme Tholomier, Helen Davis Bondarenko, Pierre I Karakiewicz, Sebastiano Nazzani, Felix Preisser, Assaad El-Hakim, Kevin C Zorn
INTRODUCTION: Neurovascular bundle (NVB) preservation during robot-assisted radical prostatectomy (RARP) directly affects patient functional outcomes. Despite careful surgical planning, many NVB preservation techniques are changed intraoperatively from their preoperative plan. Our objective was to identify risk factors predicting intraoperative change in NVB preservation technique during RARP. MATERIALS AND METHODS: Prospective data from 578 RARPs performed by a single surgeon between 2010 and 2017 at a tertiary care center...
February 2019: Canadian Journal of Urology
Nirmish Singla, Jordon T Walker, Solomon L Woldu, Karen De La Fuente, Ellen Araj, Brandon Swartz, Payal Kapur, Claus G Roehrborn
INTRODUCTION: To determine whether quantifying the proximity of positive prostate biopsy cores to the capsular edge may aid in identifying patients at risk for extracapsular extension (ECE) at the time of radical prostatectomy (RP). MATERIALS AND METHODS: We reviewed a single-surgeon experience of 429 systematic transrectal prostate biopsies from 2010-2014. Marking ink was applied to the capsular edge ex vivo following specimen acquisition, and the proximity of cancer to the stained capsular edge was measured...
February 2019: Canadian Journal of Urology
Deen Sharma
No abstract text is available yet for this article.
February 2019: Canadian Journal of Urology
Kevin R Loughlin
No abstract text is available yet for this article.
February 2019: Canadian Journal of Urology
Heidi Schatten
No abstract text is available yet for this article.
February 2019: Canadian Journal of Urology
Jaasmit Khurana, Vivian Ip, Gerald Todd, Rakesh V Sondekoppam
Pain control following major abdominal surgery remains a significant barrier to patient comfort. Although thoracic epidurals have been used to provide analgesia for these surgeries, the transversus abdominis plane (TAP) block is gaining popularity. The TAP catheter insertion method has transformed over the past two decades from a blinded technique to one conducted primarily under ultrasound guidance by anesthesiologists. Recently, however, interest has increased on the potential for direct surgical insertion of catheters into the TAP plane following flank incisions due to anatomical considerations...
December 2018: Canadian Journal of Urology
Theodore R Saitz, Anil A Thomas
A healthy 35-year-old male presented for vasectomy after fathering two children. Due to difficulty palpating the left vas, the patient was taken to the operating room for scrotal exploration and vasectomy. The left vas was absent; however, a 1.2 cm pearly nodule was identified in the scrotum along its suspected course. This nodule was excised, found to contain thick white pasty fluid, and confirmed vas deferens by pathology. The patient was found to have normal kidneys on renal ultrasound and was indeed a carrier for cystic fibrosis gene mutations...
December 2018: Canadian Journal of Urology
Ali Syed, Joon Yau Leong, Seth Teplitsky, William Li, Akhil Das
We report a rare complication of rectourethral fistula formation 6 weeks after a 70-year-old man underwent an uneventful HoLEP procedure. Cystourethrogram confirmed the diagnosis and the patient was managed conservatively with chronic indwelling catheter placement for 6 weeks. After this, his symptoms resolved completely and a repeat cystourethrogram showed marked resolution of the fistulous tract. The cause of the fistula formation is believed to be due to a delayed thermal or infectious reaction. Post-procedure follow up is necessary in all patients to monitor for complications that do not arise immediately after surgery...
December 2018: Canadian Journal of Urology
Ericka Sohlberg, Andrew Sun, Rustin Massoudi, Kris Prado, Eila Skinner
While renal angiomyolipomas (AMLs) generally remain small and asymptomatic, larger AMLs are more common in tuberous sclerosis patients. Giant AMLs over 20 cm are a rare entity and little is known about their management. We present a unique case of a 48-year-old woman with tuberous sclerosis and a 39 cm AML arising from a solitary kidney, after undergoing nephrectomy for a prior AML. Giant renal AMLs can occur in patients with tuberous sclerosis and resection should be considered even for large tumors. Renal sparing is often difficult and patients should be counseled about potential need for postoperative hemodialysis...
December 2018: Canadian Journal of Urology
Takeshi Yamasaki, Satoshi Tamada, Minoru Kato, Taiyo Otoshi, Hisao Tanaka, Taro Iguchi, Tatsuya Nakatani
INTRODUCTION: Recently, the use of indocyanine green (ICG) with near infrared fluorescence (NIRF) imaging has emerged as an alternative technique for the real-time delineation of resection margins during partial nephrectomy (PN). We aimed to assess the feasibility of using NIRF imaging with ICG during laparoscopic partial nephrectomy (LPN) to delineate the margin between normal renal parenchyma and renal cortical tumors. MATERIALS AND METHODS: A retrospective comparison of real-time tumor margin identification and operative outcomes was conducted for 83 patients who underwent LPN with NIRF imaging (IMAGE1 system) and 74 patients who did not...
December 2018: Canadian Journal of Urology
Rachel A Moses, Annah J Vollstedt, Vernon M Pais
INTRODUCTION: Though widely performed, the safety of non-intravenous contrast (NIVC) urography in patients with documented intravenous, iodinated contrast allergic like reactions (ICA) is unclear. The purpose of this study was to determine the risk of "allergic-like" reaction (ALR) events in patients with ICA undergoing NIVC urography. MATERIALS AND METHODS: Patients undergoing contrast urography at a single institution were identified between 2011-2014...
December 2018: Canadian Journal of Urology
Karen M Doersch, G Luke Machen, Kim H Thai, John Sung, Marawan M El Tayeb
INTRODUCTION: Stent placement is a common procedure for addressing obstructive uropathy. However, lack of operating room (OR) availability can substantially delay this procedure. In this study, we sought to assess the feasibility, safety, and efficacy of this procedure in a clinical setting using nitrous oxide (N2O) and local anesthesia. MATERIALS AND METHODS: Patients included in this study included those who were determined to need management of urinary obstruction with a JJ ("double J") stent and had their procedure performed in the clinic procedure suite with N2O anesthesia...
December 2018: Canadian Journal of Urology
Mark Broadwin, Alex J Vanni
INTRODUCTION: There is no standardized treatment algorithm for isolated fossa navicularis strictures and treatment modality often falls to surgeon preference. We evaluated the outcomes of a standardized algorithm for fossa navicularis strictures based on stricture etiology, lumen size, and glans size to minimize the number of patients requiring a two-stage urethral reconstruction. MATERIALS AND METHODS: We retrospectively reviewed a prospectively maintained urethral reconstruction database by a single surgeon from 2011-2018...
December 2018: Canadian Journal of Urology
Kevan M Sternberg, Andrew Pham, Theodore Cisu, Marissa L Kildow, Kristina L Penniston
INTRODUCTION: Renal colic is commonly seen in the emergency department (ED), where the focus is on diagnosis and symptom control. Educational materials are sometimes provided upon discharge, however, no standard content has been established. We characterized the educational materials given to patients reporting to EDs in different regions across the U.S. for symptomatic kidney stones, specifically evaluating disease-specific information, symptom management, prevention strategies including dietary recommendations (DRs), and patient follow up plans...
December 2018: Canadian Journal of Urology
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