Canadian Journal of Urology

INTRODUCTION: Prostate cancer is the third leading cause of death from cancer among Canadian men. High intensity focused ultrasound (HIFU) is a novel approach for primary treatment of localized prostate cancer. Little is known, however, about its costs. We aimed to collect the direct costs and health-related quality of life (HRQoL) data of HIFU in primary treatment of localized low and intermediate risk prostate cancer in Ontario. MATERIALS AND METHODS: We collected direct costs and HRQoL data of 20 patients with localized low or intermediate risk prostate cancer who received whole-gland HIFU at a privately owned clinic in Ontario...

INTRODUCTION: Most men diagnosed with very-low and low-risk prostate cancer are candidates for active surveillance; however, there is still a misclassification risk. We examined whether PI-RADS category 4 or 5 combined with ISUP 1 on prostate biopsy predicts upgrading and/or adverse pathology at radical prostatectomy. MATERIALS AND METHODS: A total of 127 patients had ISUP 1 cancer on biopsy after multiparametric MRI (mpMRI) and then underwent radical prostatectomy...

INTRODUCTION: In May 2022, lawmakers in Oklahoma passed House Bill 4327, which outlawed abortion after fertilization. The governor signed the bill on May 25, 2022. It is uncertain whether these changes will motivate more men in Oklahoma to undergo vasectomy. MATERIALS AND METHODS: Males seeking vasectomy were informed of the study and asked to participate. Participants filled out a survey regarding their marital status, number of children, fertility treatment history, and their influences in making the decision to pursue vasectomy...

INTRODUCTION: Despite the growing body of literature on sacral neuromodulation (SNM) outcomes, research focusing on male patients remains limited and often represented by small cohorts nested within a larger study of mostly women. Herein, we evaluated the outcomes of SNM in a male-only cohort with overactive bladder (OAB), fecal incontinence (FI), chronic bladder pain, and neurogenic lower urinary tract dysfunction (NLUTD). MATERIALS AND METHODS: This retrospective cohort study included 64 male patients who underwent SNM insertion between 2013 and 2021 at a high-volume tertiary center...

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INTRODUCTION:   Prostate cancer has a variable natural history and, despite the existence of biochemical recurrence (BCR) predictors, they are still limited in predicting outcomes.  The role of testosterone in advanced prostate cancer is well known, however its role in localized prostate cancer is still uncertain.  In the present study, we evaluated the relationship of testosterone levels and androgen receptor (AR) expression with oncological and functional outcomes, in patients undergoing radical retropubic prostatectomy (RRP)...

INTRODUCTION: Renal cell carcinoma is as the most prevalent form of kidney cancer, with the clear cell subtype comprising approximately 75% of cases. The identification of predictive and prognostic biomarkers has emerged as a crucial area of research within the field. Despite advancements in treatment, metastatic renal cell carcinoma presents formidable challenges, with survival rates heavily dependent upon the optimal choice of treatment. MATERIALS AND METHODS: This review summarizes the current literature regarding the prognostic and predictive value of biomarkers in patients with renal cell carcinoma...

No abstract text is available yet for this article.

No abstract text is available yet for this article.

No abstract text is available yet for this article.

Drug-induced nephrolithiasis represents only 1%-2% of stone cases. Here we focus on drugs capable of crystallizing and forming stone, specifically phenazopyridine (Pyridium/Azo). This is a case of a patient who presented with a stone conglomerate in the right proximal ureter and underwent definitive treatment. Interestingly, the stone had a purple hue with FTIR spectroscopy showing stone composition of calcium oxalate (monohydrate and dihydrate) and a material resembling phenazopyridine. We retrospectively learned that she used multiple extended courses of phenazopyridine over 3 months...

Urethral injuries are rare among the pediatric population, and the majority occur after trauma. This is the case of an eight-year-old female with complete proximal urethral disruption and ruptured bladder neck without pelvic fracture after a motor vehicle crash. After the accident, her bladder neck was reapproximated and a suprapubic tube was placed. Three months later, she underwent reconstruction for a bladder neck closure and appendicovesicostomy. In managing these patients, focus should first be directed at achieving a safe means of urinary drainage, and next to repair the lower urinary tract to maximize continence and minimize complications...

Holmium enucleation of the prostate (HoLEP) is a gold-standard, size-independent surgical treatment for benign prostatic hyperplasia (BPH) distinguished for its efficacy in tissue removal, shorter catheterization durations, lower transfusion rates, and decreased hospital stays when compared to transurethral resection of the prostate (TURP). The objective of this article is to demonstrate the step-by-step procedure of holmium laser cystolitholapaxy and enucleation of the prostate for BPH, emphasizing a top-down modified two-lobe technique with early apical release which enhances visualization and irrigation flow during the enucleation process...

INTRODUCTION: Interstitial cystitis/bladder pain syndrome (IC/BPS) is characterized by chronic pelvic pain and usually accompanies lower urinary tract symptoms. We have previously reported that amniotic bladder therapy (ABT) provides symptomatic improvement in refractory IC/BPS patients for up to 3 months. Herein, we evaluated the durability of ABT up to 6 months. MATERIALS AND METHODS: Consecutive IC/BPS patients received intra-detrusor injections of 100 mg micronized amniotic membrane...

Prostate cancer is the second most common cancer in men across the world. Prior to PSA testing, men usually presented with locally advanced disease detected on digital rectal exam or with metastatic disease. PSA ushered in the era of serum biomarkers for prostate cancer. It has taken over three decades to refine the role of PSA in prostate cancer detection. The lack of specificity has spurred research into finding better, readily obtainable biomarkers with high sensitivity and specificity. The trick is to find the prostate cancers that are a threat, not the ones that aren't...

INTRODUCTION: Prostate cancer is the second most common malignancy in men worldwide. Genomic VPAC receptors are expressed on malignant prostate cancer cells and can be targeted and imaged optically by a peptide labeled fluorophore. The objective of our study was to assess the feasibility of detecting cancer of the prostate using a voided urine sample. MATERIALS AND METHODS: Patients ≥ 40 years old, with lower urinary tract symptoms and serum PSA > 4 ng/mL formed the study group...

INTRODUCTION: To define the smallest prostate needle biopsy (PNB) template necessary for accurate tissue diagnosis in men with markedly elevated PSA while decreasing procedural morbidity. MATERIALS AND METHODS: We performed a chart review of 80 men presenting with a newly elevated PSA > 100 ng/mL who underwent biopsy (PNB or metastatic site). For patients who underwent a full 12-core biopsy, simulated templates of 2- to 10-cores were generated by randomly drawing subsets of biopsies from their full-template findings...

INTRODUCTION: The evolving landscape of healthcare information dissemination has been dramatically influenced by the rise of artificial intelligence (AI) driven chatbots, providing patients with accessible and interactive platforms to obtain knowledge about medical procedures and conditions. Among the various surgical interventions in urology, inflatable penile prosthesis (IPP) is a common treatment for men with erectile dysfunction. As patients increasingly seek comprehensive resources to understand what this procedure entails, AI-based chat technologies, such as ChatGPT, have become more prominent...

INTRODUCTION: Immune checkpoint inhibitors (ICIs) are approved for advanced urothelial cancer alone and as first-line in combination with enfortumab vedotin. Platinum based chemotherapy which is another frontline choice is often not a treatment option for older patients due to comorbidities that increase with age. Despite ICIs being better tolerated compared to traditional chemotherapy little is known about their efficacy and toxicity in patients ≥ 90 years due to the rarity of this population in clinical trials...

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