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    2163 results match your criteria Canadian Urological Association Journal [Journal]

    1 OF 44

    An in-house Composix™-based pubovaginal sling trial for female stress urinary incontinence: Five-year comparative followup to tension-free and transobturator vaginal tapes.
    Can Urol Assoc J 2017 Aug;11(8):275-280
    Division of Urology, CHU de Québec, Université Laval, Quebec City, QC, Canada.
    Introduction: We compared the efficacy of three slings in the long-term treatment of stress urinary incontinence (SUI): tension-free vaginal tape (TVT), vaginal tape-obturator (TVT-O), and an in-house two-layered polypropylene mesh with a submicronic polytetrafluoroethylene (Composix™). Our primary endpoint was the objective measurement of continence (24-hour pad test). Secondarily, we measured the satisfaction and complication rates. Read More

    Improving access to urologists through an electronic consultation service.
    Can Urol Assoc J 2017 Aug;11(8):270-274
    Department of Urology, University of Ottawa; Ottawa, ON, Canada.
    Introduction: Access to specialist services is limited by wait times and geographic availability. Champlain Building Access to Specialist Advice (BASE) has been implemented in our service region to facilitate access to specialists by primary care providers (PCPs). Through a secure web-based system, PCPs are able to send eConsults instead of requesting a formal in-office consultation. Read More

    Does surgical delay for radical prostatectomy affect patient pathological outcome? A retrospective analysis from a Canadian cohort.
    Can Urol Assoc J 2017 Aug;11(8):265-269
    Division of Urology, Department of Surgery, Centre Hospitalier Universitaire de Montréal (CHUM), Montreal, QC, Canada.
    Introduction: We sought to assess the impact of surgical wait time (SWT) to robot-assisted radical prostatectomy (RARP) on final pathological outcome.

    Methods: A retrospective review of RARP patient records operated between 2006 and 2015 was conducted. SWT was defined as period from prostate biopsy to surgery. Read More

    Dimercaptosuccinic acid scintigraphy vs. ultrasound for renal parenchymal defects in children.
    Can Urol Assoc J 2017 Aug;11(8):260-264
    Division of Urology, Department of Surgery; CHU de Québec, Université Laval, Quebec City, QC, Canada.
    Introduction: Dimercaptosuccinic acid (DMSA) scintigraphy is the gold standard in the evaluation of renal parenchymal defects and is widely used in the pediatric population. As more recent ultrasound equipment was purchased at our tertiary pediatric centre, our objective was to evaluate if renal ultrasound (US) results are equivalent or sufficient when compared to DMSA scintigraphy in the assessment of renal anomalies.

    Methods: The charts of all 463 patients who underwent DMSA scintigraphy between January 2009 and May 2014 at our pediatric tertiary centre were reviewed. Read More

    Childhood bladder and bowel dysfunction predicts irritable bowel syndrome phenotype in adult interstitial cystitis/bladder pain syndrome patients.
    Can Urol Assoc J 2017 Aug;11(8):255-259
    Department of Urology, Queen's University, Kingston, ON, Canada.
    Introduction: Many clinicians have suggested that a history of bladder and bowel dysfunction (BBD) in childhood predisposes to the development of interstitial cystitis/bladder pain syndrome (IC/BPS) or irritable bowel syndrome (IBS) in adulthood. We hypothesized that BBD symptoms in childhood would predict the IBS-associated phenotype in adult IC/BPS patients.

    Methods: Consecutive female patients (n=190) with a diagnosis of IC/BPS were administered a modified form of a clinical BBD questionnaire (BBDQ) to capture childhood BBD-like symptoms, as well as Interstitial Cystitis Symptoms Index (ICSI), Interstitial Cystitis Problem Index (ICPI), Pelvic Pain and Urgency/Frequency (PUF) questionnaires and UPOINT categorization. Read More

    Ex-vivo ureteroscopy of deceased donor kidneys.
    Can Urol Assoc J 2017 Aug;11(8):251-253
    Department of Surgery, Divisions of Urology and Transplant, Baylor Scott & White Health/Texas A&M Health Science Centre College of Medicine, Temple, TX, United States.
    Introduction: When encountered, the ideal management of lithiasis in deceased donor kidneys is not well-defined. With advances in endourological techniques, minimally invasive treatments are becoming an increasingly viable option. We set out to describe our experience performing ex-vivo ureteroscopy on cadaveric donor kidneys, including one in which the procedure was completed on-pump. Read More

    Radical cystectomy in patients with disseminated disease: An assessment of perioperative outcomes using the National Surgical Quality Improvement Program database.
    Can Urol Assoc J 2017 Aug;11(8):244-248
    Division of Urology, Department of Surgery; Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.
    Introduction: We sought to determine the effect of the presence of disseminated disease on perioperative outcomes following radical cystectomy for bladder cancer.

    Methods: We identified 4108 eligible patients who underwent radical cystectomy for bladder cancer using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. We matched patients with disseminated cancer at the time of surgery to those without disseminated cancer using propensity scores. Read More

    An assessment of Prostate Cancer Research International: Active Surveillance (PRIAS) criteria for active surveillance of clinically low-risk prostate cancer patients.
    Can Urol Assoc J 2017 Aug;11(8):238-243
    University of Ottawa, Division of Urology, Department of Surgery, Ottawa, ON, Canada.
    Introduction: Active surveillance is a strategy to delay or prevent treatment of indolent prostate cancer. The Prostate Cancer Research International: Active Surveillance (PRIAS) criteria were developed to select patients for prostate cancer active surveillance. The objective of this study was to compare pathological findings from PRIAS-eligible and PRIAS-ineligible clinically low-risk prostate cancer patients. Read More

    Benchmarking quality for renal cancer surgery: Canadian Kidney Cancer information system (CKCis) perspective.
    Can Urol Assoc J 2017 Aug;11(8):232-237
    Division of Urology, Princess Margaret Hospital, University of Toronto, Toronto, ON; Canada.
    Introduction: There is a lack of validated quality metrics to evaluate the care of patients receiving surgery for renal cell carcinoma (RCC). To address this, the Kidney Cancer Research Network of Canada defined a list of quality indicators (QI) to assess hospital-level performance. We have case-mix adjusted these QIs to benchmark RCC surgical care at Canadian academic centres. Read More

    Case: Spontaneous regression of post-radical prostatectomy prostate-specific antigen elevation without adjuvant therapy in a patient with lymph node metastasis.
    Can Urol Assoc J 2017 Jul 11;11(7):E315-E317. Epub 2017 Jul 11.
    Department of Surgery, Division of Urology, McMaster University, Hamilton ON, Canada.
    Prostate cancer remains the most frequently diagnosed cancer among men. The combination of clinical stage, serum prostate-specific antigen (PSA), and Gleason score (biopsy) assists in predictive assessment of pathological stage and prognosis. Furthermore, pathological criteria, including Gleason score, surgical margin status, extracapsular extension, seminal vesicle invasion, and lymph node involvement, provide prognostication in patients undergoing radical prostatectomy (RP). Read More

    Case series: Bladder clot evacuation using a prostate morcellation device.
    Can Urol Assoc J 2017 Jul 11;11(7):E311-E314. Epub 2017 Jul 11.
    Division of Urology, Baylor Scott and White Health; Temple, TX, United States.
    Introduction: We sought to provide a technical update on the use of a prostate morcellator device (PMD) to manage organized blood clots of the bladder following laser prostatectomy.

    Methods: Herein, we describe our experience in using the Wolf Piranha morcellator in managing organized bladder blood clots supplemented with a retrospective chart review of the patients in whom this procedure was performed.

    Results: Six patients, all male with a mean age of 75 ± 8. Read More

    Case series: Transplantation of kidneys from donors with renal artery aneurysm.
    Can Urol Assoc J 2017 Jul 11;11(7):E307-E310. Epub 2017 Jul 11.
    Department of Transplant Surgery, University of Miami Miller School of Medicine, Miami, FL, United States.
    Introduction: With the present disparity between organ availability and recipient demands, we reported our experience in transplanting kidneys with renal artery aneurysm after back-table reconstruction.

    Methods: Four patients were identified. The repair consisted of excision of the aneurysm with ostial closure, and for one of the cases, an ovarian vein patch was used. Read More

    A prospective audit on the effect of training and educational workshops on the incidence of urethral catheterization injuries.
    Can Urol Assoc J 2017 Jul 11;11(7):E302-E306. Epub 2017 Jul 11.
    Department of Urology, Tallaght Hospital, Dublin, Ireland.
    Introduction: The incidence of iatrogenic urethral catheterization (UC) injuries is approximately 0.3%. Resultant complications are associated with patient morbidity and unnecessary healthcare costs. Read More

    Ischemic priapism: Can eosinophil count and platelet functions be positive predictive factors in etiopathogenesis.
    Can Urol Assoc J 2017 Jul 11;11(7):E297-E301. Epub 2017 Jul 11.
    Department of Urology, Meram Medical Faculty, Necmettin Erbakan University, Konya; Turkey.
    Introduction: We evaluated the relation between ischemic priapism (IP) and blood count parameters in IP patients. We especially wanted to examine the contribution of eosinophil count (EC), platelet count (PC), and mean platelet volume (MPV) values, which are suspected predictive parameters for vascular endothelium damage and venoocclusive pathogenesis and etiopathogenesis, particularly in IP.

    Methods: A total of 40 IP patients fulfilled the study criteria. Read More

    Conservative treatment of upper urinary tract carcinoma: Long-term results.
    Can Urol Assoc J 2017 Jul 11;11(7):E291-E296. Epub 2017 Jul 11.
    Department of Urology, Ramón y Cajal University Hospital, Madrid, Spain.
    Introduction: We sought to assess the long-term results of conservative treatment for upper urinary tract carcinoma (UUTC) with regard to tumour recurrence and preservation of renal unit.

    Methods: From October 1987 to January 2014, 65 patients (median age 68 years) were diagnosed with UUTC and underwent endoscopic and open surgical techniques. Thirteen patients had bilateral disease and one had a single kidney. Read More

    The role of urinary cytology when diagnostic workup is suspicious for upper tract urothelial carcinoma but tumour biopsy is nonconfirmatory.
    Can Urol Assoc J 2017 Jul 11;11(7):E285-E290. Epub 2017 Jul 11.
    Department of Urology, University of Rochester Medical Centre; Rochester, NY, United States.
    Introduction: We sought to determine the value of obtaining preoperative urinary cytology when diagnostic workup of an upper tract mass is suspicious for upper tract urothelial carcinoma (UTUC), but biopsy fails to confirm the diagnosis.

    Methods: Using billing code data, 239 patients were identified as having undergone radical nephroureterectomy (RNU) by 16 urologists from September 29, 1998 to July 31, 2015. Of this group, 19 adult patients had a presumed preoperative diagnosis of UTUC in a native kidney, at least three months of followup, no history of concurrent radical cystectomy with RNU, and negative/non-diagnostic tissue biopsy. Read More

    Salvage prostatectomy for post-radiation adenocarcinoma with treatment effect: Pathological and oncological outcomes.
    Can Urol Assoc J 2017 Jul 11;11(7):E277-E284. Epub 2017 Jul 11.
    Department of Urology; University of Texas MD Anderson Cancer Centre, Houston, TX, United States.
    Introduction: Prostate biopsies following localized radiation therapy for prostate cancer often demonstrate residual prostatic carcinoma with treatment effect (CTE). The final oncological outcome of prostatic CTE is currently uncertain. We studied the pathological and oncological outcomes for a large cohort of patients who had CTE on post-radiation therapy biopsy and subsequently underwent salvage radical prostatectomy (SRP). Read More

    Retrograde leak point pressure measurement improves outcomes of the Virtue male sling for postprostatectomy incontinence.
    Can Urol Assoc J 2017 Jul 11;11(7):E271-E276. Epub 2017 Jul 11.
    Division of Urology, Department of Surgery, Faculté de Médecine et Science de la Santé, Université de Sherbrooke, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC; Canada.
    Introduction: We aimed to compare the efficacy of two different sling tensioning approaches, and to report our experience, including safety and impact on quality of life (QoL) of the Virtue(®) male sling for the treatment of postprostatectomy incontinence (PPI).

    Methods: From our prospectively maintained database, we retrospectively identified all men treated with the Virtue male sling for PPI between March 2009 and February 2014 by two urologists in two institutions. Baseline demographic data and the sling tensioning method were abstracted from the database. Read More

    Evolving attitudes toward robotic surgery among Canadian urology residents.
    Can Urol Assoc J 2017 Jul 11;11(7):E266-E270. Epub 2017 Jul 11.
    Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada.
    Introduction: Robotic-assisted laparoscopic surgery (RAS) has not been adopted as rapidly or widely in Canada as in the U.S. In 2011, Canadian urology residents felt that RAS represented an expanding field that could potentially negatively impact their training. Read More

    Early clamp release during laparoscopic partial nephrectomy: Implications for preservation of renal function.
    Can Urol Assoc J 2017 Jul 11;11(7):E261-E265. Epub 2017 Jul 11.
    Schulich School of Medicine and Dentistry and Department of Surgery, Division of Urology, Western University, London, ON, Canada.
    Introduction: Intraoperative warm ischemic time (WIT), associated with hilar clamping during partial nephrectomy (PN), is an established modifiable risk factor for renal dysfunction. We assessed early clamp release (ECR) as a strategy to reduce WIT and assess its impact on renal function and bleeding.

    Methods: We retrospectively assessed patients who underwent minimally invasive PN by a single surgeon at our centre since December 2011. Read More

    Taking the first steps in establishing recommendations for testosterone monitoring in men with prostate cancer on androgen-deprivation therapy.
    Can Urol Assoc J 2017 Jun;11(6):210-211
    Department of Urology, Queen's University, Kingston, ON, Canada.
    The paper by Shayegan et al in this issue of CUAJ represents an important initial step in establishing recommendations for hormonal monitoring in men with prostate cancer on androgen-deprivation therapy (ADT). As with most subjects related to the actions of testosterone, the survey adds to the controversies, but also opens the opportunity to explore several of the concerns relevant to the hormonal management of prostate cancer. Read More

    Testosterone monitoring for men with advanced prostate cancer: Review of current practices and a survey of Canadian physicians.
    Can Urol Assoc J 2017 Jun;11(6):204-209
    Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON.
    Androgen-deprivation therapy (ADT) is a standard of care in the treatment of advanced prostate cancer; however, testosterone monitoring practices for men undergoing ADT vary across Canada. Although a testosterone level of 1.7 nmol/L or lower has historically been defined as the accepted castrate level, newer assays with improved sensitivity have shown that both medical and surgical castration can suppress testosterone levels to below 0. Read More

    Are renal tumour scoring systems better than clinical judgement at predicting partial nephrectomy complexity?
    Can Urol Assoc J 2017 Jun;11(6):199-203
    Division of Urology, Department of Surgery, The Ottawa Hospital, University of Ottawa.
    Introduction: We aimed to determine how renal tumour scoring systems, such as RENAL, PADUA, and Centrality (C)-index, compare to clinical judgement at predicting time required for tumour removal and kidney reconstruction during partial nephrectomy.

    Methods: A consecutive cohort of partial nephrectomy patients treated at The Ottawa Hospital, a tertiary care uro-oncological centre, was retrospectively reviewed. Preoperative axial images were reviewed by four experienced urological oncologists who independently rated the complexity of a partial nephrectomy from 1-10 to generate a clinical judgement score. Read More

    Randomized, controlled trial of laser vs. bipolar plasma vaporization treatment of benign prostatic hyperplasia.
    Can Urol Assoc J 2017 Jun;11(6):194-198
    Department of Urology, Queen's University, Kingston, ON, Canada.
    Introduction: Prostate vaporization technology is becoming a standard of care for treatment of moderate, symptomatic benign prostatic hyperplasia (BPH). We compared two transurethral prostate vaporization technologies with respect to cost, efficiency, efficacy, safety, and surgical team satisfaction.

    Methods: Fifty-five patients meeting standardized symptom criteria for BPH were randomized to either Olympus Plasma Button(TM) or Biolitec EVOLVE(®) diode laser vaporization. Read More

    Pathology review impacts clinical management of patients with T1-T2 bladder cancer.
    Can Urol Assoc J 2017 Jun;11(6):188-193
    Division of Urology, McGill University Health Centre, Montreal, QC, Canada.
    Introduction: We sought to evaluate the contemporary role of a pathology review on management implications of patients with bladder cancer.

    Methods: A total of 98 consecutive specimens from transurethral resections in patients with suspected bladder tumours were reviewed at our institution by genitourinary pathologist. Patients were classified into risk groups according to pathology reports obtained before and after review. Read More

    Positive surgical margins during partial nephrectomy for renal cell carcinoma: Results from Canadian Kidney Cancer information system (CKCis) collaborative.
    Can Urol Assoc J 2017 Jun;11(6):182-187
    Division of Urology, McMaster University, Hamilton, ON; Canada.
    Introduction: We sought to determine the incidence, risk factors, and prognosis for patients with positive surgical margin (PSM) during partial nephrectomy (PN) for renal cell carcinoma (RCC).

    Methods: From the Canadian Kidney Cancer information system (CKCis) database, a historical cohort of PN patients with PSM were identified and compared to negative surgical margin (NSM). Risk factors for PSM were examined through multivariable logistic regression. Read More

    Contemporary cost-consequence analysis of blue light cystoscopy with hexaminolevulinate in non-muscle-invasive bladder cancer.
    Can Urol Assoc J 2017 Jun;11(6):173-181
    Division of Urology, Departments of Surgery and Surgical Oncology, Princess Margaret Cancer Centre, University Health Network and the University of Toronto, Toronto, ON.
    Introduction: Previous studies have suggested cost-savings using blue light cystoscopy (BLC) with hexaminolevulinate (HAL) compared to white light cystoscopy (WLC) during transurethral resection of bladder tumour (TURBT) for non-muscle-invasive bladder cancer (NMIBC), secondary to improvements in recurrence and progression rates; however, these studies have used 'best case scenario' recurrence rate probabilities, thus decreasing generalizability of the findings. The objective of this study was to perform a contemporary cost-effectiveness assessment of BLC compared to WLC at the time of TURBT.

    Methods: A decision and cost-effectiveness model with a five-year time horizon following initial TURBT was used. Read More

    The value of complementing administrative data with abstracted information on smoking and obesity: A study in kidney cancer.
    Can Urol Assoc J 2017 Jun;11(6):167-171
    Department of Internal Medicine, Sunnybrook Health Sciences Centre, University of Toronto; Toronto, ON, Canada.
    Introduction: Variables, such as smoking and obesity, are rarely available in administrative databases. We explored the added value of including these data in an administrative database study evaluating the association of statin use with survival in kidney cancer.

    Methods: We linked administrative data with chart-abstracted data on smoking and obesity for 808 patients undergoing nephrectomy for kidney cancer. Read More

    Global implementation of advanced urological care: Policy implementation research.
    Can Urol Assoc J 2017 Jun;11(6):157-160
    Fellow, Stellenbosch Institute for Advanced Study (STIAS), Wallenberg Research at Stellenbosch University, Stellenbosch 7600, South Africa and Department of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada.
    Introduction: In high-resource countries, modern treatments for urological diseases have led to significant reductions in mortality and morbidity; however, the benefits of modern treatment have yet to reach the majority of people worldwide. As attention is focused on improving urological care in the global community, policy and implementation research (PIR) offers a platform for effective organization and engagement.

    Methods: We have compiled a photo essay to illustrate the fundamental components of PIR. Read More

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