Cuaj-Canadian Urological Association Journal最新文献

{"title":"Comparison of upper, middle, and lower pole pathologic biopsies of the testes in patients with non-obstructive azoospermia.","authors":"Onur Dede, Mazhar Utanğaç","doi":"10.5489/cuaj.9067","DOIUrl":"https://doi.org/10.5489/cuaj.9067","url":null,"abstract":"<p><strong>Introduction: </strong>Infertility is a widespread global health issue with a multifactorial etiology, affecting a significant proportion of couples. Male factors, either alone or in combination with female factors, play a crucial role in contributing to infertility. Non-obstructive azoospermia (NOA), characterized by the absence of sperm in the ejaculate due to spermatogenic failure, represents one of the most severe forms of male infertility. Microdissection testicular sperm extraction (m-TESE) has emerged as a primary therapeutic approach for these patients. This study aimed to investigate histopathologic variances between different poles of the testicles in NOA patients undergoing m-TESE and to compare the results using the Johnsen testicular biopsy classification.</p><p><strong>Methods: </strong>Forty-two consecutive NOA patients who underwent m-TESE between November 2022 and December 2023 were included in this prospective study. Data on patient demographics, perioperative variables, and postoperative outcomes were collected and analyzed. Testicular biopsies from the upper, middle, and lower poles were histopathologically examined, and the Johnsen testicular biopsy scoring system was used for comparison.</p><p><strong>Results: </strong>Histologic evaluation revealed Sertoli cell only syndrome in nine cases (SCO), maturation arrest (MA) in 12 cases, and hypospermatogenesis (HS) in 21 cases. Pathologic findings were consistent across all poles of the testicle. Johnsen testicular biopsy scores showed similar results among patients. The success rates of sperm retrieval varied, with two of nine patients with SCO, four of 12 with MA, and 16 of 21 with HS achieving successful results.</p><p><strong>Conclusions: </strong>Our study demonstrated consistent histopathologic patterns across different poles of the testis, emphasizing the importance of comprehensive histologic assessment for predicting sperm retrieval success. As a result of our study, we found that the upper middle and lower poles of the testis were similar in terms of histologic and Johnsen testicular biopsy scoring system. Future research should focus on refining histopathologic classification systems and further optimizing surgical techniques to enhance outcomes in this patient population.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case - Hematuria with clot retention after clonidine/arginine growth hormone stimulation test.","authors":"Sami Mostafa, Hailey H Frye, Brent Cleveland, Duong Tu, Martin Koyle","doi":"10.5489/cuaj.9162","DOIUrl":"https://doi.org/10.5489/cuaj.9162","url":null,"abstract":"<p><p>Arginine and clonidine Time Testing has been utilized to stimulate growth hormone (GH) in the pediatric population. This challenge test has been associated with transitory, self-limited, gross painless hematuria. We report a pre-pubertal child who underwent a GH stimulation test that led to painful hematuria with clot retention. The patient was managed expectantly as an outpatient, with subsequent resolution of all clots in the bladder on repeat US. GH stimulation test with arginine and clonidine has the potential to cause significant hematuria with clot retention that might entail intervention and has not previously been reported in the literature.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Taking notes: A urologist's \"tech\"-nique for streamlining patient encounters using artificial intelligence medical scribes.","authors":"Nathan Colin Wong","doi":"10.5489/cuaj.7269","DOIUrl":"https://doi.org/10.5489/cuaj.7269","url":null,"abstract":"","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of shockwave lithotripsy before percutaneous nephrolithotomy on the risk of renal arteriovenous fistula.","authors":"Mehmet Eflatun Deniz, Cevahir Ozer, Mehmet Vehbi Kayra, Ismail Karluka, Mustafa Mazican, Mehmet Resit Goren","doi":"10.5489/cuaj.9122","DOIUrl":"https://doi.org/10.5489/cuaj.9122","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to assess the impact of shockwave lithotripsy (SWL) on the incidence of renal arteriovenous fistula (AVF) following percutaneous nephrolithotomy (PCNL).</p><p><strong>Methods: </strong>We retrospectively analyzed data from patients who underwent PCNL and/or SWL for kidney stones, as well as angioembolization for renal AVF, between January 2000 and December 2024. Patients with inadequate followup or insufficient medical records were excluded. Patients were divided into two groups: The first group included those who did not undergo SWL before PCNL, while the second group included those who underwent SWL. Various patient factors, stone characteristics, and surgical features were compared between the groups.</p><p><strong>Results: </strong>We reviewed data from 851 PCNL patients, 3043 SWL patients, and 31 patients who underwent angioembolization for renal AVF. Fourteen patients were excluded due to insufficient data. A total of seventeen patients (1.2%) developed renal AVF after PCNL, with 13 (76.5%) of them having undergone prior SWL at the same renal unit. In the group with a history of SWL before PCNL, the odds ratio calculated for the occurrence of AVF was 190.4. (95% confidence interval 55.1-657.1, p<0.001).</p><p><strong>Conclusions: </strong>AVF is a serious complication that occurs after vascular damage. Both SWL and PCNL are among the treatments that can cause this complication. Due to their additive effects, performing SWL and PCNL consecutively in a short period appears to increase the risk of developing AVF. Careful patient management is essential to minimize this risk.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Involvement of community urologists in research in Canada.","authors":"Nasir Mahmood","doi":"10.5489/cuaj.9176","DOIUrl":"https://doi.org/10.5489/cuaj.9176","url":null,"abstract":"","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing virtual and in-person training for intracavernosal injection therapy in a multidisciplinary sexual health clinic within a prostate cancer survivorship program.","authors":"Anna-Lisa V Nguyen, Sania Julian, Rosalie Ho, Christine Zarowski, Meghan Lui, Irene Yu, Daniella Sare, Monita Sundar, Celestia S Higano, Ryan Flannigan","doi":"10.5489/cuaj.9104","DOIUrl":"https://doi.org/10.5489/cuaj.9104","url":null,"abstract":"<p><strong>Introduction: </strong>The Sexual Health Clinic (SHC) offered by the Prostate Cancer Supportive Care (PCSC) Program delivers sexual health therapies for prostate cancer (PCa) patients and their partners. Since April 2020, training for using intracavernosal injections (ICI) to treat erectile dysfunction has been offered in either in-person or virtual appointments. This study's primary objective was to assess the effectiveness of virtual compared to in-person ICI training by analyzing clinical and patient-reported outcomes (PROs) within each group.</p><p><strong>Methods: </strong>This is a retrospective, ethics-approved chart review of all patients who received ICI training between January 2019 and April 2023. PROs collected were obtained prospectively during routine clinical care. Outcomes, including PROs, satisfaction, and adverse events, were measured using surveys and validated questionnaires.</p><p><strong>Results: </strong>Over four years, 74 patients received ICI training, 54 virtually and 24 in-person. Each group's demographics are similar with respect to age, education level, ethnicity, and partner information. Most patients had not attempted ICI before enrolling in the SHC and were not satisfied with other therapeutic options to treat their ED. Adherence was high in both groups. Virtual and in-person ICI teaching was similar with respect to clinical outcomes and satisfaction. Overall satisfaction was low in both groups. The frequency of adverse events was comparable.</p><p><strong>Conclusions: </strong>Overall, clinical outcomes with ICI training in the virtual format do not appear to differ from those completed in person. Larger, prospective studies are needed to confirm these results.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case series - Laparoscopic radical nephrectomy for kidney cancer in pregnancy.","authors":"Braden Millan, Katherine Steckham, Meghan Elizabeth Ough Vlasschaert, David Hogarth, Geoffrey Gotto","doi":"10.5489/cuaj.8842","DOIUrl":"https://doi.org/10.5489/cuaj.8842","url":null,"abstract":"","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case - Novel transurethral repair of an intraperitoneal bladder rupture.","authors":"Mariah Keeling, Geemitha Ratnayake Mudiyanselage, Yanbo Guo","doi":"10.5489/cuaj.9154","DOIUrl":"https://doi.org/10.5489/cuaj.9154","url":null,"abstract":"","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effectiveness of en-bloc resection techniques vs. conventional transurethral resection for non-muscle-invasive bladder cancer: A systematic review and meta-analysis.","authors":"David E Hinojosa-Gonzalez, Gal Saffati, Troy La, Jackson Cathey, Juan C Angulo-Lozano, Gustavo Salgado-Garza, Jonathan Walsh, Bailey Slawin, Shane Kronstedt, Kate Lowrey, Jeremy R Slawin","doi":"10.5489/cuaj.9070","DOIUrl":"https://doi.org/10.5489/cuaj.9070","url":null,"abstract":"<p><strong>Introduction: </strong>Transurethral en-bloc resection of bladder tumor (ERBT) has emerged as an alternate technique to conventional transurethral resection of bladder tumor (cTURBT). While theoretically advantageous, the comparative effectiveness of ERBT across various technical approaches remains unclear. We performed an updated systematic review and meta-analysis to evaluate perioperative, pathologic, and oncologic outcomes of ERBT vs. cTURBT.</p><p><strong>Methods: </strong>We systematically searched PubMed, EMBASE, Scopus, and Google Scholar for randomized controlled trials (RCTs) comparing ERBT and cTURBT. The primary outcome was recurrence-free survival (RFS). Secondary outcomes were operative time, complication rates, detrusor muscle presence, and need for repeated resection. Meta-analyses were performed, with subgroup analyses stratified by ERBT technique.</p><p><strong>Results: </strong>A total of 10 RCTs with 1973 patients (1012 ERBT, 961 cTURBT) were included. Overall data favored ERBT in RFS (hazard ratio [HR] 0.85, 95% confidence interval [CI] 0.71-1.01, p=0.07, I²=48%), with bipolar ERBT demonstrating significantly improved RFS (HR 0.51, 95% CI 0.32-0.81, p=0.004). ERBT had longer operative times compared to cTURBT (MD 3.52 minutes, 95% CI 1.25-5.80, p=0.001, I²=71%). There were no significant differences in catheter time or hospital stay between groups. ERBT had a non-significant lower incidence of bladder perforation (odds ratio [OR] 0.41, 95% CI 0.16-1.04, p=0.06, I²=52%) and obturator nerve reflex (OR 0.27, 95% CI 0.10-0.74, p=0.01, I²=79%) compared to cTURBT. ERBT was not significantly associated with higher detrusor muscle presence (OR 2.08, 95% CI 0.94-4.58, p=0.07, I²=78%).</p><p><strong>Conclusions: </strong>ERBT might have oncologic and perioperative benefits, in addition to technical advantages, relative to cTURBT. Variations in resection instruments used impact the consistency of results.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Public awareness of testicular torsion is lacking in Edmonton.","authors":"Neel Phaterpekar, Darcie Kiddoo, Daniel Keefe, Sana Samadi, Troy Turner, Peter Metcalfe","doi":"10.5489/cuaj.9066","DOIUrl":"https://doi.org/10.5489/cuaj.9066","url":null,"abstract":"<p><strong>Introduction: </strong>The time from symptom onset to intervention dictates morbidity in testicular torsion (TT). Delayed presentation negatively impacts surgical outcomes and poor knowledge about TT is hypothesized to be a potential cause of delays. Our study characterizes baseline public awareness rates among families in Edmonton and assesses the association between awareness and TT outcomes.</p><p><strong>Methods: </strong>Patients and their caregivers completed surveys assessing TT awareness. Families were surveyed in two groups: those who presented with TT and age-matched controls. Affected families gave additional information about symptoms, time to notify parents, and present to the hospital. Outcomes were assessed at followup and through medical record review.</p><p><strong>Results: </strong>Of 61 families, 18 (29.5%) patients and 22 (36.1%) parents had heard of TT. Among TT-affected patients (n=30), time to report symptoms (3.2 vs. 20.5 hours, p<0.01) and to arrive at hospital (3.0 vs. 20.8 hours, p<0.01) was significantly longer for patients requiring orchiectomy. Total time (odds ratio [OR] 0.992, p=0.01) and pain (OR 0.904, p=0.05) were associated with outcome. No differences in awareness were seen between patients who underwent orchiopexy vs. orchiectomy (23.8% vs. 25.0%, p>0.99).</p><p><strong>Conclusions: </strong>We demonstrate that most Edmonton families have never heard of TT and that the pre-admission interval constitutes a substantial proportion of delays in surgery. Although time and pain ratings were associated with outcomes in TT, further evidence is required to demonstrate that awareness impacts outcomes significantly.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}