Cuaj-Canadian Urological Association Journal最新文献

{"title":"Identifying factors influencing specialty choice in urology by female medical students.","authors":"Nicolas Siron, Romy Kafyeke, Nick Lee, Vishwasree Samala, Marie-Lyssa Lafontaine, Mona Ouirzane, Nancy Nimer, Claudia Deyermendjian, Teodora Podasca, Stacey de Lima, Mélanie Aubé-Peterkin, Ashley Cox, Naeem Bhojani","doi":"10.5489/cuaj.9244","DOIUrl":"https://doi.org/10.5489/cuaj.9244","url":null,"abstract":"<p><strong>Introduction: </strong>As of 2019, females represented 11% of the urology workforce in Canada. Lack of female role models, quality of life, and gender/sex discrimination may be important deterrent factors to female applicants entering surgical specialties. Limited research exists on which factors are important in choosing urology as a specialty by female applicants. In this study, we aimed to determine which factors affect specialty choice in urology by medical school applicants and to identify any disparities by sex.</p><p><strong>Methods: </strong>From November 2022 to May 2023, a survey was diffused to medical students enrolled in all Canadian medical schools. The questionnaire included 23 factors that may affect specialty choice. A five-point Likert scale was used to assess each factor's influence on the student's interest in urology. Pearson-Chi squared test was used to compare response rates between sexes.</p><p><strong>Results: </strong>A total of 424 Canadian medical students responded to the survey. Common incentivizing factors for choosing urology as a specialty was medical-surgical approach, doctor-patient relationship, and financial benefits. Common deterrent factors were perception that urology is a male-dominated field, lifestyle of surgical residencies, and lack of female role models in urology. Females were more likely to report lower clinical exposure to urology and be deterred by the male predominance in the field.</p><p><strong>Conclusions: </strong>While female medical students are more likely to be disincentivized to choose urology as a specialty due to it being a male-dominated field, early exposure through research, role models, or shadowing is essential to incentivize interest in urology among female medical students.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253544","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":"Comparison of 90-day morbidity and mortality between ileal conduit and orthotopic neobladder following radical cystectomy in a large multi-institutional database: The Canadian CBCIS experience.","authors":"Hanaa Fekak, Wassim Kassouf, Rodney H Breau, Adrian Fairey, Agnihotram V Ramanakumar, Camilla Tajzler, Eric Hyndman, Jasmir G Nayak, Jonathan Izawa, Bobby Shayegan, Girish S Kulkarni, Afsaneh Eskandari, Michele Lodde, Ricardo A Rendon, D Robert Siemens, Claudio Jeldres, Peter C Black, Jean-Baptiste Lattouf","doi":"10.5489/cuaj.9204","DOIUrl":"https://doi.org/10.5489/cuaj.9204","url":null,"abstract":"<p><strong>Introduction: </strong>In patients undergoing radical cystectomy, ileal conduit (IC) urinary diversions are more frequently carried out than orthotopic neo-bladder reconstructions (ONB). Patients selected for IC likely have more comorbidities, advanced disease, and older age, with many being poor candidates for ONB; ONB often ends up being selected by younger and healthier patients. Differences in complications experienced by IC and ONB patients may be due to differences between patients or urinary diversions. To guide patient counseling and care, we aimed to assess 90-day complications and mortality for patients undergoing either procedure in a large, contemporary, Canadian cohort.</p><p><strong>Methods: </strong>Patient information was obtained from the Canadian Bladder Cancer Information System (CBCIS), encompassing 14 academic Canadian centers. Patients who underwent radical cystectomy between February 2015 and September 2023 were included. Ninety-day complications were analyzed according to the Clavien-Dindo severity scale. Perioperative parameters and 90-day mortality were compared between IC and ONB diversion. We used rank-sum and Chi-squared exact tests as exploratory statistic. Unconditional logistic regression was used to evaluate the association between IC and ONB complications.</p><p><strong>Results: </strong>Of 2161 patients, 1799 (83%) received an IC and 362 (16%) an ONB. Patients were followed for a median of 235 days (interquartile range [IQR] 486). The median age was 69 years (IQR 14). The age-adjusted Charlson comorbidity index (aCCI) was significantly higher in the IC group (median [IQR] 5 [2] vs. 4 [2], p<0.001). The 90-day complication rate was 46% and the 90-day mortality rate was 4.3% for the entire cohort. On multivariable logistic regression, the risk of overall complications was significantly higher in the ONB than in the IC group (odds ratio 2.2, 95% confidence interval 1.7-2.8, p<0.001). Ninety-day mortality was 4.9% in the IC group and 0.82% in the ONB group.</p><p><strong>Conclusions: </strong>In this multi-institutional cohort, patients with ONB had higher odds of perioperative complications; however, there was no difference in higher-severity complications between diversions.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253587","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":"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":"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":"E317-E321"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453882/pdf/","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":"OA","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":"10.5489/cuaj.9162","url":null,"abstract":"","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":"E339-E340"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453887/pdf/","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":"OA","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":"10.5489/cuaj.7269","url":null,"abstract":"","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":"E346-E348"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453891/pdf/","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":"OA","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":"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":"E322-E327"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453884/pdf/","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":"OA","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":"10.5489/cuaj.9176","url":null,"abstract":"","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":"E344-E345"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453890/pdf/","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":"OA","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, Maria Daniella Sare, Monita Sundar, Celestia S Higano, Ryan Flannigan","doi":"10.5489/cuaj.9104","DOIUrl":"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 (ED) has been offered either in-person or by 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":"E294-E300"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453883/pdf/","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":"OA","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":"10.5489/cuaj.8842","url":null,"abstract":"","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":"E341-E343"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453889/pdf/","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":"OA","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":"10.5489/cuaj.9154","url":null,"abstract":"","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":"E336-E338"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453892/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}