Cuaj-Canadian Urological Association Journal最新文献

{"title":"Fact-checking my CaRMS letter, or a Valentine to urology.","authors":"Michael Leveridge","doi":"10.5489/cuaj.9136","DOIUrl":"10.5489/cuaj.9136","url":null,"abstract":"","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":"19 2","pages":"7-8"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11819850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415520","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":"The use of focal therapy for the treatment of prostate cancer in Canada Where are we, how did we get here, and where are we going?","authors":"Ravi Kumar, Sangeet Ghai, Antonio Finelli, Laurence Klotz, Adam Kinnaird, Miles Mannas, Bimal Bhindi, Rafael Sanchez-Salas, Maurice Anidjar, Ardalanejaz Ahmad, Joseph Chin, Brant Inman, Nathan Perlis","doi":"10.5489/cuaj.8888","DOIUrl":"10.5489/cuaj.8888","url":null,"abstract":"<p><strong>Introduction: </strong>Focal therapy is an emerging treatment for localized prostate cancer (PCa). The objectives of this review were to: 1) review how focal therapies are regulated and approved; 2) summarize the scope and quality of the literature regarding safety, efficacy, and side-effects; and 3) outline ongoing clinical trials of focal therapy in Canada.</p><p><strong>Methods: </strong>Using the PRISMA framework for scoping reviews, we searched PubMed, Embase, and Cochrane from 2021-2024, complementing Hopstaken et al's search up to 2020. We focused on studies reporting functional and oncologic outcomes. Additionally, we examined the FDA database for regulatory details and ongoing trials in Canada via ClinicalTrials.gov.</p><p><strong>Results: </strong>FDA approval for prostate tissue ablation was granted to high-intensity focused ultrasound (HIFU) in 2015 via the de novo pathway; other therapies followed the 510(k) route, citing equivalence to predicate devices. Most studies are in early stages, primarily single-arm, prospective cohort designs. Oncologic outcomes like cancer detection and survival rates, alongside functional data, such as adverse events and erectile function, were assessed. Recurrence-free survival at 48 months ranged from 58-92%, pad-free rates were greater than 95%, and rates of new-onset erectile dysfunction were variable, ranging from no change to 50%. Rates of serious adverse events were low, ranging from 0-14%. Three Canadian clinical trials are actively enrolling participants, and five private clinics were found offering private HIFU, irreversible electroporation, or transurethral ultrasound ablation.</p><p><strong>Conclusions: </strong>Focal therapy technologies have gained regulatory approval for prostate tissue ablation, and aside from provincial support for cryoablation in Alberta, are available to Canadians through private payment or clinical trials. Many studies demonstrate promising cancer control and impressive functional outcomes but are limited by their short followup and lack of comparator group. Clinical trial or registry participation should be prioritized to ensure an evidence-based integration into current prostate cancer treatment approaches.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":"63-72"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11819858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479832","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":"Advocating for better prostate cancer outcomes.","authors":"Ricardo A Rendon","doi":"10.5489/cuaj.9109","DOIUrl":"10.5489/cuaj.9109","url":null,"abstract":"","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":"19 2","pages":"9"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11819854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415503","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":"Impact of pre-treatment counseling on decisional regret of prostate cancer survivors Cross-sectional analysis of patient-reported experience following diagnosis or treatment.","authors":"Thomas M Southall, David Chung, Jasmir G Nayak, Premal Patel","doi":"10.5489/cuaj.8918","DOIUrl":"10.5489/cuaj.8918","url":null,"abstract":"<p><strong>Introduction: </strong>Prostate cancer (PCa) impacts patient lives beyond oncologic concerns alone. PCa survivorship entails all impacts of PCa, from time of diagnosis to end of life. This may include decision regret (DR). We aimed to determine survivor experiences from a functional perspective throughout survivorship.</p><p><strong>Methods: </strong>Our cross-sectional survey was circulated to all members of the Manitoba Prostate Cancer Support Group. Questions explored patient understanding of functional impacts concerning treatment. Survey items included binary and Likert scale questions, and an open-answered question asking how care may be improved. Responses were used to identify predictors of DR.</p><p><strong>Results: </strong>A total of 514 patients received our survey, with a response rate of 23.7% (n=122). Most survivors were offered radical prostatectomy (RP) or radiation therapy, at 73.0% and 63.9%, respectively; 14.9% reported lacking understanding of treatment impact on erections. Similarly, 11.5% reported lacking understanding of treatment on urinary continence. Predictors of DR included treatment with RP and low pre-treatment understanding of potential erectile dysfunction (ED) and urinary incontinence.</p><p><strong>Conclusions: </strong>PCa survivors are at high risk of DR, particularly those who undergo treatment with RP and those who identify as having low pre-treatment understanding of potential ED and urinary incontinence. Virtual care did not impact DR. Results highlight the importance of thorough counseling on functional aspects of PCa management prior to treatment.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":"32-39"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11819849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479828","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":"Optimizing kidney stone care with multidisciplinary collaboration and improved guideline adherence.","authors":"Andrea Lantz Powers","doi":"10.5489/cuaj.9108","DOIUrl":"10.5489/cuaj.9108","url":null,"abstract":"","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":"19 2","pages":"61-62"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11819847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415534","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":"Fractional CO₂ laser for the treatment of Peyronie's disease A pilot clinical trial.","authors":"Justin Y H Chan, Abdullah Alhamam, Luke Witherspoon, Jason K Rivers, Ryan K Flannigan","doi":"10.5489/cuaj.8852","DOIUrl":"10.5489/cuaj.8852","url":null,"abstract":"<p><strong>Introduction: </strong>Fractional CO₂ laser therapy is used to treat fibrosing conditions similar to Peyronie's disease (PD). The aim of the study was to evaluate the safety and efficacy of using a fractional CO₂ laser in the management of chronic phase PD.</p><p><strong>Methods: </strong>This was a single-site, non-randomized, open-label study using a fractional CO₂ laser. Subjects underwent three treatment sessions every six weeks with a fractional CO₂ device. Topical triamcinolone was applied immediately after each treatment. Between treatments, patients performed penile modeling three times daily. Penile curvature assessments, self-reported questionnaires, and adverse event screenings were completed at baseline, 24 weeks, and 52 weeks.</p><p><strong>Results: </strong>Five patients were included in the study. The median baseline penile curvature was 37.0° (interquartile range [IQR] 33.0°, 53.0°), and at 52 weeks, this had reduced to a median curvature of 28.0° (IQR 17.50°, 44.0°, p=0.03), representing a median reduction in penile curvature by 24.3% (IQR 17.0%, 47.5%). The International Index of Erectile Function Overall scores were comparable at baseline and at 52 weeks (median 59.0, IQR 42.5, 66.5 vs. median 60.0, IQR 53.5, 70.0 respectively, p=0.81). Patients did report significant improvement in overall Peyronies' Disease Questionnaire scores from baseline to 52 weeks after laser treatment (median 26.0, IQR15.0, 29.5, vs. median 14.0, IQR 7.0, 22.50, respectively, p=0.03). Four patients reported self-limiting side effects immediately after laser therapy that resolved spontaneously within two weeks.</p><p><strong>Conclusions: </strong>With encouraging results at 52 weeks, fractional CO₂ laser therapy may serve as a well-tolerated and minimally invasive therapy for PD in the future.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":"25-31"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11819855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479827","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":"Perioperative outcomes of adrenal surgery Does surgical specialty matter?","authors":"Basil Ahmad, Duva Karunakaran, Naji J Touma","doi":"10.5489/cuaj.7852","DOIUrl":"10.5489/cuaj.7852","url":null,"abstract":"<p><strong>Introduction: </strong>Management of adrenal disease requires a multidisciplinary approach often involving varied specialists. Surgical management has often overlapped between general surgeons, usually with an interest in surgical endocrinology, or urologists with minimally invasive surgical skills. The objectives of this study were to define perioperative outcomes of contemporary Canadian adrenal surgery and determine whether those outcomes are impacted by surgical subspecialty. As a secondary outcome, an assessment of the variability in the indications for adrenal surgery was carried out between the two surgical subspecialties.</p><p><strong>Methods: </strong>A retrospective chart review of all adrenalectomies performed at our center from August 2013 to August 2023 was conducted. The only exclusion criterion was when an adrenalectomy was performed secondary to the main procedure. Data was collected and grouped under four categories: patient characteristics, indications for an adrenalectomy, procedural statistics, and perioperative patient outcomes.</p><p><strong>Results: </strong>A total of 121 adrenalectomies were performed in a period of just over 10 years. Of these, 103 were included in the analysis. Thirty-seven were performed by general surgery, whereas 66 were performed by urology. There were no significant differences in patients' age and Charlson comorbidity score between the two surgical specialties. The indications for the adrenalectomy were similar between the specialties, and were as follows: 32 (31.1%) for pheochromocytoma, 24 (23.3%) for a cortical functional lesion, 19 (18.4%) for a metastatectomy, 16 (15.5%) for size or growth, and 10 (9.7%) for adrenocortical carcinoma. There were no differences in overall operating room time or type of procedure. Most (89.3%) of the procedures were performed laparoscopically. Patients that were operated on by general surgeons were more likely to be readmitted within 30 days than those operated on by urologists (five patients [13.5%] vs. one patient [1.5%], respectively, p=0.04), and more likely to require intensive care unit (ICU)/stepdown ICU admission (19 patients [51.4%] vs. 19 [28.8%], respectively, p=0.04). There was no difference in length of stay or postoperative complications. There was, however, one Clavien-Dindo 5 complication after a procedure performed by general surgery.</p><p><strong>Conclusions: </strong>Most adrenalectomies at this one Canadian center are performed by urology. Indications for adrenalectomy are similar between the specialties. Although postoperative complication rates are similar, rates of 30-day readmission and ICU/stepdown admission were decreased when urologists performed adrenalectomies. Adrenalectomies may be performed safely by either specialty, and factors such as local expertise and surgical volumes are likely important.</p>","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":"53-57"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11819856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808532","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":"Trends in kidney stone prevalence among U.S. adults A concerning contemporary gender analysis from the NHANES database.","authors":"Kelven W Chen, Malek Meskawi, Larry E Miller, Samir Bhattacharyya, Thomas Tailly, Ben H Chew, Naeem Bhojani","doi":"10.5489/cuaj.8935","DOIUrl":"10.5489/cuaj.8935","url":null,"abstract":"","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":"58-60"},"PeriodicalIF":1.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11819852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142485864","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 - Atypical animal-induced scrotal traumas.","authors":"Luke Witherspoon, Ali Dergham, Joseph Y Nashed, Hamidreza Abdi, Sohrab Naushad Ali, Ilias Cagiannos, Jeffrey T Warren, Christopher Morash","doi":"10.5489/cuaj.8809","DOIUrl":"10.5489/cuaj.8809","url":null,"abstract":"","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":" ","pages":"E69-E71"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523555","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":"2025 Canadian Urological Association Expert Report: Muscle-invasive bladder cancer.","authors":"Girish S Kulkarni, Peter C Black, Srikala S Sridhar, Alexandre R Zlotta, Bobby Shayegan, Ricardo A Rendon, Peter Chung, Theodorus van der Kwast, Nimira Alimohamed, Yves Fradet, Andrea Kokorovic, Fabio L Cury, Wassim Kassouf, Dominick Bossé, Jason Izard, Kristen McAlpine","doi":"10.5489/cuaj.9096","DOIUrl":"10.5489/cuaj.9096","url":null,"abstract":"","PeriodicalId":50613,"journal":{"name":"Cuaj-Canadian Urological Association Journal","volume":"19 1","pages":"E1-E16"},"PeriodicalIF":1.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11790035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123136","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}