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Canadian Journal of Urology最新文献

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Propensity score matched survival analysis of octogenarians with muscle-invasive bladder cancer: chemoradiation compared to radical cystectomy. 80多岁癌症肌肉浸润性膀胱癌患者的倾向性评分匹配生存分析：放化疗与根治性膀胱切除术的比较。
IF 1.5 4区 医学
Canadian Journal of Urology Pub Date : 2023-10-01
Arjun Pon Avudaiappan, Pushan Prabhakar, Hariharan Ganapathi, Nathan VanderVeer-Harris, Jorge Caso, Rohan Garje, Murugesan Manoharan
{"title":"Propensity score matched survival analysis of octogenarians with muscle-invasive bladder cancer: chemoradiation compared to radical cystectomy.","authors":"Arjun Pon Avudaiappan,&nbsp;Pushan Prabhakar,&nbsp;Hariharan Ganapathi,&nbsp;Nathan VanderVeer-Harris,&nbsp;Jorge Caso,&nbsp;Rohan Garje,&nbsp;Murugesan Manoharan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Radical cystectomy (RC) is an effective curative treatment option for muscle-invasive bladder cancer (MIBC). However, chemoradiation (CRT) is an evolving bladder preservation protocol alternative to RC. With the increase in life expectancy, it is essential to understand the survival outcomes among octogenarians treated with RC and CRT. In this study, we use the National Cancer Database (NCDB) to compare the survival outcomes between RC and CRT in octogenarians.</p><p><strong>Materials and methods: </strong>We collected the data of patients treated for bladder cancer between 2004 to 2018 from the NCDB. Our primary analytic cohort included patients with MIBC (cT2-T4N0M0). We identified the octogenarians and categorized them into RC and CRT arms. The RC arm included those who received RC. The CRT arm included those who received chemotherapy within 90 days of curative radiation therapy. After 1:1 propensity score matching, overall survival (OS) outcomes were compared between both arms.</p><p><strong>Results: </strong>Among the octogenarians, the median OS for patients treated with RC was 26.1 months (95% CI, 23.9-28.2), and CRT was 28.7 months (95% CI, 26.8-30.6). Our covariate analyses showed that academic institutions performed more RC (49% RC and 29.7% CRT) and community programs served more CRT (45.7% CRT and 24.2% RC). A multivariate Cox regression analysis showed that the mortality risk increased as the Charlson-Deyo comorbidity score and T stage increased.</p><p><strong>Conclusion: </strong>Octogenarians treated with RC and CRT had similar OS. As life expectancy increases, it is essential to individualize the treatment strategy based on risk assessment and its potential benefits.</p>","PeriodicalId":56323,"journal":{"name":"Canadian Journal of Urology","volume":"30 5","pages":"11686-11691"},"PeriodicalIF":1.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41241296","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}
引用次数: 0
Re: Venture capital investment in urology, 2011 to mid-2021. 回复：泌尿外科风险投资，2011年至2021年年中。
IF 1.5 4区 医学
Canadian Journal of Urology Pub Date : 2023-10-01
Leonard G Gomella
{"title":"Re: Venture capital investment in urology, 2011 to mid-2021.","authors":"Leonard G Gomella","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":56323,"journal":{"name":"Canadian Journal of Urology","volume":"30 5","pages":"11667"},"PeriodicalIF":1.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41241298","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}
引用次数: 0
Legends in Urology V30I05. 泌尿外科传奇V30I05。
IF 1.5 4区 医学
Canadian Journal of Urology Pub Date : 2023-10-01
Christopher Chapple
{"title":"Legends in Urology V30I05.","authors":"Christopher Chapple","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":56323,"journal":{"name":"Canadian Journal of Urology","volume":"30 5","pages":"11646-11649"},"PeriodicalIF":1.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41241294","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}
引用次数: 0
Interdisciplinary planning improves radiologist obtained access for percutaneous nephrolithotomy. 跨学科规划改善了放射科医生获得的经皮肾取石术的途径。
IF 1.5 4区 医学
Canadian Journal of Urology Pub Date : 2023-10-01
Christopher J Staniorski, Mitchell B Alameddine, Shyam Patnaik, Michelle J Semins
{"title":"Interdisciplinary planning improves radiologist obtained access for percutaneous nephrolithotomy.","authors":"Christopher J Staniorski,&nbsp;Mitchell B Alameddine,&nbsp;Shyam Patnaik,&nbsp;Michelle J Semins","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Proper antegrade access for percutaneous nephrolithotomy (PCNL) is essential for success but can be challenging. Previous work evaluating access obtained by interventional radiology (IR), largely in the emergent setting, has shown high rates of additional access at the time of PCNL. We hypothesize that efforts to improve pre-procedural communication between urology and IR can impact the utility of the access for subsequent PCNL.</p><p><strong>Material and methods: </strong>We conducted a retrospective review of patients undergoing PCNL at a single hospital from January 2011 to December 2022. Adult patients undergoing PCNL with established preoperative access were included.</p><p><strong>Results: </strong>A total of 141 cases were identified with preoperative access. A total of 111 patients had evidence of planning with IR prior to antegrade access. There were high rates of anatomic abnormality (50%) and staghorn calculus (53%). Patients with planned access had higher body mass index (BMI). While preoperative access was initially utilized in 97% of cases, 6% required additional access to be obtained intraoperatively; this included a low rate of new access in those that were previously discussed with IR (4% vs. 17%, p = 0.02). Overall stone free rates (91%), rates of second stage procedures (55%) and complications (14%) were similar between planned and unplanned groups.</p><p><strong>Conclusion: </strong>In this retrospective study of complex patients with large stone burden presenting for PCNL with preoperative antegrade access obtained by IR, the rate of new access was far lower than prior reports. This was likely influenced by urologist involvement in planning access.</p>","PeriodicalId":56323,"journal":{"name":"Canadian Journal of Urology","volume":"30 5","pages":"11692-11697"},"PeriodicalIF":1.5,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41241293","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}
引用次数: 0
Re: Less is more: single dose versus extended antibiotic prophylaxis for transperineal prostate biopsy. 少即是多:经会阴前列腺活检单剂量与延长抗生素预防。
IF 1.5 4区 医学
Canadian Journal of Urology Pub Date : 2023-08-01
Roderick Clark, Jay D Raman
{"title":"Re: Less is more: single dose versus extended antibiotic prophylaxis for transperineal prostate biopsy.","authors":"Roderick Clark,&nbsp;Jay D Raman","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":56323,"journal":{"name":"Canadian Journal of Urology","volume":"30 4","pages":"11605-11606"},"PeriodicalIF":1.5,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10110554","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}
引用次数: 0
Less is more: single dose versus extended antibiotic prophylaxis for transperineal prostate biopsy. 少即是多:单剂量与延长抗生素预防经会阴前列腺活检。
IF 1.5 4区 医学
Canadian Journal of Urology Pub Date : 2023-08-01
Maxwell Sandberg, Wyatt Whitman, Janmejay Hingu, Parth Thakker, Anita Rong, Caleb Bercu, Jacob Greenberg, Ronald Davis Ⅲ, Ashok Hemal, Matvey Tsivian
{"title":"Less is more: single dose versus extended antibiotic prophylaxis for transperineal prostate biopsy.","authors":"Maxwell Sandberg,&nbsp;Wyatt Whitman,&nbsp;Janmejay Hingu,&nbsp;Parth Thakker,&nbsp;Anita Rong,&nbsp;Caleb Bercu,&nbsp;Jacob Greenberg,&nbsp;Ronald Davis Ⅲ,&nbsp;Ashok Hemal,&nbsp;Matvey Tsivian","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>There is an ongoing debate as to the appropriate regimen of antibiotic prophylaxis with transperineal (TP) biopsy. The objective of this study was to report the rate of infection following TP biopsy at a high-volume institution and assess the impact of single dose antibiotics at the time of biopsy versus outpatient antibiotics in preventing postprocedural infections.</p><p><strong>Materials and methods: </strong>Records of men undergoing TP prostate biopsy from 2012 to 2022 were reviewed. Patients were divided into two groups, those who received single dose intravenous (IV) antibiotics at the time of biopsy (n = 440) and those who received both IV antibiotics at the time of biopsy and outpatient antibiotics before/after biopsy (n = 327). Post biopsy infection was defined as at least one of the following: fever (≥ 38.3°C) with/without symptoms of urinary tract infection or positive urine culture (> 105 colony forming units) within 72 hours post biopsy. The rates of infection were compared between the two groups.</p><p><strong>Results: </strong>A total of 767 biopsies were included in the study. Infection rate post TP biopsy was 1.83% (n = 14). The infection rate for patients with single dose prophylaxis was 2.05% (n = 9) and 1.53% (n = 5) for those that received the extended antibiotic regimen. No significant difference in infection rates between the different antibiotic regimens was found (p = 0.597).</p><p><strong>Conclusions: </strong>Overall rates of infection after TP prostate biopsy are very low. Our data indicate that single dose and extended regimen of antibiotic prophylaxis show similar infection rates. These findings support antibiotic stewardship and encourage further research into the appropriate regimen of prophylaxis for TP prostate biopsy.</p>","PeriodicalId":56323,"journal":{"name":"Canadian Journal of Urology","volume":"30 4","pages":"11599-11604"},"PeriodicalIF":1.5,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10105351","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}
引用次数: 0
Calyceal diverticulum simulating a renal tumor. 肾盏憩室模拟肾肿瘤。
IF 1.5 4区 医学
Canadian Journal of Urology Pub Date : 2023-08-01
Joaquin Fernandez-Alberti, Ramon Coronil, Alejandro Iotti, Alejandro Nolazco, Marcelo Featherston
{"title":"Calyceal diverticulum simulating a renal tumor.","authors":"Joaquin Fernandez-Alberti,&nbsp;Ramon Coronil,&nbsp;Alejandro Iotti,&nbsp;Alejandro Nolazco,&nbsp;Marcelo Featherston","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Calyceal diverticulum (CD) is a rare anatomic anomaly with an incidence of 0.2% to 0.6% in the patients undergoing renal imaging. They are considered benign lesions and malignancy is exceedingly rare. For diagnosis it is suggested to perform a multiphasic contrast-enhanced computed tomography (CT) evidencing a diverticulum of the pelvicalyceal system with thin-walled cavities communicating with the central collecting system. However, they can be usually mistaken as kidney cancers leading to unjustified nephrectomy. Here, we present a case of a 34-year-old patient who underwent surgery in 2022 due to suspected kidney cancer and histopathological analysis surprisingly reported a CD.</p>","PeriodicalId":56323,"journal":{"name":"Canadian Journal of Urology","volume":"30 4","pages":"11629-11632"},"PeriodicalIF":1.5,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10110552","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}
引用次数: 0
Proposal to decrease incidence, morbidity, and associated healthcare costs regarding difficult and traumatic urethral catheterization - a protocol for DMC hospitals: A pilot study. 降低困难和创伤性导尿的发生率、发病率和相关医疗费用的建议——DMC医院的方案:一项试点研究。
IF 1.5 4区 医学
Canadian Journal of Urology Pub Date : 2023-08-01
Jordan Sarver, Remington Farley, Shane Daugherty, Jordan Bilbrew, Joshua Palka
{"title":"Proposal to decrease incidence, morbidity, and associated healthcare costs regarding difficult and traumatic urethral catheterization - a protocol for DMC hospitals: A pilot study.","authors":"Jordan Sarver,&nbsp;Remington Farley,&nbsp;Shane Daugherty,&nbsp;Jordan Bilbrew,&nbsp;Joshua Palka","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Difficult and traumatic urethral catheterization is a common reason for urologic consult. Catheter insertion and management is common for patients who are managed in the hospital setting.</p><p><strong>Materials and methods: </strong>A four-question survey was distributed across three hospitals at a single-institution.</p><p><strong>Results: </strong>A total of 41 nursing staff responses were recorded. Forty-four percent of the nursing staff reported prior participation in a traumatic catheter insertion. Ninety percent of total responders reported a prior involvement with a difficulty catheter.</p><p><strong>Conclusion: </strong>Patient morbidity and healthcare costs regarding traumatic and difficult catheterization is significant. Utility of protocols and education could potentially reduce these burdens and enhance patient care.</p>","PeriodicalId":56323,"journal":{"name":"Canadian Journal of Urology","volume":"30 4","pages":"11624-11628"},"PeriodicalIF":1.5,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10110553","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}
引用次数: 0
Emergence of artificial generative intelligence and its potential impact on urology. 人工生成智能的出现及其对泌尿外科的潜在影响。
IF 1.5 4区 医学
Canadian Journal of Urology Pub Date : 2023-08-01
Mohamed Javid, Madhu Reddiboina, Mahendra Bhandari
{"title":"Emergence of artificial generative intelligence and its potential impact on urology.","authors":"Mohamed Javid,&nbsp;Madhu Reddiboina,&nbsp;Mahendra Bhandari","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial generative intelligence (AGI) and large language models (LLMs) have gained significant attention in healthcare and hold enormous promise for transforming every aspect of our life and urology is no exception.</p><p><strong>Materials and methods: </strong>We conducted a comprehensive literature search of electronic databases and included articles discussing AGI and LLMs in healthcare. Additionally, we have incorporated our experiences interacting with the ChatGPT and GPT-4 in different situations with real case reports and case constructs.</p><p><strong>Results: </strong>Our review highlights the potential applications and likely impact of these technologies in urology, for differential diagnosis, prioritizing treatment options, and facilitating research, surgeon, and patient education. At their current developmental stage, we have recognized the need for concurrent validation and continuous human interaction necessary to induce inverse reinforced learning with human feedback to mature them to authenticity. We need to consciously adjust to the hallucinations and guard patients' confidentiality before their extensive implementations in clinical practice. We propose possible remedies for these shortcomings and emphasize the critical role of human interaction in their evolution.</p><p><strong>Conclusion: </strong>The integration of these tools has the potential to revolutionize urology, but it also presents several challenges needing attention. To harness the full potential of these models, urologists must consistently engage in training these tools with their clinical sense and experience. We urge the urology community to actively participate in AGI and LLM development to address potential challenges. These models could help us in unleashing our full potential and help us achieve a better work-life balance.</p>","PeriodicalId":56323,"journal":{"name":"Canadian Journal of Urology","volume":"30 4","pages":"11588-11598"},"PeriodicalIF":1.5,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10105349","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}
引用次数: 0
How I Do It: Maintenance avelumab for advanced urothelial carcinoma 我怎么做:维持avelumab治疗晚期尿路上皮癌
IF 1.5 4区 医学
Canadian Journal of Urology Pub Date : 2023-08-01
Aly-Khan A Lalani
{"title":"How I Do It: Maintenance avelumab for advanced urothelial carcinoma","authors":"Aly-Khan A Lalani","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>For more than four decades, platinum-based chemotherapy regimens have served as the established standard-of-care for advanced urothelial carcinoma (aUC). However, advancements in our understanding of cancer biology and tumor microenvironment have reshaped the therapeutic landscape and prognosis of this incurable disease. Immune checkpoint inhibitors (ICIs) that target programmed cell death 1 (PD-1) and programmed cell death ligand 1 (PD-L1) are firmly established tools in aUC management, leading to enhanced life span and improved quality of life for patients. In patients who achieved stable disease or better following platinum-based chemotherapy, maintenance therapy with the PD-L1 antibody avelumab significantly enhanced overall survival (OS) by approximately 7 months compared to best supportive care in the phase 3 JAVELIN Bladder 100 trial. As a result, avelumab received FDA approval in June 2020 as a maintenance therapy for aUC patients treated with first-line platinum-based chemotherapy. Therefore, aUC care plans should incorporate maintenance avelumab into standard first-line treatment regimens for these patients. The objective of this brief article is to provide insight into the utilization of avelumab, identify patients who may benefit from this treatment, and review the methodology, advantages, potential side effects and their management.</p>","PeriodicalId":56323,"journal":{"name":"Canadian Journal of Urology","volume":"30 4","pages":"11633-11638"},"PeriodicalIF":1.5,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10532224","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}
引用次数: 0
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