Using active surveillance for Gleason 7 (3+4) prostate cancer: A narrative review
Can Urol Assoc J. 2023 Dec 21. doi: 10.5489/cuaj.8539. Online ahead of print.ABSTRACTThe interest in broadening the application of active surveillance (AS) has been increasing, encompassing patients who may not strictly adhere to the conventional criteria for low-risk prostate cancer (PCa), particularly those diagnosed with small-volume Gleason grade group 2 disease. Nonetheless, accurately identifying individuals with low-intermediate risk PCa who can safely undergo AS without facing disease progression remains a challenge.This review aims to delve into the progression of this evolving trend specifically within this cohor...
Source: Canadian Urological Association Journal - February 21, 2024 Category: Urology & Nephrology Authors: Rui Bernardino Rashid K Sayyid Ricardo Le ão Alexandre R Zlotta Theodorus van der Kwast Laurence Klotz Neil E Fleshner Source Type: research

Addressing controversial areas in the management of advanced prostate cancer in Canada: Areas of consensus and controversy from the third Canadian consensus forum
CONCLUSIONS: CCF3 identified consensus agreement and provides guidance on >30 practice scenarios related to management of PCa and nine areas of controversy, which represent opportunities for research and education to improve patient care. Consensus initiatives provide valuable guidance on areas of controversy as clinicians await high-level evidence.PMID:38381937 | DOI:10.5489/cuaj.8537 (Source: Canadian Urological Association Journal)
Source: Canadian Urological Association Journal - February 21, 2024 Category: Urology & Nephrology Authors: Fred Saad Sebastien J Hotte Krista Noonan Shawn Malone Christopher Morash Tamim Niazi Ricardo A Rendon Bobby Shayegan Naveen S Basappa Ilias Cagiannos Brita Danielson Guila Delouya Ricardo Fernandes Cristiano Ferrario Antonio Finelli Geoffrey T Gotto Robe Source Type: research

Impacts of the COVID-19 pandemic on diagnosis of renal cell carcinoma and disease stage at presentation
CONCLUSIONS: The first year following the COVID-19 pandemic saw an 11.1% increase in patients presenting with pT3 RCC. These findings are suggestive of a clinically significant stage migration, which paired with prolonged wait times for surgery, provide critical consideration in the urgency of diagnostic and treatment decisions for RCC in the immediate future.PMID:38381938 | DOI:10.5489/cuaj.8519 (Source: Canadian Urological Association Journal)
Source: Canadian Urological Association Journal - February 21, 2024 Category: Urology & Nephrology Authors: W C Ian Janes Mitchell G Fagan J Matthew Andrews David R Harvey Geoff M Warden Paul H Johnston Michael K Organ Source Type: research

Point-of-care-ultrasound for the assessment of post-renal transplant recipients
CONCLUSIONS: We introduced a novel and guideline-based POCUS curriculum that leveraged local ultrasound educators and found improved theoretical knowledge and skill confidence in our cohort of transplant physicians. This course will serve as the first step toward a validated competency-based training system for POCUS use in the immediate post-renal transplant setting, and likely will be incorporated into the training of the modern transplant physician.PMID:38381939 | DOI:10.5489/cuaj.8531 (Source: Canadian Urological Association Journal)
Source: Canadian Urological Association Journal - February 21, 2024 Category: Urology & Nephrology Authors: Michael Uy Cameron Lam Yanbo Guo Rahul Bansal Richard Hae Azim Gangji Christine Ribic Shahid Lambe Source Type: research

Inter-observer variance of examiner scoring in urology Objective Structured Clinical Examinations (OSCEs)
CONCLUSIONS: Given a specific clinical scenario in an OSCE exam, inter-rater reliability of scoring can be compromised on occasion. Care should be taken when high-stakes decisions about promotion are made based on OSCEs with limited standardization.PMID:38381940 | DOI:10.5489/cuaj.8571 (Source: Canadian Urological Association Journal)
Source: Canadian Urological Association Journal - February 21, 2024 Category: Urology & Nephrology Authors: Naji J Touma Charles A Paco Iain MacIntyre Source Type: research

Incidence and survival of secondary malignancies after external beam radiotherapy for prostate cancer in the Surveillance, Epidemiology, and End Results database
CONCLUSIONS: The risk of BCa and RCa is approximately twice as high for men undergoing EBRT for localized PCa compared to RP, but that risk is declining, likely reflecting advancements in radiation delivery. The development of secondary RCa or BCa does not confer an elevated risk of death compared to their primary counterparts.PMID:38381941 | DOI:10.5489/cuaj.8508 (Source: Canadian Urological Association Journal)
Source: Canadian Urological Association Journal - February 21, 2024 Category: Urology & Nephrology Authors: Melissa J Huynh Lawson Eng Long H Ngo Nicholas E Power Sophia C Kamran Theodore T Pierce Andrea C Lo Source Type: research

Comprehensive analysis of the performance of GPT-3.5 and GPT-4 on the American Urological Association self-assessment study program exams from 2012-2023
CONCLUSIONS: GPT-4 scored significantly higher than GPT-3.5 on the AUA SASP exams in overall performance, across all test years, and in various urology topic areas. This suggests improvement in evolving AI language models in answering clinical urology questions; however, certain aspects of medical knowledge and clinical reasoning remain challenging for AI language models.PMID:38381942 | DOI:10.5489/cuaj.8526 (Source: Canadian Urological Association Journal)
Source: Canadian Urological Association Journal - February 21, 2024 Category: Urology & Nephrology Authors: Ali Sherazi David Canes Source Type: research

Efficacy of GreenLight laser prostatectomy in urinary retention
CONCLUSIONS: GreenLight laser prostatectomy is an effective and durable treatment for UR with a high catheter-free rate and comparable outcomes when performed to manage LUTS.PMID:38381943 | DOI:10.5489/cuaj.8556 (Source: Canadian Urological Association Journal)
Source: Canadian Urological Association Journal - February 21, 2024 Category: Urology & Nephrology Authors: Anastasia MacDonald Moustafa Fathy Parsa Nikoufar Amr Hodhod Ruba Abdul Hadi Saud Alhelal Husain Alaradi Ahmed S Zakaria Walid Shahrour Hazem Elmansy Source Type: research

Examining the utility of routine perioperative hemoglobin monitoring in patients undergoing radical nephrectomy
CONCLUSIONS: In patients who have a reassuring POD1 Hgb value, with a drop of <15 g/L or an absolute value of >100 g/L, consideration can be made towards discontinuing routine Hgb testing in the absence of a clinical indication. Age, blood loss, and preoperative Hgb are factors that may affect a patient's overall risk of transfusion.PMID:38381923 | DOI:10.5489/cuaj.8603 (Source: Canadian Urological Association Journal)
Source: Canadian Urological Association Journal - February 21, 2024 Category: Urology & Nephrology Authors: Charlie J Gillis Ali Sherazi Ricardo A Rendon Gabriela Ilie Ross Mason Source Type: research

An in-depth analysis on the effects of body composition in patients receiving neoadjuvant chemotherapy for urothelial cell carcinoma
CONCLUSIONS: Based on our retrospective cohort study, NAC did not affect obesity and FMI, but there was a significant decrease in SMI. Sarcopenic obesity was associated with increased severity of NAC adverse events. As such, the presence of this factor may help predict tolerance of NAC.PMID:38381924 | DOI:10.5489/cuaj.8542 (Source: Canadian Urological Association Journal)
Source: Canadian Urological Association Journal - February 21, 2024 Category: Urology & Nephrology Authors: Landan MacDonald Ricardo A Rendon Myuran Thana Lori Wood Robyn MacFarlane David Bell Jon Duplisea Ross Mason Source Type: research

Analyzing the influence of expanding multispecialty adoption of robotic surgery on robotic urologic care: A decade-long assessment of two Canadian academic hospitals
CONCLUSIONS: Over the last decade, RAS access by specialty has increased at two Canadian academic centers due to growing multispecialty use. As there was a fixed, single-robotic system at each of the hospital centers, there was a substantial reduction in the number of RAS performed per surgeon over time, as well as a gradual increase in the SWT. The current low number of available robots and unsustainable funding resources may hinder universal patient access to RAS.PMID:38381925 | DOI:10.5489/cuaj.8524 (Source: Canadian Urological Association Journal)
Source: Canadian Urological Association Journal - February 21, 2024 Category: Urology & Nephrology Authors: Ahmed Ibrahim Imad Matta Ahmed S Zakaria Abdulghani Khogeer Nick Lee Tawfik Elseherbini David Dan Nguyen Nicholas J Corsi David Bouhadana Adel Arezki Anindyo Chakraborty Malek Meskawi Assaad Elhakim Kevin C Zorn Source Type: research

Outcomes after chronic isolated epididymal pain: A retrospective study
CONCLUSIONS: Chronic epididymal pain is a condition with limited data surrounding its management. Prior to referral, a large proportion of patients did not undergo any conservative treatment, and of those that did, there was limited response. For those who underwent surgical intervention, all were pain-free on followup, except three patients who underwent epididymectomy.PMID:38381926 | DOI:10.5489/cuaj.8701 (Source: Canadian Urological Association Journal)
Source: Canadian Urological Association Journal - February 21, 2024 Category: Urology & Nephrology Authors: David Chung Suvig Dua Dhiraj Bal Harliv Dhillon Premal Patel Source Type: research

Incidence and trends in the treatment of kidney stones in Canada: A population-based cohort study
CONCLUSIONS: Our study provides the first population-based data on the demographics of stone formers and treatment trends across Canada. There has been a 4.7% increase in kidney stone episodes over the study period. Those presenting to hospital or requiring intervention for a kidney stone are more likely to be male, age 41-65, and undergo URS.PMID:38381927 | DOI:10.5489/cuaj.8596 (Source: Canadian Urological Association Journal)
Source: Canadian Urological Association Journal - February 21, 2024 Category: Urology & Nephrology Authors: Michael Ordon Andrea Lantz Powers Ben H Chew Jason Y Lee Michael Kogon Sri Sivalingam Shubha De Naeem Bhojani Sero Andonian Source Type: research

Understanding the sleep-pain relationship in patients with interstitial cystitis/bladder pain syndrome
CONCLUSIONS: Findings suggest depressive symptoms and pain catastrophizing may be important psychosocial mechanisms in the sleep-to-pain relationship. These results help guide future sleep and pain research in IC/BPS and aid in developing and refining treatments.PMID:38381928 | DOI:10.5489/cuaj.8686 (Source: Canadian Urological Association Journal)
Source: Canadian Urological Association Journal - February 21, 2024 Category: Urology & Nephrology Authors: Alexandra A Kelly Krista Jones Olivia Pineau J Curtis Nickel Jessica Rose Robert Moldwin Christopher Doiron Claus Riedl Mauro Cervigni Jean Wyndaele Dean A Tripp Source Type: research

Micro cost-effectiveness analysis of standard vs. mini percutaneous nephrolithotomy: A single Canadian institution's experience
CONCLUSIONS: Despite higher upfront costs, mCPNL may represent a valid, cost-effective alternative to sPCNL for select stones due to clinical and economic benefits in Canadian institutions.PMID:38381929 | DOI:10.5489/cuaj.8679 (Source: Canadian Urological Association Journal)
Source: Canadian Urological Association Journal - February 21, 2024 Category: Urology & Nephrology Authors: Ahmed Shoeib Ailsa Gan James Watterson Brian Blew Nicholas R Paterson Source Type: research