Subjects -> MEDICAL SCIENCES (Total: 8821 journals)
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    - SURGERY (412 journals)

UROLOGY, NEPHROLOGY AND ANDROLOGY (159 journals)                     

Showing 1 - 159 of 159 Journals sorted alphabetically
Acta Urológica Portuguesa     Open Access   (Followers: 1)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 3)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 1)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 11)
Advances in Urology     Open Access   (Followers: 13)
African Journal of Nephrology     Open Access  
African Journal of Urology     Open Access   (Followers: 7)
AJP Renal Physiology     Hybrid Journal   (Followers: 8)
Aktuelle Urologie     Hybrid Journal   (Followers: 4)
American Journal of Kidney Diseases     Hybrid Journal   (Followers: 42)
American Journal of Men's Health     Open Access   (Followers: 9)
American Journal of Nephrology     Full-text available via subscription   (Followers: 38)
Andrologia     Hybrid Journal   (Followers: 2)
Andrology     Hybrid Journal   (Followers: 4)
Andrology & Gynecology : Current Research     Hybrid Journal   (Followers: 4)
Andrology and Genital Surgery     Open Access   (Followers: 7)
Andrology-Open Access     Open Access  
Annales d'Urologie     Full-text available via subscription  
Arab Journal of Nephrology and Transplantation     Open Access   (Followers: 1)
Arab Journal of Urology     Open Access   (Followers: 7)
Archives of Clinical Nephrology     Open Access   (Followers: 2)
Archivio Italiano di Urologia e Andrologia     Open Access   (Followers: 1)
Archivos Españoles de Urología     Open Access  
Asian Journal of Andrology     Open Access   (Followers: 1)
Asian Journal of Urology     Open Access   (Followers: 3)
Bangladesh Journal of Urology     Open Access   (Followers: 5)
BANTAO Journal     Open Access  
Basic and Clinical Andrology     Open Access  
BJU International     Hybrid Journal   (Followers: 34)
BJUI Compass     Open Access   (Followers: 2)
BMC Nephrology     Open Access   (Followers: 11)
BMC Urology     Open Access   (Followers: 14)
Canadian Journal of Kidney Health and Disease     Open Access   (Followers: 8)
Canadian Urological Association Journal     Open Access   (Followers: 2)
Cancer Urology     Open Access   (Followers: 2)
Cardiorenal Medicine     Full-text available via subscription   (Followers: 1)
Case Reports in Nephrology     Open Access   (Followers: 5)
Case Reports in Nephrology and Dialysis     Open Access   (Followers: 9)
Case Reports in Urology     Open Access   (Followers: 12)
Clinical and Experimental Nephrology     Hybrid Journal   (Followers: 4)
Clinical Journal of the American Society of Nephrology     Full-text available via subscription   (Followers: 22)
Clinical Kidney Journal     Open Access   (Followers: 4)
Clinical Medicine Insights : Urology     Open Access   (Followers: 3)
Clinical Nephrology     Full-text available via subscription   (Followers: 8)
Clinical Nephrology and Urology Science     Open Access   (Followers: 6)
Clinical Queries: Nephrology     Hybrid Journal   (Followers: 1)
Cuadernos de Cirugía     Open Access   (Followers: 3)
Current Opinion in Nephrology & Hypertension     Hybrid Journal   (Followers: 10)
Current Opinion in Urology     Hybrid Journal   (Followers: 12)
Current Urology     Open Access   (Followers: 10)
Current Urology Reports     Hybrid Journal   (Followers: 5)
Der Nephrologe     Hybrid Journal  
Der Urologe     Hybrid Journal   (Followers: 1)
Diabetic Nephropathy     Open Access   (Followers: 1)
EMC - Urología     Full-text available via subscription  
Enfermería Nefrológica     Open Access   (Followers: 1)
European Urology     Full-text available via subscription   (Followers: 33)
European Urology Focus     Hybrid Journal   (Followers: 5)
European Urology Oncology     Hybrid Journal   (Followers: 1)
European Urology Open Science     Open Access   (Followers: 10)
Forum Nefrologiczne     Full-text available via subscription  
Geriatric Nephrology and Urology     Hybrid Journal   (Followers: 7)
Giornale di Clinica Nefrologica e Dialisi     Open Access  
Herald Urology     Open Access   (Followers: 2)
Hong Kong Journal of Nephrology     Open Access   (Followers: 3)
Human Andrology     Partially Free   (Followers: 2)
IJU Case Reports     Open Access  
Indian Journal of Nephrology     Open Access   (Followers: 2)
Indian Journal of Urology     Open Access   (Followers: 5)
International Brazilian Journal of Urology     Open Access   (Followers: 5)
International Journal of Nephrology     Open Access   (Followers: 2)
International Journal of Nephrology and Renovascular Disease     Open Access   (Followers: 2)
International Journal of Urology     Hybrid Journal   (Followers: 12)
International Urology and Nephrology     Hybrid Journal   (Followers: 7)
Jornal Brasileiro de Nefrologia     Open Access  
Journal für Urologie und Urogynäkologie/Österreich     Hybrid Journal  
Journal of Clinical Nephrology     Open Access   (Followers: 2)
Journal of Clinical Urology     Hybrid Journal   (Followers: 14)
Journal of Endoluminal Endourology     Open Access  
Journal of Endourology     Hybrid Journal   (Followers: 2)
Journal of Endourology Case Reports     Hybrid Journal  
Journal of Genital System & Disorders     Hybrid Journal   (Followers: 3)
Journal of Integrative Nephrology and Andrology     Open Access   (Followers: 2)
Journal of Kidney Cancer and VHL     Open Access  
Journal of Lower Genital Tract Disease     Hybrid Journal  
Journal of Nephrology     Hybrid Journal   (Followers: 4)
Journal of Nephrology Research     Open Access   (Followers: 3)
Journal of Pediatric Nephrology     Open Access   (Followers: 5)
Journal of Renal Care     Hybrid Journal   (Followers: 8)
Journal of Renal Nursing     Full-text available via subscription   (Followers: 12)
Journal of Renal Nutrition     Hybrid Journal   (Followers: 28)
Journal of Renal Nutrition and Metabolism     Open Access   (Followers: 1)
Journal of the American Society of Nephrology     Full-text available via subscription   (Followers: 31)
Journal of The Egyptian Society of Nephrology and Transplantation     Open Access  
Journal of Translational Neurosciences     Open Access  
Journal of Urology     Full-text available via subscription   (Followers: 46)
Journal of Urology & Nephrology     Open Access   (Followers: 2)
Kidney Disease and Transplantation     Open Access   (Followers: 4)
Kidney Diseases     Open Access   (Followers: 3)
Kidney International     Hybrid Journal   (Followers: 46)
Kidney International Reports     Open Access   (Followers: 3)
Kidney Medicine     Open Access  
Kidney Research Journal     Open Access   (Followers: 6)
Kidneys (Počki)     Open Access   (Followers: 1)
Nature Reviews Nephrology     Full-text available via subscription   (Followers: 22)
Nature Reviews Urology     Full-text available via subscription   (Followers: 13)
Nefrología (English Edition)     Open Access  
Nefrología (Madrid)     Open Access  
Nephro-Urology Monthly     Open Access   (Followers: 1)
Nephrology     Hybrid Journal   (Followers: 13)
Nephrology Dialysis Transplantation     Hybrid Journal   (Followers: 27)
Nephron     Hybrid Journal   (Followers: 4)
Nephron Clinical Practice     Full-text available via subscription   (Followers: 4)
Nephron Experimental Nephrology     Full-text available via subscription   (Followers: 4)
Nephron Extra     Open Access   (Followers: 1)
Nephron Physiology     Full-text available via subscription   (Followers: 4)
Neurourology and Urodynamics     Hybrid Journal   (Followers: 1)
OA Nephrology     Open Access   (Followers: 2)
Open Access Journal of Urology     Open Access   (Followers: 6)
Open Journal of Nephrology     Open Access   (Followers: 5)
Open Journal of Urology     Open Access   (Followers: 6)
Open Urology & Nephrology Journal     Open Access  
Pediatric Urology Case Reports     Open Access   (Followers: 7)
Portuguese Journal of Nephrology & Hypertension     Open Access   (Followers: 1)
Progrès en Urologie     Full-text available via subscription  
Progrès en Urologie - FMC     Full-text available via subscription  
Prostate Cancer and Prostatic Diseases     Hybrid Journal   (Followers: 6)
Renal Failure     Open Access   (Followers: 12)
Renal Replacement Therapy     Open Access   (Followers: 4)
Research and Reports in Urology     Open Access   (Followers: 4)
Revista de Nefrología, Diálisis y Trasplante     Open Access   (Followers: 1)
Revista Mexicana de Urología     Open Access   (Followers: 1)
Revista Urologia Colombiana     Open Access  
Saudi Journal of Kidney Diseases and Transplantation     Open Access   (Followers: 2)
Scandinavian Journal of Urology     Hybrid Journal   (Followers: 7)
Seminars in Nephrology     Hybrid Journal   (Followers: 11)
The Prostate     Hybrid Journal   (Followers: 8)
Therapeutic Advances in Urology     Open Access   (Followers: 4)
Trends in Urology & Men's Health     Partially Free   (Followers: 1)
Ukrainian Journal of Nephrology and Dialysis     Open Access   (Followers: 1)
Uro-News     Hybrid Journal   (Followers: 1)
Urolithiasis     Hybrid Journal   (Followers: 2)
Urologia Internationalis     Full-text available via subscription   (Followers: 2)
Urologia Journal     Hybrid Journal  
Urologic Clinics of North America     Full-text available via subscription   (Followers: 4)
Urologic Nursing     Full-text available via subscription   (Followers: 4)
Urologic Radiology     Hybrid Journal  
Urological Science     Open Access  
Urologicheskie Vedomosti     Open Access  
Urologie in der Praxis     Hybrid Journal  
Urologie Scan     Hybrid Journal  
Urology     Hybrid Journal   (Followers: 33)
Urology Annals     Open Access   (Followers: 4)
Urology Case Reports     Open Access   (Followers: 3)
Urology Practice     Full-text available via subscription   (Followers: 2)
Urology Times     Free   (Followers: 3)
Urology Video Journal     Open Access   (Followers: 1)
World Journal of Nephrology and Urology     Open Access   (Followers: 15)
World Journal of Urology     Hybrid Journal   (Followers: 11)


Similar Journals
Journal Cover
Canadian Urological Association Journal
Journal Prestige (SJR): 0.626
Citation Impact (citeScore): 1
Number of Followers: 2  

  This is an Open Access Journal Open Access journal
ISSN (Print) 1911-6470 - ISSN (Online) 1920-1214
Published by Canadian Urological Association Homepage  [1 journal]
  • La feuille d’automne, emportée par le vent…

    • Authors: Hassan Razvi
      PubDate: 2020-10-02
      DOI: 10.5489/cuaj.6959
      Issue No: Vol. 14, No. 10 (2020)
  • Building a Canadian Translational Bladder Cancer Research Network

    • Authors: Madhuri Koti, David M. Berman, D. Robert Siemens, Dirk Lange, Edwin Wang, Paul Toren, Bernhard J. Eigl, Céline Hardy, Robert Purves, Vincent Fradet, Yves Fradet, Jose Mansure, Wassim Kassouf, Peter C. Black
      Pages: 81
      Abstract: NA
      PubDate: 2020-10-02
      DOI: 10.5489/cuaj.6887
      Issue No: Vol. 14, No. 10 (2020)
  • Dalhousie University

    • Authors: Editor CUAJ
      PubDate: 2020-09-28
      DOI: 10.5489/cuaj.6977
      Issue No: Vol. 14, No. 10 (2020)
  • Determining generalizability of the Canadian Kidney Cancer information
           system (CKCis) to the entire Canadian kidney cancer population

    • Authors: Camilla Tajzler, Simon Tanguay, Ranjeeta Mallick, Beau Ahrens, Tina Luu Ly, Rodney H. Breau, Naveen S. Basappa, Anil Kapoor, Daniel Y.C. Heng, Frédéric Pouliot, Antonio Finelli, Luke T. Lavallee, Alan I. So, Darrel E. Drachenberg, Denis Soulieres, Georg Bjarnason, Patrick O. Richard, Ranjena Maloni, Nicholas E. Power, Michael Haan, Lori A. Wood
      Pages: 506
      Abstract: Introduction: The Canadian Kidney Cancer information system (CKCis) has prospectively collected data on patients with renal tumors since January 1, 2011 from 16 sites within 14 academic centers in six provinces. Canadian kidney cancer experts have used CKCis data to address several research questions. The goal of this study was to determine if the CKCis cohort is representative of the entire Canadian kidney cancer population, specifically regarding demographic and geographic distributions. Methods: The CKCis prospective cohort was analyzed up to December 31, 2018. Baseline demographics and tumor characteristics were analyzed, including location of patients’ residence at the time of CKCis entry. Geographic data is presented by province, rural vs. urban via postal code information (2nd digit=0) and by Canadian urban boundary files. To determine the proportion of renal cell carcinoma (RCC) patients that CKCis captures, CKCis accruals were compared to projected Canadian Cancer Society RCC incidence in 2016–2017 and the incidence from the 2016 Canadian Cancer Registry. To determine if the CKCis baseline data is representative, it was compared to registry data and other published data when registry data was not available. Results: This CKCis cohort includes 10 298 eligible patients: 66.6% male, median age 62.6 years; 14.6% had metastatic disease at the time of diagnosis and 70.4% had clear-cell carcinomas. The CKCis cohort captures about 1250 patients per year, which represents approximately 20% of the total kidney cancer incidence. The proportion of patients captured per province did vary from 13–43%. Rural patients make up 17% of patients, with some baseline differences between rural and urban patients. There appears to be no major differences between CKCis patient demographics and disease characteristics compared to national data sources. Canadian heat maps detailing patient location are presented. Conclusions: CKCis contains prospective data on >10 000 Canadian kidney cancer patients, making it a valuable resource for kidney cancer research. The baseline demographic and geographic data do appear to include a broad cross-section of patients and seem to be highly representative of the Canadian kidney cancer population. Moving forward, future projects will include determining if CKCis cancer outcomes are also representative of the entire Canadian kidney cancer population and studying variations across provinces and within rural vs. urban areas.
      PubDate: 2020-06-16
      DOI: 10.5489/cuaj.6716
      Issue No: Vol. 14, No. 10 (2020)
  • Clinical outcomes of glansectomy with split-thickness skin graft
           reconstruction for localized penile cancer

    • Authors: Ben B. Beech, David W. Chapman, Keith F. Rourke
      Pages: 6
      Abstract: Introduction: Penectomy as the traditional surgical treatment of penile cancer has substantial adverse functional and psychological impact. Glansectomy with split-thickness skin graft (STSG) reconstruction aims to provide curative resection while maximizing functional outcomes and minimizing psychological harm. We describe our outcomes of glansectomy with STSG reconstruction for penile cancer in a Canadian setting. Methods: We identified patients undergoing glansectomy with STSG genital reconstruction for squamous cell carcinoma of the penis from July 2006 to July 2019 at a single center. Patients undergoing glansectomy for reasons other than penile cancer were excluded. We collected clinical and pathological data, including patient demographics, 90-day complications, positive margin rate, local recurrence rate, disease-specific survival, and functional outcomes. Descriptive statistics were used to characterize our cohort and to examine outcomes. Results: Twelve men met study criteria with a median age of 62 years. Seven patients had failed prior treatment. The 90-day complication rate (Clavien >2) was 0% and graft take was excellent in all cases. The positive margins rate was 16.7% (n=2). Local recurrence occurred in two patients (16.7%), one of whom underwent a repeat organ-sparing surgery for salvage, while the other underwent radical penectomy for high-risk pathological features. Disease-free survival at a median followup of 14 months was 91.7% (11/12). Standing voiding and erectile function, as well as satisfactory cosmesis, were preserved in all patients. Conclusions: Glansectomy with STSG reconstruction is a safe and effective treatment for men with localized penile cancer with simultaneous preservation of cosmesis, as well as urinary and sexual function.
      PubDate: 2020-05-12
      DOI: 10.5489/cuaj.6277
      Issue No: Vol. 14, No. 10 (2020)
  • Quality of life, depression, and psychosocial mechanisms of suicide risk
           in prostate cancer

    • Authors: Dean A. Tripp, Valentina Mihajlovic, Katherine Fretz, Gagan Fervaha, Jason Izard, Rebecca Corby, D. Robert Siemens
      Pages: 92
      Abstract: Introduction: Prostate cancer (PCa) is the most common non-cutaneous cancer in men and is usually identified at a stage at which prolonged survival is expected. Therefore, strategies to address survivorship and promote well-being are crucial. This study’s aim was to better understand suicidal behavior in PCa patients by examining psychosocial mediators (i.e., depression, psychache, perceived burdensomeness [PB], thwarted belongingness [TB]) in the relationship between quality of life (PCa-QoL) and suicide risk. Methods: Four hundred and six men with PCa (Median age 69.35 years, standard deviation 7.79) completed an online survey on various psychosocial variables associated with suicide risk. A combined serial/parallel mediation model tested whether depression, in serial with both psychache and PB/TB, mediated the relationship between PCa-QoL and suicide risk. Results: Over 14% of participants’ self-reports indicated clinically significant suicide risk. Poorer PCa-QoL was related to greater depression, which was related to both greater psychache and PB/ TB, which was associated with greater suicide risk. The serial mediation effect of depression and psychache was significantly stronger than that of depression and PB/TB. PCa-QoL did not predict suicide risk through depression alone, showing that depressive symptoms affect suicide risk through psychache and PB/TB. Conclusions: Given the alarming estimate of individuals at risk for suicide in this study, clinicians should consider patients with poorer PCa-QoL and elevated depression for psychosocial referral or management. Psychache (i.e., psychological pain) and PB/TB (i.e., poor social fit) may be important targets for reducing suicide risk intervention beyond the impact of depression alone.
      PubDate: 2020-05-12
      DOI: 10.5489/cuaj.6310
      Issue No: Vol. 14, No. 10 (2020)
  • Perioperative complications and oncological outcomes following radical
           cystectomy among different racial groups: A long-term, single-center study

    • Authors: Alireza Ghoreifi, Anirban P. Mitra, Jie Cai, Gus Miranda, Siamak Daneshmand, Hooman Djaladat
      Pages: 8
      Abstract: Introduction: Current literature on perioperative and oncological outcomes following radical cystectomy among different racial groups is limited, especially among Hispanics and Asians. The objective of this study was to assess the impact of racial differences on perioperative and oncological outcomes in a large cohort of bladder cancer patients who underwent radical cystectomy. Methods: We retrospectively reviewed the records of 3293 patients who underwent radical cystectomy with curative intent at our institution between 1971 and 2017. Based on race, patients were categorized as Hispanic (n=190), Asian (n=145), African American (n=67), and Caucasian (n=2891). Baseline characteristics, pericystectomy complications, and oncological outcomes, including recurrence-free and overall survival, were compared between the racial groups. Results: Mean patient age was 68±10.6 years. Median followup was 10.28 years. Body masss index and American Society of Anesthesiologists scores were significantly higher in Hispanic and African American population, and smoking incidence was lower in Asian patients. Hispanics presented with significantly higher clinical stage and longer time interval from diagnosis to treatment (mean 85.5 vs. 75.4 days in Caucasians, p<0.001). Overall 90-day complication and readmission rates were higher in Hispanics (41.06% and 18.95%, respectively). Oncological outcomes, however, were comparable between different race groups. In multivariate analysis, pathological nodal status and lymphovascular invasion were independent predictors of oncological outcomes, but race was not. Conclusions: In this very large, ethnically diverse patient cohort who underwent radical cystectomy with curative intent, pericystectomy complications were more common in Hispanics; however, race was not an independent predictor of long-term oncological outcome.
      PubDate: 2020-05-12
      DOI: 10.5489/cuaj.6293
      Issue No: Vol. 14, No. 10 (2020)
  • Prostate cancer risk group is associated with other-cause mortality in men
           with localized prostate cancer

    • Authors: Rehana Rasul, Anne Golden, Michael A. Feuerstein
      Pages: 13
      Abstract: Introduction: Informed decision-making in localized prostate cancer must consider the natural history of the disease, risks of treatment, and the competing risks from other causes. Other-cause mortality has often been associated with comorbidity or treatment-related side effects. We aimed to examine the association between prostate cancer aggressiveness and other-cause mortality. Methods: Using the Surveillance, Epidemiology, and End Results (SEER)18 registries, patients diagnosed with localized prostate cancer between 2004 and 2015 were identified. Patients were categorized into low-, intermediate- and high-risk groups. Vital status, death due to prostate cancer, and death due to other causes were based on death certificate information. Survival analyses were performed to assess the association between prostate cancer risk group and mortality while adjusting for demographic variables, year of diagnosis, and initial therapy. Results: A total of 464 653 patients were identified with a median followup of 5.4 years. Cardiovascular disease was the most common cause of mortality during the study period. Compared to low-risk patients, intermediate- and high-risk patients had a higher risk of mortality from other cancers, cardiovascular disease, and other causes of death regardless of initial treatment. Men who underwent surgery as initial therapy had lower cumulative mortality rates compared to those with radiation as their initial therapy. Conclusions: Intermediate- and high-risk prostate cancers are associated with higher risk of other-cause mortality. This appears to be independent of treatment type and may not be solely explained by comorbidity status. Further studies controlling for comorbidity and treatment burden should be explored.
      PubDate: 2020-05-12
      DOI: 10.5489/cuaj.6324
      Issue No: Vol. 14, No. 10 (2020)
  • Knowledge and confidence level of Canadian urology residents toward
           biostatistics: A national survey

    • Authors: Félix Couture, David-Dan Nguyen, Naeem Bhojani, Jason Y. Lee, Patrick O. Richard
      Pages: 9
      Abstract: Introduction: Adequate knowledge of biostatistics is essential for healthcare providers to stay up to date with medical advances and maintain an evidence-based practice. However, training in clinical research in Canadian residency programs varies considerably. Our study aimed to determine Canadian urology trainees’ knowledge of biostatistics and interpretation of the scientific literature. Methods: We conducted a national survey of all Canadian urology residents and fellows, which assessed experiences with biostatistics, self-reported confidence with statistical questions, and knowledge of biostatistical concepts. Results: Out of 201 urology trainees, 74 (36.8%) responded to the survey. The majority of respondents disagreed or strongly disagreed with the fact that they had sufficient training in biostatistics in medical school (67.6%) or that their current knowledge was sufficient for the rest of their career (66.1%). If given the chance, 82.3% of respondents would like to learn more about biostatistics. About half of respondents were able to correctly identify ordinal variables (51.5%), discrete variables (52.9%), or interpret adjusted odds ratios (50.0%). Despite senior residents reporting more confidence on biostatistical questions, our results did not demonstrate significant differences in overall knowledge according to level of training or experience with biostatistics. Conclusions: Our results identified important knowledge gaps among current Canadian urology trainees. Most trainees do not believe they have sufficient training in biostatistics. Knowledge of basic statistical concepts was lower than expected and did not significantly differ according to level of training. Our results highlight the need for structured, dedicated training in biostatistics for urology trainees within the new Competence by Design teaching framework.
      PubDate: 2020-05-12
      DOI: 10.5489/cuaj.6495
      Issue No: Vol. 14, No. 10 (2020)
  • The intravesical injection of highly purified botulinum toxin for the
           treatment of neurogenic detrusor overactivity

    • Authors: Denise Asafu-Adjei, Alexander Small , Glen McWilliams, Giuseppe Galea, Doreen E. Chung, Jamie S. Pak
      Pages: 6
      Abstract: Introduction: We aimed to assess safety and efficacy of incobotulinumtoxinA for the treatment of neurogenic detrusor overactivity (NDO). Methods: We identified patients with NDO confirmed on urodynamics (UDS) and reported urgency incontinence (UI) in those who received intravesical incobotulinumtoxin A injection for neurogenic bladder between November 2013 and May 2017. Parameters studied were daytime frequency, daily incontinence episodes, daily pad use, clean intermittent catheterization (CIC) volumes, symptom scores (UDI6, IIQ7, PGII), and complications. Results: We examined 17 male patients who met inclusion criteria and underwent incobotulinumtoxinA injection. Mean age was 61.2±15.4 years. Fourteen patients (82%) were taking oral antimuscarinics prior to the incobotulinumtoxin A injection. There were improvements in the following parameters: average daily pads (4.5 to 3.3, p=0.465), daily urinary frequency (9.4 to 4.6, p=0.048), daily incontinent episodes (2.5 to 0.4, p=0.033), CIC volumes (400 to 550 mL, p=0.356), hours in between CIC (3.6 to 5.2, p=0.127), and the validated questionnaires UDI6 (30.6 to 7.4, p=0.543) and IIQ7 (52.4 to 6.8, p=0.029). There were no documented symptomatic urinary tract infections (UTIs) within 30 days of injection or reports of de novo urinary retention. Nine of 17 patients (53%) reported being dry at their first postoperative visit. Conclusions: In this preliminary pilot study of a small cohort of males with NDO and UI, significant improvements were seen following incobotulinumtoxinA injection in daily frequency, incontinence episodes, hours in between CIC, and quality of life. Larger-scale and long-term studies are required to confirm these results, but initial findings are promising for wider use of this formulation.
      PubDate: 2020-05-12
      DOI: 10.5489/cuaj.6182
      Issue No: Vol. 14, No. 10 (2020)
  • The algebra of clinic and telephone medicine

    • Authors: Michael Leveridge
      Pages: 296 - 7
      PubDate: 2020-10-02
      DOI: 10.5489/cuaj.6925
      Issue No: Vol. 14, No. 10 (2020)
  • The falling leaves, drift by the window…

    • Authors: Hassan Razvi
      Pages: 298 - 298
      PubDate: 2020-10-02
      DOI: 10.5489/cuaj.6924
      Issue No: Vol. 14, No. 10 (2020)
  • The history of cryosurgery in Canada: A tale of two cities

    • Authors: Joseph Chin, Brian Donnelly, Shiva Nair, Arnon Lavi
      Pages: 299 - 304
      Abstract: Although not commonly available in Canada, cryosurgery (cryoablation) for prostate cancer has been practiced in many countries. The field of cryoablation has evolved significantly over the past 30 years. Two prostate cryoablation programs were started in Canada in the early 1990s, in London, ON and Calgary, AB, focusing, respectively, on salvage therapy following radiation failure and primary local treatment. This article chronicles the development of the two programs and outlines the scientific and clinical contributions by investigators at the two centers.
      PubDate: 2020-06-16
      DOI: 10.5489/cuaj.6625
      Issue No: Vol. 14, No. 10 (2020)
  • Canadian Urological Association guideline on male urethral stricture

    • Authors: Keith F. Rourke, Blayne Welk, Ron Kodama, Greg Bailly, Tim Davies, Nancy Santesso, Philippe D. Violette
      Pages: 305 - 16
      Abstract: Urethral stricture is fundamentally a fibrosis of the urethral epithelial and associated corpus spongiosum, which in turn, causes obstruction of the urethral lumen. Patients with urethral stricture most commonly present with lower urinary tract symptoms, urinary retention or urinary tract infection but may also experience a broad spectrum of other signs and symptoms, including genitourinary pain, hematuria, abscess, ejaculatory dysfunction, or renal failure. When urethral stricture is initially suspected based on clinical assessment, cystoscopy is suggested as the modality that most accurately establishes the diagnosis. This recommendation is based on several factors, including the accuracy of cystoscopy, as well as its wide availability, lesser overall cost, and comfort of urologists with this technique. When recurrent urethral stricture is suspected, we suggest performing retrograde urethrography to further stage the length and location of the stricture or referring the patient to a physician with expertise in reconstructive urology. Ultimately, the treatment decision depends on several factors, including the type and acuity of patient symptoms, the presence of complications, prior interventions, and the overall impact of the urethral stricture on the patient’s quality of life. Endoscopic treatment, either as dilation or internal urethrotomy, is suggested rather than urethroplasty for the initial treatment of urethral stricture. This recommendation applies to men with undifferentiated urethral stricture and does not apply to trauma-related urethral injuries, penile urethral strictures (hypospadias, lichen sclerosus), or suspected urethral malignancy. In the setting of recurrent urethral stricture, urethroplasty is suggested rather than repeat endoscopic management but this may vary depending on patient preference and impact of the symptoms on the patient. The purpose of this guideline is to provide a practical summary outlining the diagnosis and treatment of urethral stricture in the Canadian setting.
      PubDate: 2020-06-17
      DOI: 10.5489/cuaj.6792
      Issue No: Vol. 14, No. 10 (2020)
  • A GRADE approach hits the mark in the new CUA male urethral stricture

    • Authors: R. Christopher Doiron
      Pages: 317 - 8
      PubDate: 2020-10-05
      DOI: 10.5489/cuaj.6940
      Issue No: Vol. 14, No. 10 (2020)
  • A prospective, multisite study analyzing the percentage of urological
           cases that can be completely managed by telemedicine

    • Authors: Bruno Turcotte, Sophie Paquet, Anne-Sophie Blais, Annie-Claude Blouin, Stéphane Bolduc, Michel Bureau, Yves Caumartin, Jonathan Cloutier, Marie-Pier Deschênes-Rompré, Thierry Dujardin, Yves Fradet, Louis Lacombe, Katherine Moore, Fannie Morin, Geneviève Nadeau, David Simonyan, Frédéric Soucy, Rabi Tiguert, Paul Toren, Michele Lodde, Frédéric Pouliot
      Pages: 319 - 21
      Abstract: Introduction: The COVID-19 pandemic has accelerated the development of telemedicine due to confinement measures. However, the percentage of outpatient urological cases that could be managed completely by telemedicine outside of the COVID-19 pandemic remains to be determined. We conducted a prospective, multisite study involving all urologists working in the region of Quebec City. Methods: During the first four weeks of the regional confinement, 18 pediatric and adult urologists were asked to determine, after each telemedicine appointment, if it translated into a complete (CCM), incomplete (ICM), or suboptimal case management (SCM, adequate only in the context of the pandemic). Results: A total of 1679 appointments representing all urological areas were registered. Overall, 67.6% (95% confidence interval [CI] 65.3; 69.8), 27.1% (25.0; 29.3), and 4.3% (3.5; 5.4) were reported as CCM, SCM, and ICM, respectively. The CCM ratio varied according to the reason for consultation, with cancer suspicion (52.9% [42.9; 62.8]) and pediatric reasons (38.0% [30.0; 46.6]) showing the lowest CCM percentages. CCM percentages also varied significantly based on the setting where it was performed, ranging from 61.1% (private clinic) to 86.8% (endourology and general hospital). Conclusions: We show that two-thirds of all urological outpatient cases could be completely managed by telemedicine outside of the pandemic. After the pandemic, it will be important to incorporate telemedicine as an alternative for a patient’s first or followup visit, especially those with geographical, pathological, and socioeconomic considerations.
      PubDate: 2020-10-02
      DOI: 10.5489/cuaj.6862
      Issue No: Vol. 14, No. 10 (2020)
  • Stakeholder perspectives and status of surgical simulation and skills
           training in Canadian urology residency program

    • Authors: Anjali M. Lobo, Steve Doucette, Andrea G. Lantz Powers
      Pages: 322 - 7
      Abstract: Introduction: With the shift to competency-based training, surgical skills lab training (SSLT) may become a mandatory part of Canadian urology residency programs (CURPs). This study aims to identify: 1) the status of SSLT in CURP; 2) stakeholder perspectives on the utility of SSLT; 3) barriers to developing and implementing SSLT; and 4) how to address these barriers. Methods: Surveys were developed and issued to three groups of stakeholders: 1) SSLT directors at all 13 CURPs (response rate 100%); 2) teaching faculty (response rate 33%); and 3) urology residents (response rate 24%). Surveys 2 and 3 were sent to 10 English CURPs. Results were collected through email and SurveyMonkey®. Results: Nine of 13 CURPs have a dedicated SSLT; 46% of CURP have 1–3 sessions per year, 8% have 5–7, and 30% >7. Most residents have independent lab access, but 80% do so less than once monthly. Over 90% of stakeholders find SSLT useful, of which high-fidelity models are most preferred (faculty rated 3.66/4, residents 3.18/4). Program directors (PDs) identified lack of protected faculty time, funding, and infrastructure as the top three barriers to SSLT implementation. Residents found lack of faculty time, protected academic time, and infrastructure as barriers. PDs viewed protecting faculty time and more funding as potential solutions, while residents suggested protected faculty and academic time, and after-hours lab access. Conclusions: Residents, faculty, and PDs in CURPs view SSLT as useful. Most CURPs have defined SSLT; programs without this have labs for resident use but are underused. To continue to develop and progress SSLT, more time, participation, and funding must be made available.
      PubDate: 2020-05-12
      DOI: 10.5489/cuaj.6286
      Issue No: Vol. 14, No. 10 (2020)
  • A continued need for simulation facilities, technologies, and resources in
           Canadian urology training

    • Authors: Elspeth M. McDougall
      Pages: 328 - 9
      PubDate: 2020-10-05
      DOI: 10.5489/cuaj.6923
      Issue No: Vol. 14, No. 10 (2020)
  • Systematic review and meta-analysis of trials evaluating the role of
           adjuvant radiation after radical prostatectomy for prostate cancer:
           Implications for early salvage

    • Authors: Bimal Bhindi, Soum D. Lokeshwar, Zachary Klaassen, Laurence Klotz, Christopher J.D. Wallis
      Pages: 330 - 6
      Abstract: Introduction: Recent reports suggest that early salvage radiation (esRT) is non-inferior to adjuvant radiation (aRT) for adverse pathological features at radical prostatectomy. However, aRT was accepted as a standard treatment primarily based on effects on biochemical progression-free survival (bPFS). In order to understand the merits of esRT, the objective was to reassess if aRT vs. observation is associated with improved overall survival (OS). Methods: A systematic review and meta-analysis of published randomized trials evaluating aRT was performed. The primary outcome was OS. Secondary outcomes were metastasis-free survival (MFS), loco-regional recurrence-free survival (RFS), bPFS, and adverse events. We performed a random-effects meta-analysis. Results: Four randomized trials including 2068 patients with a median followup of 8.7–12.6 years were identified. While all trials reported a bPFS benefit, only one reported an OS benefit. Upon meta-analysis, no significant OS benefit was detected with aRT vs. observation (hazard ratio [HR] 0.90, 95% confidence interval [CI] 0.61–1.33), although consistent bPFS (HR 0.47, 95% CI 0.41–0.54) and local-RFS (HR 0.54, 95% CI 0.39–0.73) benefits were noted. There is an uncertain MFS benefit with aRT (HR 0.79, 95% CI 0.62– 1.01), and the effect is largely driven by one trial with a notable risk of bias. There was also a risk of overtreatment, with 35–60% of patients being biochemical recurrence-free with observation alone. Adverse events risk was greater with aRT vs. observation. Conclusions: Although aRT vs. observation provides a bPFS benefit related to local control, there is no clear OS or MFS benefit, a greater risk of adverse events, and a risk of overtreatment. By extension, these data have implications for patient selection and counselling for esRT.
      PubDate: 2020-05-12
      DOI: 10.5489/cuaj.6440
      Issue No: Vol. 14, No. 10 (2020)
  • Partial vs. radical nephrectomy and the risk of all-cause mortality,
           cardiovascular, and nephrological outcomes

    • Authors: Rodney H. Breau, Anil Kapoor, Danielle M. Nash, Neal Rowe, Octav Cristea, Garson Chan, Stephanie N. Dixon, Eric McArthur, Camilla Tajzler, Ravi Kumar, Christopher Vinden, Jonathan Izawa, Amit X. Garg, Patrick P. Luke
      Pages: 337 - 45
      Abstract: Introduction: The study’s objective was to examine the effects of renal-preservation surgery on long-term mortality, cardiovascular outcomes, and renal-related outcomes. Methods: We performed a retrospective cohort study of all partial (n=575) and radical nephrectomies (n=882) for tumors ≤7 cm in diameter between 2002 and 2010 across three academic centers in Ontario, Canada. We linked records from provincial databases to assess patient characteristics and outcomes (median seven years’ followup using retrospective data). A weighted propensity score was used to reduce confounding. The primary outcome was allcause mortality. Secondary outcomes included hospitalization with major cardiovascular events, non-cancer related mortality, kidney cancer-related mortality, and dialysis. Results: Mean one-year postoperative estimated glomerular filtration rate (eGFR) was 71 mL/min/1.73 m2 in the partial group and 52 mL/min/1.73 m2 in the radical group. Partial nephrectomy was associated with a lower risk of all-cause mortality in the first five years after surgery (hazard ratio [HR] 0.42, 95% confidence interval [CI] 0.27–0.66), which did not extend beyond five years (HR 1.01, 95% CI 0.68–1.49). Kidney cancer-related mortality was lower in the partial compared to the radical group for the first four years after surgery (HR 0.16, 95% CI 0.04–0.72). There were no significant differences between the groups for cardiovascular outcomes or non-cancer-related deaths. Conclusions: Overall survival and cancer-specific survival was reduced in radical nephrectomy patients. However, despite reduced renal function in the radical nephrectomy group, noncancer- related death, cardiovascular events, and dialysis were not significantly different between groups. Long-term benefits of partial nephrectomy may be less than previously believed.
      PubDate: 2020-05-12
      DOI: 10.5489/cuaj.6436
      Issue No: Vol. 14, No. 10 (2020)
  • A Canadian approach to the regionalization of testis cancer: A review

    • Authors: Gregory J. Nason, Lori A. Wood, Robert A. Huddart, Peter Albers, Ricardo A. Rendon, Lawrence H. Einhorn, Craig R. Nichols, Christian Kollmannsberger, Lynn Anson-Cartwright, Joan Sweet, Padraig Warde, Michael A.S. Jewett, Peter Chung, Philippe L. Bedard, Aaron R. Hansen, Robert J. Hamilton
      Pages: 346 - 51
      Abstract: At the Canadian Testis Cancer Workshop, the rationale and feasibility of regionalization of testis cancer care were discussed. The two-day workshop involved urologists, medical and radiation oncologists, pathologists, radiologists, physician’s assistants, residents and fellows, and nurses, as well as patients and patient advocacy groups. This review summarizes the discussion and recommendations of one of the central topics of the workshop — the centralization of testis cancer in Canada. It was acknowledged that non-guideline-concordant care in testis cancer occurs frequently, in the range of 18–30%. The National Health Service in the U.K. stipulates various testis cancer care modalities be delivered through supraregional network. All cases are reviewed at a multidisciplinary team meeting and aspects of care can be delivered locally through the network. In Germany, no such network exists, but an insurance-supported online second opinion network was developed that currently achieves expert case review in over 30% of cases. There are clear benefits to regionalization in terms of survival, treatment morbidity, and cost. There was agreement at the workshop that a structured pathway for diagnosis and treatment of testis cancer patients is required. Regionalization may be challenging in Canada because of geography; independent administration of healthcare by each province; physicians fearing loss of autonomy and revenue; patient unwillingness to travel long distances from home; and the inability of the larger centers to handle the ensuing increase in volume. We feel the first step is to identify the key performance indicators and quality metrics to track the quality of care received. After identifying these metrics, implementation of a “networks of excellence” model, similar to that seen in sarcoma care in Ontario, could be effective, coupled with increased use of health technology, such as virtual clinics and telemedicine.
      PubDate: 2020-05-12
      DOI: 10.5489/cuaj.6268
      Issue No: Vol. 14, No. 10 (2020)
  • Urological issues in pregnancy: A review for urologists

    • Authors: Joshua White, Jesse Ory, Andrea G. Lantz Powers, Michael Ordon, Jamie Kroft, Ashley Cox
      Pages: 352 - 7
      Abstract: Urological issues in the pregnant patient present a unique clinical dilemma. These patients may be challenging to treat due to risks associated with medications and surgical procedures. This review aims to provide an update on the physiological changes and surgical risks in pregnancy. In addition, we review the approach for management of urolithiasis and urinary tract infections in pregnancy. Lastly, we highlight the importance of a multidisciplinary approach to placenta percreta, a condition not commonly addressed in urological education.
      PubDate: 2020-05-12
      DOI: 10.5489/cuaj.6526
      Issue No: Vol. 14, No. 10 (2020)
  • Resident exposure to open simple prostatectomy in the United Kingdom:
           Going, going, gone' (Re: National discrepancies in residency training
           of open simple prostatectomy for benign prostatic enlargement: Redefining
           our gold standard, CUAJ, June 2020)

    • Authors: Editor CUAJ
      Pages: 358 - 9
      Abstract: n/a
      PubDate: 2020-10-02
      DOI: 10.5489/cuaj.6794
      Issue No: Vol. 14, No. 10 (2020)
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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