Aspirin Use and Lethal Prostate Cancer in the Health Professionals Follow-up Study.

Background: Aspirin use probably protects against some malignancies but its effects on lethal prostate cancer (PC) are unclear.

Objective: To investigate the association between regular aspirin use and lethal PC.

Design, Setting, And Participants: Participants were aged 40-75 yr at baseline in 1986 and have been followed with biennial questionnaires.

Prostate cancer screening among family physicians in Ontario: An update on attitudes and current practice.

Introduction: This study serves as an update of prostate cancer screening practices among family physicians in Ontario, Canada. Since this population was first surveyed in 2010, the Canadian Task Force on Preventive Health Care (CTFPHC) and the United States Preventive Services Task Force (USPSTF) released recommendations against prostate cancer screening.

Methods: An online survey was developed through input from urologists and family practitioners.

High-intensity Focused Ultrasound (HIFU) as salvage therapy for radio-recurrent prostate cancer: predictors of disease response.

Background: Some men with localized radio-recurrent prostate cancer may benefit from salvage high-intensity focused ultrasound (HIFU). Herein, we describe oncologic outcomes and predictors of disease response after salvage whole gland HIFU from our prospective cohort.

Materials And Methods: Patients with localized radio-recurrent prostate cancer were prospectively enrolled from January 2005 to December 2014.

Management of pelvic fracture-associated urethral injuries: A survey of Canadian urologists.

Introduction: The management of pelvic fracture-associated urethral injuries (PFUI) is not standardized and optimal management is controversial. We surveyed Canadian urologists about their experiences and opinions regarding optimal management of PFUI.

Methods: Canadian urologists were surveyed via an anonymous, bilingual, web-based, 12-item questionnaire.

Pathologic correlation of transperineal in-bore 3-Tesla magnetic resonance imaging-guided prostate biopsy samples with radical prostatectomy specimen.

Purpose: To determine the accuracy of in-bore transperineal 3-Tesla (T) magnetic resonance (MR) imaging-guided prostate biopsies for predicting final Gleason grades in patients who subsequently underwent radical prostatectomy (RP).

Methods: A retrospective review of men who underwent transperineal MR imaging-guided prostate biopsy (tpMRGB) with subsequent radical prostatectomy within 1 year was conducted from 2010 to 2015. All patients underwent a baseline 3-T multiparametric MRI (mpMRI) with endorectal coil and were selected for biopsy based on MR findings of a suspicious prostate lesion and high degree of clinical suspicion for cancer.

Regular Aspirin Use and the Risk of Lethal Prostate Cancer in the Physicians' Health Study.

Background: Regular aspirin use probably protects against some malignancies including prostate cancer (PC), but its impact on lethal PC is particularly unclear.

Objective: To investigate the association between regular aspirin and (1) the risk of lethal PC in a large prospective cohort and (2) survival after PC diagnosis.

Design, Setting, And Participants: In 1981/82, the Physicians' Health Study randomized 22 071 healthy male physicians to aspirin, β-carotene, both, or placebo.

Data on Medicare eligibility and cancer screening utilization.

Health insurance is associated with increased utilization of cancer screening services. Data on breast, prostate and colorectal cancer screening were abstracted from the 2012 Behavioral Risk Factor and Surveillance System. This data in brief includes two sets of analyses: (i) the use of cancer screening in individuals within the low-income bracket and (ii) determinants for each of the three approaches to colorectal cancer screening (fecal occult blood test, colonoscopy and sigmoidoscopy+fecal occult blood test).

Impact of resident involvement in endoscopic bladder cancer surgery on pathological outcomes.

Objective: Transurethral resection of bladder tumor (TURBT) pathology specimens which lack muscle are associated with clinical upstaging and may necessitate repeat resections, potentially delaying curative treatment. This study evaluated whether resident involvement in TURBT is associated with suboptimal perioperative outcomes.

Materials And Methods: All TURBTs performed at a Canadian healthcare institution from November 2011 to June 2014 were reviewed.

Transurethral Resection of the Prostate Biopsy of Suspected Anterior Prostate Cancers Identified by Multiparametric Magnetic Resonance Imaging: A Pilot Study of a Novel Technique.

Objective: To describe a novel biopsy technique that involves performing a cognitively directed transurethral resection of the prostate (TURP) to diagnose suspected anterior prostate cancers (APCs) detected by multiparametric magnetic resonance imaging (mpMRI) in patients with prior negative transrectal ultrasound (TRUS)-guided biopsies.

Methods: This is a prospective study in which participants aged 50-75 were offered inclusion if they had an elevated prostate-specific antigen level, a lesion suspicious for APC on mpMRI, and at least one prior negative TRUS-guided prostate biopsy. Prostatic mpMRI was acquired with a 3-Tesla machine without endorectal coil.

The impact of Medicare eligibility on cancer screening behaviors.

Introduction: Lack of health insurance limits access to preventive services, including cancer screening. We examined the effects of Medicare eligibility on the appropriate use of cancer screening services in the United States.

Methods: We performed a cross-sectional analysis of the 2012 Behavioral Risk Factor and Surveillance System (analyzed in 2014).

Primary genitourinary melanoma: Epidemiology and disease-specific survival in a large population-based cohort.

Background: Primary genitourinary (GU) melanoma is a rare disease, which is poorly characterized.

Objective: To examine clinical characteristics and survival outcomes of primary GU melanoma among men and women.

Design, Setting, And Participants: Retrospective study using the Surveillance, Epidemiology, and End Results database (1973-2010) was used to identify primary GU melanoma cases by tumor site and histology codes.

Trends in utilisation, perioperative outcomes, and costs of nephroureterectomies in the management of upper tract urothelial carcinoma: a 10-year population-based analysis.

Objective: To perform a population-based study to evaluate contemporary utilisation trends, morbidity, and costs associated with nephroureterectomies (NUs), as contemporary data for NUs are largely derived from single academic institution series describing the experience of high-volume surgeons and it is unclear if the same favourable results occur at a national level.

Patients And Methods: Using the Premier Hospital Database, we captured patients undergoing a NU with diagnoses of renal pelvis or ureteric neoplasms from 2004 to 2013. We fitted regression models, adjusting for clustering by hospitals and survey weighting to evaluate 90-day postoperative complications, operating-room time (OT), prolonged length of stay (pLOS), and direct hospital costs among open (ONU), laparoscopic (LNU) and robotic (RNU) approaches.

The Contemporary Incidence and Sequelae of Rhabdomyolysis Following Extirpative Renal Surgery: A Population Based Analysis.

Purpose: We evaluate the contemporary incidence and consequences of postoperative rhabdomyolysis after extirpative renal surgery.

Materials And Methods: We conducted a population based, retrospective cohort study of patients who underwent extirpative renal surgery with a diagnosis of a renal mass or renal cell carcinoma in the United States between 2004 and 2013. Regression analysis was performed to evaluate 90-day mortality (Clavien grade V), nonfatal major complications (Clavien grade III-IV), hospital readmission rates, direct costs and length of stay.

Contemporary trends in high-dose interleukin-2 use for metastatic renal cell carcinoma in the United States.

Background: Targeted therapies (TTs) have revolutionized metastatic renal cell carcinoma (mRCC) treatment in the past decade, largely replacing immunotherapy including high-dose interleukin-2 (HD IL-2) therapy. We evaluated trends in HD IL-2 use for mRCC in the TT era.

Methods: Our cohort comprised a weighted estimate of all patients undergoing HD IL-2 treatment for mRCC from 2004 to 2012 using the Premier Hospital Database.

Contrast-enhanced Ultrasonography for Surveillance of Radiofrequency-ablated Renal Tumors: A Prospective, Radiologist-blinded Pilot Study.

Objective: To prospectively evaluate the performance of contrast-enhanced ultrasonography (CEUS) for surveillance after radiofrequency ablation (RFA) of small renal masses by comparing CEUS to the contrast-enhanced computed tomography (CECT), the current gold standard.

Patients And Methods: Patients underwent surveillance after RFA of small renal masses (≤4 cm) consisting of CECT scans at 3 and 6 months and every 6 months thereafter. Participants additionally underwent ≥1 CEUS within 90 days before CECT.

The Effect of Resident Involvement on Perioperative Outcomes in Transurethral Urologic Surgeries.

Objective: To conduct the first study of intra- and postoperative outcomes related to intraoperative resident involvement in transurethral resection procedures for benign prostatic hyperplasia and bladder cancer in a large, multi-institutional database.

Design: Relying on the American College of Surgeons National Surgical Quality Improvement Program Participant User Files (2005-2012), we abstracted all cases of endoscopic prostate surgery (EPS) for benign prostatic hyperplasia and transurethral resection of bladder tumors (TURBTs). Multivariable logistic regression models were constructed to assess the effect of trainee involvement (postgraduate year [PGY] 1-2: junior, PGY 3-4: senior, PGY ≥ 5: chief or fellow) vs attending only on operative time and length of hospital stay, as well as 30-day complication, reoperation, and readmission rates.

Pure laparoscopic unilateral nephrectomy for a patient with a polycystic horseshoe kidney.

A 45-year-old female patient with autosomal dominant polycystic kidney disease (ADPKD) and a horseshoe kidney underwent right laparoscopic nephrectomy. The indication for nephrectomy was to create space within the right iliac fossa for renal transplantation. The operation proceeded as routine for laparoscopic nephrectomy for ADPKD, but was uniquely challenging due to the large size and extensive vasculature of the polycystic horseshoe kidney.

The impact of method of distal ureter management during radical nephroureterectomy on tumour recurrence.

Introducton: Radical nephroureterectomy for upper tract urothelial carcinoma (UTUC) must include some form of distal ureter management to avoid high rates of tumour recurrence. It is uncertain which distal ureter management technique has the best oncologic outcomes. To determine which distal ureter management technique resulted in the lowest tumour recurrence rate, we analyzed a multi-institutional Canadian radical nephroureterectomy database.

Intermittent androgen deprivation therapy for prostate cancer: translating randomized controlled trials into clinical practice.

Introduction: Intermittent androgen deprivation therapy (IADT) for prostate cancer involves cycles of androgen deprivation therapy (ADT) with a period between cycles where testosterone is allowed to rise above castrate levels. A number of recent randomized controlled trials (RCTs) have compared survival and health-related quality-of-life (HRQOL) between IADT and continuous ADT (CADT). This review seeks to critically analyze these published trials for their relevance to clinical practice.

Defining a new testosterone threshold for medical castration: Results from a prospective cohort series.

Background: We seek to determine if testosterone levels below the accepted castration threshold (50 ng/dL) have an impact on time to progression to castrate-resistant prostate cancer (CRPC).

Methods: This is a prospective cohort series of patients undergoing androgen deprivation therapy (ADT) with luteinizing hormone-releasing hormone agonist or antagonist at a tertiary centre from 2006 to 2011. Serum testosterone level was assessed every 3 months.

Obesometric factors associated with increased skin-to-stone distances in renal stone patients.

Introduction: Obese patients are at increased risk for renal stones as well as treatment failures due to increased skin-to-stone distances (SSD) and harder stone compositions. We investigated the relationships between obesometric parameters (body mass index [BMI], body fat distribution and obesity-related hormone levels) with SSD and stone hardness.

Materials And Methods: We prospectively enrolled patients undergoing stone interventions at our institution.

A novel endoscopic treatment for ureteric remnant hemorrhage post laparoscopic radical nephrectomy.

Laparoscopic radical nephrectomy is commonly used to treat renal masses. Given the ubiquitous presence of this technique, rare complications are becoming more commonplace. It is thus essential that practicing urologists be aware of all possible complications as well as the novel management approaches that exist.