CUA 2018: Routine Complete Blood Count has Limited Value Post-Percutaneous Nephrolithotomy in Identifying Hemorrhagic or Infectious Complications
Halifax, Nova Scotia (UroToday.com) At the beginning of his talk, Tad Kroczak, MD, a urology fellow at the University of Toronto, gave a brief background to the percutaneous nephrolithotomy (PCNL) procedure by explaining how complication rates are usually quite low at high volume centers. Similarly, he did mention that hemorrhage and sepsis rates are typically < 5%. Additionally, Dr. Kroczak mentioned that post-operative bloodwork including a complete blood count (CBC) is routinely performed in the early post-operative period at most centers during the routine overnight admission. Due to the low prevalence of any complications following PCNL, a postoperative CBC test may represent a low-value care practice without much benefit. Dr. Kroczak set out in order to test this question and determine the validity of this procedure.
CUA 2018: Renal Cell Carcinoma in the Canadian Indigenous Population
Halifax, Nova Scotia (UroToday.com) Previous studies have demonstrated that kidney cancer incidence rates are 37% higher in native Alaskan/American native (NA/AN) men and 56% higher in NA/AN women than in European Americans1. Furthermore, for European Americans, the kidney cancer mortality rate declined from 1990 to 2009, however it did not change for NA/ANs, who had a significantly higher rate than European Americans (likelihood of death from kidney cancer was almost twice as high). Similar studies have not been performed in Canada. Whether the diagnosis and treatment of renal cell carcinoma (RCC) in Indigenous Canadians are different than non-Indigenous Canadians is unknown.
CUA 2018: Comparing Outcomes of Second Line Axitinib or Everolimus in Metastatic Renal Cell Carcinoma Patients: Results From the Canadian Kidney Cancer Information System
Halifax, Nova Scotia (UroToday.com) Over the last several years, we have seen a multitude of systemic therapy agents introduced in both the first and second line setting for the treatment of metastatic renal cell carcinoma (mRCC). In Canada, second-line treatment of mRCC (after-first-line vascular endothelial growth factor-targeted therapy [VEGF-TT]) includes everolimus, axitinib, and nivolumab. Prior to July 2017, the pan-Canadian Oncology Drug Review indicated that axitinib could only be used if a patient had an intolerance or a contraindication to everolimus. At the CUA 2018 annual meeting, Naveen S. Basappa, MD, and colleagues presented results comparing outcomes of second-line axitinib to everolimus for mRCC.
CUA 2018: Ureteral Stent Versus no Ureteral Stent for Ureteroscopy in the Management of Renal and Ureteral Calculi: A Cochrane Review
Halifax, Nova Scotia (UroToday.com) Urolithiasis is one of the most common urologic diseases with an increasing prevalence in United States and Worldwide. According to recent data, approximately 8% and 10% women and men have urolithiasis in the United States, respectively. With stone being so common, there are treatment modalities that are being developed for effective surgical management. With advancement of surgical endoscopic technology, ureteroscopy (URS) is being used more frequently in the management of amenable stones less than 2cm in size.
CUA 2018: State-of-the-Art Lecture: The Opioid Epidemic and Sexual Dysfunction: Current Challenges and a Future Roadmap for the Practicing Clinician
Halifax, Nova Scotia (UroToday.com) Hossein Sadeghi-Nejad, MD from Rutgers University, gave an extremely important lecture on the reality of North America’s opioid epidemic. He began by instructing the audience that as clinical practitioners, every physician has an innate responsibility to attempt to do a patient right. Very often as it seems, pain medications can easily be misused which lead to much more dangerous and deadly drugs.
CUA 2018: Robotic vs. Open Prostatectomy: A Real-World, Single-Centre Canadian Experience
Halifax, Nova Scotia (UroToday.com) Current data demonstrate similar outcomes in robotic and open radical prostatectomies (RP. However, there is still a debate surrounding the benefits of robotic vs. RP. The authors presented a study aiming to compare real-world perioperative outcomes of both modalities at a large Canadian academic center.
CUA 2018: Factors Associated with Usage of Bone-Targeted Therapies in Metastatic Castration-Resistant Prostate Cancer
Halifax, Nova Scotia (UroToday.com) Metastatic castration-resistant prostate cancer (mCRPC) is the last phase of prostate cancer (PC). Bone metastasis occur in over 85% of men with MCRPC patients. Bone-targeted therapies are prescribed for the prevention of skeletal-related events occurring secondary to bone metastasis. These include Zoledronic acid, which is a bisphosphonate and given intravenously every 4 weeks, and Denosumab, which is a receptor activator of nuclear factor kappa B ligand (RANKL) inhibitor, and given subcutaneously every 4 weeks.