CUA 2018: Holmium Laser-Assisted Endoscopic-Guided Retrograde Nephrostomy Access for Percutaneous Nephrolithotomy in Prone Split-leg Position

Halifax, Nova Scotia ( In modern clinical practice, obtaining percutaneous access during percutaneous nephrolithotomy (PCNL) remains a challenge for many urologists, thus requiring assistance from interventional radiologists to create antegrade access prior to the procedure. However, the retrograde approach has recently begun to gain favor in some clinical practices since the refinement of the technique with the Lawson puncture wire from Cook Medical.

CUA 2018: Comparing Laparoscopic Cytoreductive Nephrectomy to Open Surgery: A Large, Multicentre, Retrospective Analysis

Halifax, Nova Scotia ( Laparoscopic surgery is known to minimize perioperative morbidity and decrease the length of hospital admission, however, its benefit in cytoreductive nephrectomy continues to be a topic of debate. A previously published multi-center experience of laparoscopic cytoreductive nephrectomy found that among 120 patients, median operative time was 210 min, and median estimated blood loss was 150 cc1.

CUA 2018: Identifying the Spatio-Functional Origins of Drug Resistance with Rapid Tumour Xenografts

Halifax, Nova Scotia ( At the CUA 2018 annual meeting, Nicholas Power, MD from Western University discussed his team’s work identifying spatio-functional origins of drug resistance using rapid tumor xenograft models. Indeed, the treatment of patients with advanced cancers increasingly relies on expensive agents targeting specific molecular or cellular aberrations.

CUA 2018: Effects of a Changing Patient Population on Percutaneous Nephrolithotomy Outcomes

Halifax, Nova Scotia ( Percutaneous nephrolithotomy (PCNL) remains the treatment of choice for large kidney stones. According to current guidelines of both leading Urological organizations such American Urological Association as well as the European Association of Urology, PCNL is the gold standard for stones larger than 2cm. Due to complex nature of the procedure, there have been many modifications proposed to improve the outcomes of the procedure. These changes are thought to improve the surgical outcomes. In this regard, studies assessing the PCNL outcomes over time with different types of surgical techniques is of value for the current state of the literature.

CUA 2018: Disparity in Public Funding of Therapies for Metastatic Castrate-Resistant Prostate Cancer Across Canadian Provinces

Halifax, Nova Scotia ( Treatment using abiraterone acetate, enzalutamide, cabazitaxel, and radium-223 (Ra-223) has been demonstrated to improve overall survival and quality of life for patients with metastatic castrate-resistant prostate cancer (mCRPC).  Despite their proven benefits, access to these therapies varies across Canada.  The Genitourinary Research Consortium (GURC) is a national collaboration of physicians who treat advanced prostate cancer with common interests in research, education, and best practice.

CUA 2018: Educational Needs of Canadian Physicians in the Management of Advanced Prostate Cancer

Halifax, Nova Scotia ( Since 2010, the treatment landscape for metastatic castration-resistant prostate cancer (mCRPC) has rapidly evolved, with many new treatment options now available. As a result, the role of physicians is also changing, with many urologists and radiation oncologists now managing patients with mCRPC (treating patients with abiraterone, enzalutamide, Radium-223, etc), a role traditionally served by medical oncologists. Physician education is critical, given the increase of treatment options, earlier indications for therapy, and sequencing possibilities. At the CUA 2018 annual meeting, Alan So, MD, and colleagues presented results of their study investigating which educational topics are most critical to physicians treating patients with mCRPC. 

CUA 2018: Minimizing Ionizing Radiation Exposure During Retrograde Fluoroscopic Guided Ureteral Stent Insertion in the Pregnant Patient

Halifax, Nova Scotia ( Management of urolithiasis and establishing a definitive diagnosis during pregnancy poses a significant challenge to urologists. Symptomatic stone events are associated with preterm rupture of membranes, preterm labor, and mild pre-eclampsia. Ultrasonography is the 1st line imaging modality for the diagnosis of urolithiasis in pregnant patients. However, when intervention is required to resolve the renal colic, ultrasonography may be suboptimal and often fluoroscopy is used to navigate and guide the procedure.

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