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HOW I DO IT


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  • Robotic intracorporeal orthotopic neobladder in the supine Trendelenburg position: a stepwise approach

    Bhattu S. Amit, Ritch R. Chad, Jahromi Mona, Banerjee Indraneel, Gonzalgo L. Mark, MD Department of Urology, University of Miami Miller School of Medicine, Miami, Florida, USA

    Robotic radical cystectomy with urinary diversion has become increasingly utilized for the surgical management of bladder cancer. Orthotopic neobladder reconstruction is still performed worldwide primarily via an extracorporeal approach because of the difficulty associated with robotic intracorporeal reconstruction. The objective of this article is to demonstrate a stepwise approach for robotic intracorporeal neobladder in a standardized manner that adheres to the principles of open surgery.

    Keywords: robotics, intracorporeal, neobladder, supine, patient positioning, orthotopic, table motion,

    Aug 2021 (Vol. 28, Issue 4 , Page 10794)
  • How I Do It: Temporarily Implanted Nitinol Device (iTind)

    Elterman Dean, Gao Bruce, Zorn C. Kevin, Bhojani Naeem, Chughtai Bilal, MD Division of Urology, Department of Surgery, University of Toronto, Toronto, Ontario, Canada

    Benign prostatic hyperplasia is a common and progressive disease affecting aging men which has a significant impact on quality of life. The second-generation Temporarily Implanted Nitinol Device (iTind) is an FDA approved temporary prostatic urethral device which can be deployed using standard flexible cystoscopy without sedation or general anesthesia. The device is left in-situ for 5 to 7 days and is then entirely removed in the office, using an open-ended silicone catheter. Prospective, randomized data indicate that iTind has favorable functional and sexual patient outcomes. Readers will familiarize themselves with iTind, significant historical studies and the technique for deploying iTind using a flexible cystoscope in the office setting.

    Keywords: prostate, BPH, TMIST, iTind,

    Aug 2021 (Vol. 28, Issue 4 , Page 10788)
  • Using darolutamide in advanced prostate cancer: How I Do It

    Hamilton Joelle, MD Urology Centers of Alabama, Homewood, Alabama, USA

    Darolutamide is a nonsteroidal androgen inhibitor FDA approved for the treatment of castration-resistant non-metastatic prostate cancer (nmCRPC). After decades of offering androgen deprivation therapy (ADT) alone or first-generation androgen receptor blockers for patients whose PSA was rising despite castrate levels of testosterone, there are now three different treatment options to add to ADT. These include apalutamide approved in February 2018, enzalutamide FDA approved in June 2018, and darolutamide approved July 2019. Each of these androgen receptor pathway blockers, when added to ADT or surgical orchiectomy, prolongs metastasis-free-survival (MFS) and median survival (MS). This paper focuses on the use of the newest approved agent in this class, darololutmide.

    Keywords: prostate cancer, castrate-resistant, non-metastatic disease, antiandrogen, darolutamide,

    Jun 2021 (Vol. 28, Issue 3 , Page 10673)
  • How I Do It: PureWick female external catheter: a non-invasive urine management system for incontinent women

    Uhr Alex, Glick Lydia, Barron Suzanne, Zavodnick Jillian, Mark R. James, Shenot Patrick, Murphy Alana, MD Department of Urology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA

    Catheter associated urinary tract infections (CAUTIs) are common hospital-acquired infections and remain a significant medical and financial challenge to the healthcare system. Despite this risk, incontinent women may require prolonged catheterization to accurately monitor urine output and prevent skin breakdown. The PureWick Female External Urinary Catheter is a promising non-invasive urine collection system for use in incontinent women that may help reduce CAUTI rates, maintain skin integrity, accurately quantify urine output, and avoid extra healthcare costs.

    Keywords: urinary incontinence, catheter associated UTI (CAUTI), female external collection device,

    Jun 2021 (Vol. 28, Issue 3 , Page 10669)
  • How I Do It: The pudendal nerve block for pediatric ambulatory urologic surgery

    Okoro Chinonyerem, Cannon Shannon, Low Daniel, Lendvay S. Thomas, MD Department of Urology, University of Washington Medical Center, Seattle, WA

    Regional analgesia is an important adjunct for perioperative pain management in the setting of pediatric penile surgeries. Caudal epidural analgesia (CEA) is the most common analgesic technique performed, but it has limitations and associated morbidity. The pudendal nerve block (PNB) is an effective alternative to CEA with a lower risk profile; in prior examination of the approach, PNB has been demonstrated to have similar postoperative pain control outcomes. We describe our technique and highlight observations made as we have transitioned from CEA to PNB for many patients.

    Keywords: pudendal nerve block, regional anesthesia, pediatric urology, pain management,

    Apr 2021 (Vol. 28, Issue 2 , Page 10648)
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Current Issue

August 2021, Vol.28 No.4
canadian journal of urology