The Canadian Journal Of Urology[JOURNAL]
Sun
200 papers
The new gold standard for surgical management of BPH: an institutional experience with 1000 HoLEPs.
Shah YB, Im BH, Hochberg AR … +5 more , Freudenburg EP, Jiang J, Gao BM, Shah MS, Das AK
Can J Urol · 2025 Mar · PMID 40194931 · Publisher ↗
INTRODUCTION: Holmium Laser Enucleation of the Prostate (HoLEP) is a size-independent, endoscopic management option for benign prostatic hyperplasia (BPH). HoLEP offers a distinct advantage for patients who are at high-r...
INTRODUCTION: Holmium Laser Enucleation of the Prostate (HoLEP) is a size-independent, endoscopic management option for benign prostatic hyperplasia (BPH). HoLEP offers a distinct advantage for patients who are at high-risk for bleeding whilst preserving prostatic tissue for pathology analysis, unlike photoselective vaporization. Further, HoLEP avoids the need for cystotomy, unlike simple open and robotic prostatectomy, by using intravesical morcellation. We report our experience with the first 1000 HoLEP procedures at our institution. MATERIALS AND METHODS: We performed a retrospective review of all HoLEP procedures performed at our institution from 2013-2021 to capture patient demographics, procedure details, and outcomes. Unpaired two sample t-tests were used to compare outcomes, p < 0.05 considered statistically significant. RESULTS: The average patient age and BMI were 71.1 y (±8.1 y) and 27.9 kg/m (±4.9 kg/m), respectively. 69.4% of patients were on an alpha blocker and 33.3% of patients were on a 5-alpha reductase inhibitor preoperatively. 11.2% of cases were redo outlet procedures including after prior Urolift®. Average prostate volume was 108.0 mL (±66.5 mL) and average enucleation time was 119.7 min (±56 min). On average, 65 g (±53.2 g) prostate tissue was resected. Pre-operative and post-operative flow, post-void residual (PVR), AUA symptom score (AUA-SS), and quality of life (QoL) score showed notable improvement. Complication rates remained low, with the most common including blood transfusion (2.8%), urethral stricture (1.9%), and persistent stress urinary incontinence (1.3%). CONCLUSIONS: HoLEP is emerging as the new surgical gold standard for BPH. A steep learning curve remains for urologists. Nonetheless, this procedure holds great promise in improving patient experiences with BPH.
A practical approach to the difficult urethral catheterization for urology trainees.
MacNevin W, Keefe DT, Milford K … +1 more , Paterson NR
Can J Urol · 2025 Mar · PMID 40194930 · Publisher ↗
Urethral catheterization is an important skill to develop as consultations for "difficult catheterization" are common in practice. Developing a broad approach to difficult urethral catheterization is crucial to improve t...
Urethral catheterization is an important skill to develop as consultations for "difficult catheterization" are common in practice. Developing a broad approach to difficult urethral catheterization is crucial to improve trainee success rates. Strategies and techniques to improve catheterization success are often passed down and shared between trainees without formal documentation or dissemination of techniques. Herein, we present a framework for difficult urethral catheterization based on clinical history and patient examination, while also providing additional techniques and troubleshooting to overcome common challenges with urethral catheterization in adult and pediatric patients.
Robotic-assisted laparoscopic pyelolithotomy in a horseshoe kidney.
Aron S, Galvez A, Nasseri R … +2 more , Berrios S, Sheetz T
Can J Urol · 2024 Dec · PMID 39675040
Nephrolithiasis is one of the most common indications for surgery in patients with a horseshoe kidney. Robotic-assisted surgery has become a staple in urologic practice, yet its application in stone management is largely...
Nephrolithiasis is one of the most common indications for surgery in patients with a horseshoe kidney. Robotic-assisted surgery has become a staple in urologic practice, yet its application in stone management is largely undefined. We present a patient with a horseshoe kidney, who underwent a robotic-assisted laparoscopic pyelolithotomy (RPL) to treat a 3 cm stone burden. This procedure allowed for safe access that could not be obtained with percutaneous nephrolithotomy (PCNL) and stone removal without fragmentation, which would have been challenging with traditional laparoscopy. We advocate for the use of robotic-assisted laparoscopic pyelolithotomy in cases of aberrant anatomy complicating a heavy stone burden.
Single-port robotic laparoscopic ureterocalicostomy: surgical technique and clinical outcomes.
Xu AJ, Lin JS, Chen PY … +3 more , Carbunaru S, Lee YS, Zhao LC
Can J Urol · 2024 Dec · PMID 39675039
INTRODUCTION: We describe a method of robotic ureterocalicostomy (RALUC) with the Da Vinci Single Port (SP) platform and present clinical outcomes in our cohort of patients. MATERIALS AND METHODS: We retrospectively revi...
INTRODUCTION: We describe a method of robotic ureterocalicostomy (RALUC) with the Da Vinci Single Port (SP) platform and present clinical outcomes in our cohort of patients. MATERIALS AND METHODS: We retrospectively reviewed all patients undergoing RALUC with the SP platform in a single-institution, IRB-approved database between 2020-2023. Demographics, preoperative, intraoperative, and postoperative outcomes were collated. Surgical success was defined as freedom from hardware, avoidance of additional surgical reconstruction, and no obstruction on follow up imaging/ureteroscopy. An incision is made 1/3rd the distance from anterior superior iliac spine to the umbilicus. The retroperitoneal space is entered and SP Access Port is placed. The psoas is identified and concomitant ureteroscopy is used to identify the ureter. The ureter is dissected to the most proximal aspect and transected. The remaining proximal ureteral stump is suture ligated. The lower pole parenchyma is removed to access the calyx. Absorbable barbed suture is used to control parenchymal bleeding and evert the mucosal edge of the calyx. Barbed suture is then used for the ureterocaliceal anastomosis over a ureteral stent. RESULTS: Six patients underwent RALUC. Retroperitoneal approach was used for 5/6 cases. Prior ureteral surgery had been performed in 4/6 patients. Fifty percent of cases included an additional procedure with a median operative time of 248 minutes. One patient required nephrostomy tube placement postoperatively. Median follow up was 10.35 months with surgical success rate of 67%. CONCLUSIONS: SP RALUC is a safe and feasible option for proximal ureteral reconstruction in patients with unfavorable upper urinary tract anatomy or in salvage cases.
Clinical implications of tumor laterality in renal cell carcinoma.
Grassauer J, Chou WH, Geduldig A … +2 more , Schmidt J, Chakiryan NH
Can J Urol · 2024 Dec · PMID 39675038
INTRODUCTION: It is unclear whether laterality has prognostic implications for patients with renal cell carcinoma (RCC). Some suggest that left sided tumors may have worse survival outcomes. The purpose of this study is...
INTRODUCTION: It is unclear whether laterality has prognostic implications for patients with renal cell carcinoma (RCC). Some suggest that left sided tumors may have worse survival outcomes. The purpose of this study is to associate tumor characteristics and clinical outcomes with laterality in patients with RCC. MATERIALS AND METHODS: Patients with RCC were identified in the National Cancer Database between 2004-2020. Patients were categorized as having either localized, regional or metastatic disease. Time-series charts were generated to demonstrate laterality differences and variance over time. Multivariable Cox proportional hazards regression was utilized to associate laterality with overall survival, stratified by clinical stage. Kaplan-Meier estimates were utilized to visualize survival functions. RESULTS: A total of 306,196 patients were included, 156,450 (51.1%) had right sided tumors and 283,282 (92.5%) had localized RCC. Localized tumors were more likely to be right sided (0.51 [95% CI 0.50-0.52], p < 0.001). Metastatic and regional tumors (cN+M0) were more likely to be left sided (0.48 [0.47-0.49], p < 0.001; and 0.43 [0.41-0.45], p < 0.001; respectively). For localized disease, smaller tumors were more likely to be right sided (< 2 cm: 0.52 [0.51-0.52], p < 0.001), while tumors > 7cm showed no significant site association (0.49 [0.49-0.50], p = 0.07). When stratified by staging, there were no significant associations between laterality and OS (localized RCC: HR 1.01 [0.99-1.02], p = 0.50; metastatic RCC: 1.03 [1.00-1.07], p = 0.7; cN+M0 RCC: 0.96 [0.86-1.07], p = 0.50). CONCLUSIONS: Left-sided RCC tumors are associated with larger tumor size and a higher propensity for regional nodal involvement and distant metastases. However, they do not demonstrate more aggressive behavior leading to meaningful survival differences.
Measuring the efficacy of Serenoa repens (USPlus) extract with mobile uroflowmetry.
Winograd J, Lama J, Codelia-Anjum A … +7 more , Bhojani N, Elterman DS, Zorn KC, Margolis E, Brahmbhatt J, Gonzalez R, Chughtai B
Can J Urol · 2024 Dec · PMID 39675037
INTRODUCTION: Benign prostatic hyperplasia (BPH) is a prevalent condition affecting a significant portion of the male population, leading to secondary lower urinary tract symptoms (LUTS). Alternative therapies such as ph...
INTRODUCTION: Benign prostatic hyperplasia (BPH) is a prevalent condition affecting a significant portion of the male population, leading to secondary lower urinary tract symptoms (LUTS). Alternative therapies such as phytotherapy using Lipidosterolic extract of Serenoa repens (LSESR USPlus) are commonly used. However, the efficacy of LSESr remains controversial due to conflicting data. We sought to determine the effect of a standardized USP-verified Saw Palmetto extract on male LUTS secondary to BPH. MATERIALS AND METHODS: In this prospective single-arm trial, we investigated the efficacy of a standardized USP-verified Saw Palmetto extract in treating male LUTS secondary to BPH. We utilized the ProudP mobile application for home uroflowmetry and symptom assessment. RESULTS: Results from 46 patients using 320 mg daily of USP-verified Saw Palmetto extract revealed significant improvements in IPSS and QoL scores at 12 weeks compared to baseline, particularly in patients with moderate symptoms. Uroflowmetry parameters also improved with increased flow rates, primarily in patients with mild symptoms. CONCLUSION: Our findings support the efficacy of USP-verified Saw Palmetto extract in alleviating LUTS in men with BPH. Further studies are warranted in larger, diverse cohorts over longer follow up periods.
Hypogonadism, frailty, and postoperative outcomes among men undergoing partial nephrectomy.
Lazarovich A, Greenberg DR, Rhodes SP … +6 more , Bhambhvani HP, Gago LC, Patel HD, Brannigan RE, Shoag JE, Halpern JA
Can J Urol · 2024 Dec · PMID 39675036
INTRODUCTION: To determine the prevalence of hypogonadism in men undergoing partial nephrectomy (PN) and whether hypogonadism and frailty are associated with adverse postoperative outcomes. MATERIALS AND METHODS: We iden...
INTRODUCTION: To determine the prevalence of hypogonadism in men undergoing partial nephrectomy (PN) and whether hypogonadism and frailty are associated with adverse postoperative outcomes. MATERIALS AND METHODS: We identified men undergoing PN between 2012-2021 using the Merative Marketscan database. Patients were considered to have hypogonadism if diagnosed within 5 years prior to PN. Frailty was determined using the Hospital Frailty Risk Score (HFRS). Length of stay (LOS), complications, ED visits, and inpatient readmissions were compared. Sub-group analysis of men with hypogonadism was performed to determine if testosterone replacement therapy (TRT) improved clinical outcomes. RESULTS: Among 9,105 men who underwent PN, 809 (8.9%) were hypogonadal prior to PN. Hypogonadal men were significantly more frail compared to eugonadal men (HFRS score: median 6.7, IQR 4.1-10.1 vs. median 5.6, IQR 3.3-8.8, p < 0.001). However, there was no significant difference in LOS following PN nor in 90-day postoperative complications, ED visits, or inpatient readmission between men with and without hypogonadism. However, intermediate- and high-risk frailty were associated with increased risk of 90-day ED visits and 90-day inpatient readmission compared to low-risk patients. Among high-risk men with hypogonadism, TRT was associated with decreased risk of 90-day ED visits (p = 0.04). CONCLUSIONS: Frailty was associated with postoperative outcomes following PN. Hypogonadism was associated with frailty, and treatment of hypogonadal men with TRT was associated with reduction in post-operative risk. These findings suggest a role for frailty assessment, and possibly testosterone screening, in men undergoing PN.
Illuminating the use of photodynamic therapy in urologic oncology.
Yankelevich GR, Moreland K, Swancutt MM … +1 more , Grubb RL
Can J Urol · 2024 Dec · PMID 39675035
INTRODUCTION: We report the first scoping review of the clinical urologic literature for photodynamic therapy (PDT) among multiple urologic malignancies. MATERIALS AND METHODS: A scoping review using Medline and Embase w...
INTRODUCTION: We report the first scoping review of the clinical urologic literature for photodynamic therapy (PDT) among multiple urologic malignancies. MATERIALS AND METHODS: A scoping review using Medline and Embase was performed for treatment of urologic malignancies with PDT. RESULTS: There were 84 papers included with the majority involving bladder and prostate cancer. Upper tract urothelial cancer (UTUC) only comprised three publications and there was no clinical data for renal or testicular cancer. Utilizing PDT in prostate cancer led to a negative biopsy rate of 30%-100%. Bladder cancer treatment with PDT had a 3-month complete response rate of 31.5%-100%. UTUC management with PDT reported at least 50% complete response rate. CONCLUSIONS: Ultimately, PDT has been established as a safe and effective treatment for urologic malignancies and we provide the first comprehensive review of the literature regarding the utility of this treatment modality.
Legends in Urology v31I06.
Montorsi F
Can J Urol · 2024 Dec · PMID 39675034
Abstract loading — click title to view on PubMed.
My Morning Commute and the Impact of Urology.
Gomella LG
Can J Urol · 2024 Dec · PMID 39675033
Abstract loading — click title to view on PubMed.
Rapid onset severe hyperkalemia during robotic radical cystectomy: a case report.
Buell M, Hu B
Can J Urol · 2024 Oct · PMID 39462535
Radical cystectomy is a preferred treatment for muscle-invasive bladder cancer. Despite known complications, rapid onset, severe hyperkalemia necessitating abortion of surgery has not been reported. In this case report...
Radical cystectomy is a preferred treatment for muscle-invasive bladder cancer. Despite known complications, rapid onset, severe hyperkalemia necessitating abortion of surgery has not been reported. In this case report, a patient with end stage renal disease (ESRD) undergoing attempted cystectomy developed severe intraoperative hyperkalemia and acidosis that led to abortion of surgery and transfer to the medical intensive care unit for emergent hemodialysis. The multifactorial etiology was related to respiratory acidosis, ESRD, patient positioning, clipping of ureters, and body habitus, as well as an idiopathic element. Knowledge of hyperkalemia etiologies can assist in diagnosis and treatment of this serious condition.
How I Do It: EnPlace sacrospinous ligament fixation.
Chughtai B, Codelia-Anjum A, Elterman DS … +2 more , Pillalamarri N, Lucente V
Can J Urol · 2024 Oct · PMID 39462534
Pelvic organ prolapse (POP) is a common condition that significantly impairs a woman's quality of life. Currently a range of interventions from non-surgical to surgical options exist, all with their unique advantages an...
Pelvic organ prolapse (POP) is a common condition that significantly impairs a woman's quality of life. Currently a range of interventions from non-surgical to surgical options exist, all with their unique advantages and disadvantages. Among these, the EnPlace system stands out as a truly minimally invasive transvaginal percutaneous device designed to repair apical POP by bilaterally anchoring sutures to the sacrospinous ligaments. Readers will familiarize themselves with the EnPlace, relevant historical studies, and the technique for EnPlace transvaginal percutaneous sacrospinous ligament fixation for hysteropexy or colposuspension.
Practical, cost-effective removal of Hem-o-lok Weck clip: a novel technique.
Rolig B, Brown JA
Can J Urol · 2024 Oct · PMID 39462533
The Hem-o-lok Weck clip is part of a polymer locking ligation system often employed for hemostasis in surgical practices. Its use is routine in a wide array of surgical subspecialties. Surgeons have limited options in re...
The Hem-o-lok Weck clip is part of a polymer locking ligation system often employed for hemostasis in surgical practices. Its use is routine in a wide array of surgical subspecialties. Surgeons have limited options in removing these clips when they are aberrantly positioned. Herein, we describe a novel, cost-effective approach for removing a Hem-o-lok clip using standard robotic instruments. This simple approach will allow surgeons to remove a Hem-o-lok clip precisely and quickly if it is not adequately placed. During a routine robotic-assisted laparoscopic prostatectomy a Hem-o-lok Weck clip was noted to be in juxtaposition to the rectal wall, and it was deemed appropriate to remove it. Ultimately, the indwelling Prograsp forceps was moved from the right fourth arm position to the left arm position. This allowed the Prograsp forceps to compress the scissors in the right hand port, which was insufficient in cutting the hinge of the clip. This provided sufficient force to cut through the clip at its hinge with ease. The Hem-o-lok Weck clip is used in various surgical specialties. It is occasionally placed suboptimally and requires removal. Given the challenge of finding and using the clip removal device, surgeons should be aware of this simple and cost-effective way of removing a Hem-o-lok clip if desired.
Artificial intelligence improves urologic oncology patient education and counseling.
Shah YB, Ghosh A, Hochberg A … +3 more , Mark JR, Lallas CD, Shah MS
Can J Urol · 2024 Oct · PMID 39462532
INTRODUCTION: Patients seek support from online resources when facing a troubling urologic cancer diagnosis. Physician-written resources exceed the recommended 6-8th grade reading level, creating confusion and driving pa...
INTRODUCTION: Patients seek support from online resources when facing a troubling urologic cancer diagnosis. Physician-written resources exceed the recommended 6-8th grade reading level, creating confusion and driving patients towards unregulated online materials like AI chatbots. We aim to compare the readability and quality of patient education on ChatGPT against Epic and Urology Care Foundation (UCF). MATERIALS AND METHODS: We analyzed prostate, bladder, and kidney cancer content from ChatGPT, Epic, and UCF. We further studied readability-adjusted responses using specific AI prompting (ChatGPT-a) and Epic material designated as Easy to Read. Blinded reviewers completed descriptive textual analysis, readability analysis via six validated formulas, and quality analysis via DISCERN, PEMAT, and Likert tools. RESULTS: Epic met the recommended grade level, while UCF and ChatGPT exceeded it (5.81 vs. 8.44 vs. 12.16, p < 0.001). ChatGPT text was longer with more complex wording (p < 0.001). Quality was fair for Epic, good for UCF, and excellent for ChatGPT (49.5 vs. 61.67 vs. 64.33). Actionability was overall poor but particularly lowest (37%) for Epic. On qualitative analysis, Epic lagged on all quality measures. When adjusted for user education level (ChatGPT-a and Epic Easy to Read), readability improved (7.50 and 3.53), but only ChatGPT-a retained high quality. CONCLUSIONS: Online urologic oncology patient materials largely exceed the average American's literacy level and often lack real-world utility for patients. Our ChatGPT-a model indicates that AI technology can improve accessibility and usefulness. With development, a healthcare-specific AI program may help providers create content that is accessible and personalized to improve shared decision-making for urology patients.
Prehabilitation in patients undergoing bladder cancer surgery - A systematic review and meta-analysis.
Steffens D, Koh C, Hirst N … +6 more , Cole R, Solomon MJ, Nguyen-Lal L, Thanigasalam R, Leslie S, Ahmadi N
Can J Urol · 2024 Oct · PMID 39462531
INTRODUCTION: The evidence on the effectiveness of prehabilitation in patients undergoing bladder cancer surgery remains lacking. Thus, the aim of this study is to determine the effectiveness of prehabilitation on reduci...
INTRODUCTION: The evidence on the effectiveness of prehabilitation in patients undergoing bladder cancer surgery remains lacking. Thus, the aim of this study is to determine the effectiveness of prehabilitation on reducing postoperative morbidity and length of hospital stay in patients undergoing bladder cancer surgery. MATERIALS AND METHODS: This systematic review included randomized controlled trials investigating the effect of prehabilitation on postoperative outcomes in patients undergoing bladder cancer surgery. A comprehensive search was conducted, with two reviewers independently screening articles and extracting data. The Cochrane Collaboration's tool was used to assess risk of bias, and GRADE to rate the quality of evidence. When possible, a random effects meta-analysis was conducted. Estimates were presented as risk ratios or mean differences with their 95% confidence intervals. RESULTS: Of the 2764 articles identified, five trials comprising 282 patients met the eligibility criteria. Prehabilitation modalities included preoperative exercise (3), preoperative nutrition (1), and multimodal (1). The mean age of patients ranged from 66.0 to 72.1 years. All included trials presented some or high risk of bias. Pooled analyses according to the different prehabilitation modalities demonstrated low to very low quality of evidence of no effect on postoperative complications and length of hospital stay. CONCLUSION: This study revealed a small number of trials investigating the effectiveness of prehabilitation on patients undergoing bladder cancer surgery. Whether prehabilitation, including preoperative exercise, nutrition and multimodal interventions reduce postoperative morbidity and length of hospital stay following bladder cancer surgery is uncertain, as the quality of evidence is very low.
Factors associated with surgical refusal and non-surgical candidacy in stage 1 kidney cancer: a National Cancer Database (NCDB) analysis.
Okhawere KE, Grauer R, Saini I … +8 more , Joel IT, Beksac AT, Ayo-Farai O, Patel R, Korn TG, Meilika KN, Pedro N, Badani KK
Can J Urol · 2024 Oct · PMID 39462530
INTRODUCTION: We aim to identify factors associated with surgical refusal and non-surgical candidacy in clinical stage I kidney masses and to evaluate their impact on overall survival (OS). MATERIALS AND METHODS: We cond...
INTRODUCTION: We aim to identify factors associated with surgical refusal and non-surgical candidacy in clinical stage I kidney masses and to evaluate their impact on overall survival (OS). MATERIALS AND METHODS: We conducted a retrospective cohort study using the National Cancer Database of patients with clinical stage I kidney cancer between 2004 and 2017. Logistic regression was used to determine baseline sociodemographic-, clinical-, and treatment facility-related factors associated with surgical refusal and non-surgical candidacy. Patients were 1.1 propensity score-matched and Cox regression analysis evaluated the impact of surgical refusal and non-surgical candidacy on OS. RESULTS: Compared to those who underwent surgery, those who refused surgery and those who were non-surgical candidates were more likely to be older, female, non-Hispanic (NH) Black, uninsured, have multiple comorbidities, and traveled a shorter distance to care. Similarly, compared to non-surgical candidates, those who refused surgery were more likely to be younger and have a tumor size ≥ 4.0 cm. Those who refused surgery had significantly lower median survival time and worse OS than those who underwent surgery (HR: 3.18, 95% CI: 2.85, 3.54). Non-surgical candidates had significantly lower median survival time and lower OS than those who had surgery (HR: 4.16, 95% CI: 3.84, 4.51). CONCLUSION: Various socioeconomic, demographic, and clinical factors are associated with patients refusing to undergo surgery, which in turn leads to lower overall survival rates in stage I kidney cancer patients. Recognizing these factors will enable healthcare professionals to address and potentially alleviate these issues, ultimately ensuring that patients receive the most appropriate care.
Implications of MRI contrast enhancement following focal prostate cancer cryoablation.
Wysock J, Persily J, Tong A … +4 more , Rapoport E, Zaslavsky B, Tafa M, Lepor H
Can J Urol · 2024 Oct · PMID 39462529
INTRODUCTION: Local disease recurrence following focal therapy (FT) for prostate cancer may be due to failure to eradicate focal disease or development of disease in the untreated prostate (in- and out-of-field recurrenc...
INTRODUCTION: Local disease recurrence following focal therapy (FT) for prostate cancer may be due to failure to eradicate focal disease or development of disease in the untreated prostate (in- and out-of-field recurrences). Several studies suggest in-field contrast enhancement (CE) on post-treatment multi-parametric (mp) MRI between 6-12 months following FT indicates residual disease. The present study assesses the incidence and oncologic implications of early CE observed following primary partial gland cryoablation (PPGCA). MATERIAL AND METHODS: The surveillance protocol for men enrolled in our prospective outcomes study following PPGCA included mpMRI at 6-12 months, 2 years, 3.5 years, and 5 years. All cases of in-field early CE were re-reviewed retrospectively and graded using the previously described Prostate Imaging after Focal Ablation scoring system. All patients exhibiting early CE were re-evaluated by a single radiologist at 2-year mpMRI Results: A total of 320 men enrolled in our PPGCA outcomes study had at least 6 months of follow up. Three hundred fifteen (98%) of these men had undergone post-PPGCA mpMRI at 6-12 months. Of these men, 9 were found to have early in-field CE and 8 underwent repeat MRI at 2 years. In all 8 cases, the CE resolved on the 2-year mpMRI. Of these 8 patients, seven underwent repeat protocol biopsy at 2 years and in-field significant disease was detected in only 1 case. CONCLUSIONS: The most compelling evidence that early CE is not indicative of prostate cancer recurrence is that all lesions resolved within 24 months. While incidence of early CE is low, its consistent resolution calls into question the clinical significance of this finding after PPGCA.
Side effect management algorithms for niraparib/abiraterone acetate in prostate cancer.
Lattouf JB, Ko JJ, Davis MK … +2 more , Constance C, Gotto GT
Can J Urol · 2024 Oct · PMID 39462528
INTRODUCTION: Niraparib, a PARP1/2 inhibitor, is newly approved in combination with abiraterone acetate (AA) plus prednisone or prednisolone (niraparib/AA+P) for the treatment of adult patients with BRCA-mutated, treatme...
INTRODUCTION: Niraparib, a PARP1/2 inhibitor, is newly approved in combination with abiraterone acetate (AA) plus prednisone or prednisolone (niraparib/AA+P) for the treatment of adult patients with BRCA-mutated, treatment-naïve metastatic castration resistant prostate cancer (mCRPC). Detailed guidance beyond the prescribing information may be helpful in managing the side effect profile and dosing practicalities of this combination therapy. MATERIALS AND METHODS: A panel of specialists convened to design management algorithms for four common niraparib/AA+P treatment-related adverse events (AEs) in mCRPC; anemia, thrombocytopenia, hypertension, and nausea. The algorithms build on Health Canada-approved prescribing information to highlight practical considerations related to monitoring, treatment adjustment, and specialist referral to support clinical practice. RESULTS: The panel's recommendations were largely aligned with the niraparib/AA+P product monograph. Single agent AA+P followed by reintroduction niraparib/AA+P using the low dose formulation of niraparib/AA were common strategies for managing higher grade AE's. Recommendations for hypertension management were expanded to include a sequence of anti-hypertensive medication trials prior to a change in anti-cancer therapy, where feasible. CONCLUSION: These algorithms are intended to provide practical assistance to Canadian clinicians managing the most common AEs encountered with the novel combination, niraparib/AA+P, for mCRPC.
Legends in Urology v31I05.
Carroll PR
Can J Urol · 2024 Oct · PMID 39462527
Abstract loading — click title to view on PubMed.
A Chief Wellness Officer, Every Hospital Should Have One; Marlon Brando Was Right.
Loughlin KR
Can J Urol · 2024 Oct · PMID 39462526
Abstract loading — click title to view on PubMed.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe