Papers by Khushabu Kasabwala
Urology, 2021
BACKGROUND Parastomal and ventral hernias are common complications in patients with continent cat... more BACKGROUND Parastomal and ventral hernias are common complications in patients with continent catheterizable channels or incontinent urinary diversions. Patients with neurogenic bladder are at particularly high risk due to weak abdominal wall musculature, and hernia repair often requires re-siting of their stoma. While parastomal hernia repair with urinary stoma re-siting has acceptable long-term success rates, it often necessitates a laparotomy which is associated with significant morbidity. OBJECTIVE To describe a novel approach to combined laparoscopic parastomal hernia repair with re-siting of the urinary stoma in patients with neurogenic bladder. The video will outline the surgical steps and pitfalls. MATERIALS AND METHODS The case begins laparoscopically or robotically with adhesiolysis to dissect out the sub-fascial portion of the channel and the parastomal hernia. The sub-fascial portion of the channel is dissected out to the anterior abdominal wall, ensuring to preserve it&...
The Canadian journal of urology, 2020
Urachal anomalies are rare in the adult population and when diagnosed, are typically malignant. H... more Urachal anomalies are rare in the adult population and when diagnosed, are typically malignant. Herein, we report a case of a 61-year-old male who underwent an excision of a urachal mass for a presumed malignancy. Pathologic evaluation demonstrated a neurofibroma. Neurofibromas are benign peripheral nerve sheath tumors that mostly appear as localized skin tumors and rarely involve the genitourinary system. Neoplastic transformation of neurofibromas is rare but not unheard. To our knowledge, this is the first description of a neurofibroma originating from the urachus.
The Health & Fitness Journal of Canada, 2020
Introduction: Unhealthy behaviours, including poor diet and lack of physical inactivity, are risk... more Introduction: Unhealthy behaviours, including poor diet and lack of physical inactivity, are risk factors for premature mortality in men worldwide. Identifying disparities and inequalities regarding these habits in Canadian men may allow for targeted interventions to promote wellness. Our objective was to evaluate a representative sample of the Canadian men to determine current diet and exercise health behaviours and identify predictors of unhealthy habits. Methods: A total of 5,362 men and women were asked to complete an online survey men’s health. Using a stratification algorithm, 2000 male survey participants which represented the population distribution of Canadian provinces were included in this study. Their diet and exercise behaviours were classified based upon pre-determined thresholds. Results: In this national survey of Canadian men, 48.9% did not meet the recommended 150 minutes of moderate exercise per week and 61.8% were classified as having an unhealthy diet. Multivari...
Readability is an important consideration in assessing healthcare-related literature. In order fo... more Readability is an important consideration in assessing healthcare-related literature. In order for a source of information to be the most beneficial to patients, it should be written at a level appropriate for the audience. The National Institute of Health recommends that health literature be written at a maximum level of sixth grade. This is not uniformly found in current health literature, putting patients with lower reading levels at a disadvantage. In February 2012, healthcare-oriented education resources were retrieved from websites obtained using the Google search phrase skull base tumors. Of the first 25 consecutive, unique website hits, 18 websites were found to contain information for patients. Ten different assessment scales were utilized to assess the readability of the patient-specific web pages. Patient-oriented material found online for skull base tumors was written at a significantly higher level than the reading level of the average US patient. The average reading le...
European Urology Oncology
International Urogynecology Journal
Female Pelvic Medicine & Reconstructive Surgery
The Journal of Urology
INTRODUCTION AND OBJECTIVES: Patients would greatly benefit from accurate and early identificatio... more INTRODUCTION AND OBJECTIVES: Patients would greatly benefit from accurate and early identification of clinically significant prostate cancer (PCa), leading to a reduction of over-diagnosis and over-treatment. The aim of this study was to determine the complementarity between a pre-biopsy urinary biomarker-based risk score (SelectMDx) followed by a post-biopsy epigenetic biomarker assay (ConfirmMDx) to identify men with high-grade PCa. METHODS: The study population consistent of 214 men who were undergoing a 12-core prostate biopsy. Average age was 65 years (range 50-75). Prior to biopsy, urine was collected following digital rectal examination, and urine samples were tested with two urinary RNAbased assays, SelectMDx for Prostate Cancer and PCA3. Biopsy tissue samples from all cores were subsequently tested with the epigenetic DNA assay ConfirmMDx (MDxHealth, Inc, Irvine, CA). This epigenetic test quantifies the relative DNA methylation intensities of 3 genes (GSTP1, RASSF1, and APC) in each individual biopsy core to generate an epigenetic risk score. The results were expressed as areas under the receiver-operating characteristic curve (AUC). High-grade PCa was defined as Gleason Score (GS) >¼7. RESULTS: Of 214 subjects, 95 (44%) had benign pathology at biopsy, 47 (22%) were diagnosed with GS6 cancer and 72 (34%) highgrade disease (GS >¼7). The pre-biopsy urinary tests SelectMDx and PCA3 yielded AUCs of 0.88 and 0.73 respectively, for detection of highgrade cancer at biopsy. The AUC of the post-biopsy ConfirmMDx test was 0.91. A combined model using both SelectMDx and ConfirmMDx showed a further improvement in performance compared to SelectMDx alone (AUC of 0.93). CONCLUSIONS: In this evaluation study, the pre-and postbiopsy RNA and DNA biomarker assays SelectMDx and ConfirmMDx outperformed PCA3 biomarker test. Combining the urinary RNA test with the epigenetic DNA test significantly improved accuracy for the identification of men with high-grade PCa.
The Journal of urology, Jan 5, 2018
To determine the association between multiple regions of interest (ROI) on pre-biopsy magnetic re... more To determine the association between multiple regions of interest (ROI) on pre-biopsy magnetic resonance imaging (MRI) and the detection of clinically significant prostate cancer (CSPC) in men undergoing MRI ultrasound fusion biopsy (Fbx). We performed a retrospective, single-institution analysis of men who underwent fusion biopsy. Men with prior positive biopsies, MRIs performed at outside institutions and MRIs prior to release of Prostate Imaging Reporting and Data System (PI-RADS) version 2 were excluded, resulting in 381 subjects. Independent variables modeled included age, number of ROIs with PI-RADS categorization ≥ 3, body-mass index (BMI), prostate-specific antigen (PSA), prostate volume, and PI-RADS. Multivariable logistic regression was utilized to determine factors associated with finding CSPC (Gleason ≥ 7) on biopsy. Median age was 67.2, interquartile range [IQR] (61.6-73.0) years. Median PSA was 6.6 [5.0-10.0] ng/mL. Adjusted analysis demonstrated that age (OR 1.10, 95%...
Current opinion in urology, Jan 2, 2018
Robotic-assisted radical prostatectomy has been rapidly adopted and is now the standard of care i... more Robotic-assisted radical prostatectomy has been rapidly adopted and is now the standard of care in the surgical management of prostate cancer. Since the initial description in 2001, the technique has evolved to optimize oncological functional outcomes. Herein, we review key techniques for the robotic-assisted radical prostatectomy. With the current influx of new technology such as focal therapy, stereotactic body radiation therapy and prostate-sparing treatments, there is greater emphasis on maximizing outcomes of robotic-assisted radical prostatectomy. The evidence-based techniques of optimizing oncological outcomes including the lymph node dissection and improving cancer control through minimizing positive surgical margins are reviewed. Improvements in functional recovery has also been seen with technical modifications such as nerve sparing, preservation of the urethral support structures and the bladder neck and optimizing the urethra-vesical reconstruction. Robotic prostatectomy...
Canadian Urological Association Journal
Introduction: Lifestyle-related diseases are the leading cause of death among North American men.... more Introduction: Lifestyle-related diseases are the leading cause of death among North American men. We evaluated health behaviours and their predictors that contribute to morbidity and mortality among Canadian men as a means to making recommendations for targeted interventions. Methods: A cross-sectional analysis of Canadian men drawn from 5362 visitors to our online survey page was conducted. The current study sample of 2000 men (inclusion: male and…
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Papers by Khushabu Kasabwala