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Volume 4, Number 1  |  January 2023

ISSN 2563-6499
10.48083/AGLR3780

Editorial Office 
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The SIUJ is published 6 times a year by the Société Internationale 
d'Urologie (SIU). It is the official peer-reviewed publication of the 
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to urologists, urology residents, family medicine specialists, 
family medicine residents, general practitioners, nurses, medical 
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was developed under the direction of the SIUJ Editorial Board. 
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Société Internationale d’Urologie (SIU). 

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damages arising from any error or omission, or from the use of any 
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SIUJ represents the opinions of the authors and not necessarily 
those of the SIU or the SIUJ.

 All Canadian prescription drug advertisements have 
been cleared by the Pharmaceutical Advertising 
Advisory Board.

Editorial Board
Editor-in-Chief
Peter C. Black, MD, Canada
Deputy Editor
Philippe E. Spiess, MD, United States
Associate Editors
Lysanne Campeau, MD, Canada
Sandro Esteves, MD, Brazil 

Sanjay Sinha, MCh, India
Henry Woo, MBBS, Australia

Social Media Editor
Jeremy Y. C. Teoh, MBBS, Hong Kong SAR

Statistical Editor
Alice Dragomir, PhD, Canada

Innovators Editor
Amanda Chung, MBBS, Australia

Regional Editors

North America
Kathleen Kobashi, MD 
United States

Middle East 
Yasser Osman, MBBCh 
Egypt

South America
Gonzalo Vitagliano, MD  
Argentina 

East Asia
Tianxin Lin, MD 
China

Eastern Europe 
Roman Sosnowski, MD 
Poland

South Asia 
Gagan Prakash 
India

Western Europe 
Tamsin Greenwell, MD 
United Kingdom

Southeast Asia 
Edmund Chiong, MBBS
Singapore

Africa
Evelyn Moshokoa, MBChB 
South Africa

A NEW TREATMENT OPTION FOR PATIENTS 
WITH UROTHELIAL CARCINOMA (UC) 

PrOPDIVO® is indicated as a monotherapy for the adjuvant treatment of adult patients with UC
who are at high risk of recurrence after undergoing radical resection of UC.1 

Please consult the OPDIVO Product Monograph at https://www.bms.com/assets/bms/ca/documents/productmonograph/OPDIVO_EN_PM.pdf
for contraindications, warnings, precautions, adverse reactions, drug interactions, dosing, and conditions of clinical use.

The Product Monograph is also available by calling us at: 1-866-463-6267.

Reference: 1. OPDIVO Product Monograph. Bristol-Myers Squibb Canada Co.

OPDIVO and the OPDIVO logo are registered trademarks of Bristol-Myers Squibb Company
used under license by Bristol-Myers Squibb Canada Co.    1506-CA-2200026E

OPDIVO is indicated for the adjuvant treatment of adult patients with urothelial carcinoma (UC) 
who are at high risk of recurrence after undergoing radical resection of UC. OPDIVO has been issued 

marketing authorization with conditions, pending the results of trials to verify its clinical benefit. 
Patients should be advised of the nature of the authorization. For further information for OPDIVO 

please refer to Health Canada’s Notice of Compliance with conditions – drug products website.
(https://w w w.canada.ca/en/health-canada/ser vices/drugs-health-products/drug-products/

notice-compliance/conditions.html)

N E W  I N D I C AT I O N

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SIUJ
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2 SIUJ  •  Volume 4, Number 1  •  January 2023 SIUJ.ORG

Editorial Board
Ahmed Adam, MBBCh
South Africa 

Wayne Lam, MBBS
Hong Kong SAR

Fahad Alyami, MBBS
Saudi Arabia

Sang Dong Lee, MD
Korea

Mohsen Azli, MD
Algeria

Medina Ndoye, MD
Senegal

Erdem Canda, MD 
Türkiye

Andrea Necchi, MD 
Italy

Yao-Chi Chuang, MD
Taiwan 

Dedan Opondo, MBChB
Kenya

Archil Chkhotua, MD
Georgia

Karima Oualla, MD
Morocco

Renu Eapen, MBBS
Australia

Lourdes Guerrios Rivera, MD 
Puerto Rico

Agus Rizal Ardy Hariandy Hamid, MD
Indonesia

Mohammed Shahait, MD
Jordan

Thomas Herrmann, MD 
Switzerland

Khurram Siddiqui, MBBS
Oman

Christopher Ho Chee Kong, MD
Malaysia

Yaya Sow, MD
Senegal

Theocharis Karaolides, MD
Cyprus

Chuan-Liang Xu, MD
China

Abdol - Mohammad Kajbafzadeh, MD 
Iran

The Société Internationale d’Urologie (SIU). 

The Society’s mission is to enable urologists in all nations, 
through international cooperation in education and research, to 
apply the highest standards of urological care to their patients. 
The SIU is a major international platform for sustainable 
urological education and collaborative philanthropic 
activities aimed at improving urological care with more than 
10 000 members from over 130 countries. 

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Volume 4, Number 1  |  January 2023

Neither the SIU nor the SIUJ endorses any service or the contents 
of any product referred to in any advertisement in the SIUJ. 
The SIU and the SIUJ assume no responsibility or liability for 
damages arising from any error or omission, or from the use of any 
information or advice contained in the SIUJ. All editorial matter in 
SIUJ represents the opinions of the authors and not necessarily 
those of the SIU or the SIUJ.

 All Canadian prescription drug advertisements have 
been cleared by the Pharmaceutical Advertising 
Advisory Board.

http://SIUJ.org
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3SIUJ.ORG SIUJ  •  Volume 4, Number 1  •  January 2023

Table of 
Contents

Editorial
Standing on the Shoulders of Giants 5 
Peter C. Black

Urology Around The World
SIU Training Scholarship: an Unforgettable Experience at the  
Muljibhai Patel Urological Hospital, Nadiad-Gujarat, India 8
Emmanuel Ugbede Oyibo

Research
Implementing HoLEP in an Academic Department With Multiple Surgeons  
in Training: Mentoring Is the Key for Success 11
Clément Klein, Thibault Marquette, Grégoire Capon, Eric Alezra, Peggy Blanc,  
Vincent Estrade, Jean-Christophe Bernhard, Franck Bladou, Grégoire Robert

Disparities in Access to Virtual Care for Urinary Tract Infections During the COVID-19 Era  20
Molly E. DeWitt-Foy, Jacob A. Albersheim, Shawn T. Grove, Lina Hamid, Sally Berryman, Sean P. Elliott

The LARCG Latin American Renal Cancer Group: Achievements in Support,  
Teaching, Research, Collaboration, and Advocacy  27
Stenio de Cássio Zequi, Francisco Rodriguez-Covarrubias, Ignacio Pablo Tobia, Alberto Jurado,  
Anamaria Autran Gomez, Luiz Meza-Montoya, Walter Henriques da Costa, Alejandro Nolazco, 
Thiago Camelo Mourao, Diego Abreu

Oncologic Outcomes of a Novel Mapping Biopsy Technique Before Surgical  
Excision in the Management of Extramammary Paget Disease 34
Kyle M. Rose, Rosalie Zurlo, Roger Li, Gerard Mosiello, Philippe E. Spiess

Review
Salvage Versus Adjuvant Radiation Therapy Following Radical Prostatectomy  
in Localised Prostate Cancer: A War Without a Winner   40
Lara Rodriguez-Sanchez, Petr Macek, Camille Lanz, Qusay Mandoorah, Nuno Dias,  
Gianmarco Colandrea, Fernando P. Secin, Amandeep M. Arora, Rafael Sanchez-Salas,  
Xavier Cathelineau

Urogenital Malignancy and Cannabis Use: A Narrative Review  51
Alice Thomson, Aoife McVey, Brennan Timm, Damien Bolton

http://SIUJ.org


4 SIUJ  •  Volume 4, Number 1  •  January 2023 SIUJ.ORG

Table of  
Contents, Cont'd

Giants in Urology

Rudolf Hohenfellner, Chairman, Department of Urology, Johannes Gutenberg University,  
Mainz, Germany, 1967 to 1996  67
Jan Fichtner, Margit Fisch

Clinical Picture
Chronic Pelvic Organ Prolapse and Bladder Calculi in an Adolescent  69
Reyhane Ebrahimi, Alireza Soltani Khaboushan, Abdol-Mohammad Kajbafzadeh

Incarcerated Internal Hernia Posterior to the Iliac Vessels After  
Uncomplicated Radical Cystectomy 71
Sydney Sparanese, Cyrus Chehroudi, Peter C. Black

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This is an open access article under the terms of a license that permits non-commercial use, provided the original work is properly cited.  
© 2023 The Authors. Société Internationale d'Urologie Journal, published by the Société Internationale d'Urologie, Canada.

SIUJ.ORG SIUJ  •  Volume 4, Number 1  •  January 2023 5

EDITORIAL

Standing on the Shoulders of Giants
Peter C. Black, Editor-in-Chief
 
Soc Int Urol J.2023;4(1):5 
DOI: 10.48083/DMJD6674

Isaac Newton famously wrote in 1676: “If I have seen a little further it is by standing on the shoulders of Giants.”  
In this issue of the SIU Journal we introduce a new feature article that we will include regularly going forward: Giants 
in Urology. In medicine and surgery, we have a certain reverence for the pioneers who established the practices we 
incorporate into daily practice—but at the same time we have a short collective memory of those who have gone before 
us. Icons in the field who drift into retirement are quickly forgotten by the next generation of urologists emerging 
from training. For this reason, we wanted to feature some of these giants. We are certainly not the first urologic 
journal to do so, but, aligned with the mission of the SIUJ, we will do this from a global perspective, showcasing giants 
from around the world, including those whose impact was perhaps appreciated only regionally.

Our first giant is Rudolf (“Rudy”) Hohenfellner, the long-time chairman of the Department of Urology at the 
Johannes Gutenberg University in Mainz, Germany. Reading this contribution from Jan Fichtner and Margaret Fisch 
reveals that this giant was himself influenced by giants that preceded him—and Hohenfellner has without question 
spawned multiple giants himself (the authors included). The legacy of passing on skills, techniques, and wisdom to 
one’s own trainees and junior faculty is without doubt a key feature of any giant in the field. Hohenfellner is like a 
godfather figure in German urology, as many chairs across the country started their careers under his tutelage. His 
surgical innovation has influenced many urologists around the world, benefitted not only all the patients he cared for 
but also all those cared for by his former trainees.

I am myself one of the many trainees influenced by Rudy Hohenfellner. I had no idea who he was at the time, but 
he was the inspiration for me to pursue a career in urology. My first urologic experiences were his weekly lectures 
in the middle years of medical school. He regularly brought patients to his lectures and interviewed them with his 
thick Viennese accent to allow the students to learn from the individual medical histories and experiences of the 
patients. Urinary diversion was a regular feature in his lectures (Mainz is after all where he developed the Mainz 
pouch), and this was part of the inspiration for me to do an elective in urology. About 25 years later, I still do a lot 
of urinary diversion (although not the Mainz variety). As I finish a continent cutaneous reservoir or an orthotopic 
neobladder, I often wonder how we get away with these extensive reconstructive surgeries. At least we have decades 
of positive experiences on which to build, but imagine the early pioneers of urinary diversion like Hohenfellner who 
were developing the techniques that we have all since adopted. Perhaps more importantly, Hohenfellner instilled in 
his trainees many other lessons that were critical to the budding surgeon: discipline, technical excellence, scientific 
rigor, innovation, and devotion to the patient. I like to say that I might not do what I do today if I had not encountered 
Rudy Hohenfellner in the late 1990s in Mainz.

I am reminded of a conversation I had with a very prominent Canadian urologist a few years ago on a subway in 
Washington DC. He was lamenting that the meeting to which we were both traveling used to attract many of the 
major “icons” (his term) in the field, but that he had noticed a gradual decline in this pattern over the years. What 
he did not recognize is that he had become an icon himself, and the urologists that he viewed as icons were mostly 
retired. There are many giants, and giants will come and go. Every urologist will have a different perspective on who 
is a giant in their region of the world and in their area of subspecialty practice. The impact of any given giant may be 
quite varied, including especially clinical research, translational research, biomarker and drug development, surgical 
innovation, modification of standard clinical practice, or exemplary leadership. Some giants will have contributed 
specifically to the success of urological organizations like the SIU, or to different urologic journals.

We therefore invite contributions from urologists around the world. Share with us the inspiration your mentor   
has imparted to others. We would like to capture in the pages of the SIU Journal some of the main achievements 
of these giants, the quintessence of their personalities, and their legacy to our field. Who are the giants are in your 
urologic sphere? Upon whose shoulders do you stand?

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