Administration of fluoroquinolones emerged as the most important risk factor for CDAD in Quebec during an epidemic caused by a hypervirulent strain of C. difficile.

A dult urinary incontinence (UI) is a highly prevalent condition, and one which can have a major impact on patients' quality of life. It is also a major focus of a urologist's workload. As a result, the Canadian Urological Association (CUA), with the aid of its Guidelines Committee, commissioned the development of a practice guideline document in 2005 first authored by Dr. Jacques Corcos. As per the CUA Guidelines Committee's mandate, all guidelines are subject to revision after 5 years. Methodology A comprehensive review of the studies published from January 2005 and November 2011 was performed using PubMed, MEDLINE and The Cochrane Library databases. In addition, the bibliographies of all relevant articles were searched to avoid exclusion of significant articles. Focus was on systematic reviews, meta-analyses and evidencebased recommendations, when available. Data from the latest consensus of the International Continence Society (ICS), the International Consultation on Incontinence (ICI), the International Urogynecological Association (IUGA), the American Urological Association (AUA), the European Association of Urology (EAU), the Urinary Incontinence Treatment Network (UITN), the Society of Obstetricians and Gynecologists of Canada (SOGC) and the American Congress of Obstetricians and Gynecologists (ACOG) were also incorporated. This review does not address U I in children or patients with neurogenic bladder. All articles were reviewed using the Evidence-Based Medicine (EBM) levels, with a Modified Oxford grading System (Appendix A).

Vesicouterine fistulas (VUF) are a pathological and uncommon connection between the uterus and the bladder. Although rare, they are usually related to cesarean section. Nowadays, their incidence increases because of the increase in Cesarean sections. Patients with VUF may have various clinical presentations. The main symptoms are urinary incontinence, which may be associated with hematuria. Vesicouterine fistulas are usually associated with psychological distress and have a negative effect on quality of life. The accurate and early diagnosis of VUF can be difficult. There are multiple ways to investigate VUF and several examinations may be required to confirm the diagnosis; these examinations may include a cystoscopy, a retrograde cystography, methylene blue test and a computed tomography scan. We present 3 cases of vesicouterine fistula with successful surgical repair in which 2 patients had an early repair. One patient had an early surgical repair because of intractable pain and the other patient because of the large size of the fistula. The fistula repair surgeries were uneventful and the patients had an unremarkable recovery. We report that early surgical management is technically feasible without significantly increasing the difficulty of the surgery, with an excellent outcome in selected patients.

Adult urinary incontinence (UI) is a highly prevalentcondition, and one which can have a major impacton patients’ quality of life. It is also a major focus ofa urologist’s workload. As a result, the Canadian UrologicalAssociation (CUA), with the aid of its Guidelines Committee,commissioned the development of a practice guideline documentin 2005 first authored by Dr. Jacques Corcos. As perthe CUA Guidelines Committee’s mandate, all guidelinesare subject to revision after 5 years.

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Cite as: Can Urol Assoc J 2017;11(1-2):E47-9. http://dx.doi.org/10.5489/cuaj.4050 Published online January 12, 2017 AbstractTraumatic urethral catheterization may result in a number of serious complications. A rare occurrence is the development of a urethral pseudoaneurysm. We report the case of a 13-year-old male who required placement of a Foley catheter for an orthopedic surgical procedure. The Foley was misplaced in the bulbourethra, resulting in the development of a bulbar artery pseudoaneurysm. Profuse bleeding via the urethra was noted after removal of the catheter, and the patient experienced severe intermittent hematuria during the postoperative period. Cystoscopy revealed a pulsatile mass within the bulbourethra. Angiography confirmed a bulbar artery pseudoaneurysm, which was successfully embolized with resolution of bleeding.

Vesicouterine fistulas (VUF) are a pathological and uncommonconnection between the uterus and the bladder. Although rare,they are usually related to cesarean section. Nowadays, theirincidence increases because of the increase in Cesarean sections.Patients with VUF may have various clinical presentations. Themain symptoms are urinary incontinence, which may be associatedwith hematuria. Vesicouterine fistulas are usually associated withpsychological distress and have a negative effect on quality of life.The accurate and early diagnosis of VUF can be difficult. There aremultiple ways to investigate VUF and several examinations may berequired to confirm the diagnosis; these examinations may includea cystoscopy, a retrograde cystography, methylene blue test and acomputed tomography scan. We present 3 cases of vesicouterinefistula with successful surgical repair in which 2 patients had anearly repair. One patient had an early surgical repair because ofintractable pain and the other patient because of the large sizeof the fistula. The fistula repair surgeries were uneventful andthe patients had an unremarkable recovery. We report that earlysurgical management is technically feasible without significantlyincreasing the difficulty of the surgery, with an excellent outcomein selected patients.