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Introduction In an effort to reduce the incidence of postoperative surgical site infections (SSIs), many hospitals have adopted a strict practice of preoperative hair removal using clippers, as opposed to razors. However, the skin of the male genitalia is delicate, elastic with irregular skin folds and may be ill-suited for clippers. Aim To compare shave quality and the degree of skin trauma using two methods of preoperative hair removal on the scrotal skin: clippers vs. razors. Methods Patients undergoing surgery involving the male genitalia requiring preoperative hair removal were randomized to hair removal using clippers or a razor. Immediately following hair removal, a standardized digital photograph was taken of the male genitalia. All digital photos were evaluated in a blinded fashion by groups of urologic surgeons and surgical nurses using a standardized five-point global rating scale. The incidence of SSIs was monitored. Main Outcome Measures Primary outcomes included blinded global ratings of (i) the completeness of the preoperative hair removal within the surgical field and (ii) degree of skin trauma following hair removal. The incidence of SSIs within 3 months of surgery was monitored throughout the study period. Results Two hundred fifteen consecutive patients were randomized (107 clipper, 108 razor). Overall, preoperative hair removal on the male genitalia using a razor resulted in significantly less skin trauma (P = 2.5E-10) and a more complete hair removal within the surgical field (P = 0.017) compared with clippers. SSIs were identified in four patients during follow-up (1.8%—two using clippers; two, razors). Conclusions Our data suggest that preoperative hair removal on the scrotal skin using a razor results in less skin trauma and improved overall shave quality with no apparent increased risk of SSIs. Based on these findings, surgeons should be permitted their choice of razors or clippers for preoperative preparation of the male genitalia.

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Background:To perform complete resection of locally advanced and recurrent rectal carcinoma, total pelvic exenteration (TPE) may be attempted. We identified disease-related outcomes and prognostic factors. Methods:We conducted a single-centre review of patients who underwent TPE for rectal carcinoma over a 10-year period. Results:We included 28 patients in our study. After a median follow-up of 35 months, 53.6% of patients were alive with no evidence of disease. The 3-year actuarial disease-free and overall survival rates were 52.2% and 75.1%, respectively. On univariate analysis, recurrent disease, preoperative body mass index greater than 30 and lymphatic invasion were poor prognostic factors for disease-free survival, and only lymphatic invasion predicted overall survival. Additionally, multivariate analysis identified lymphatic invasion as an independent poor prognostic factor for disease-free survival in this patient population with locally advanced and recurrent rectal carcinoma. Conclusion:Despite the significant morbidity, TPE can provide long-term survival in patients with rectal carcinoma. Additionally, lymphatic invasion on final pathology was an independent prognostic factor for disease-free survival.Contexte : Pour pratiquer une résection complète du cancer du rectum avancé au stade local et récidivant, on peut tenter une exentération pelvienne totale (EPT). Nous avons déterminé des résultats liés à la maladie et des facteurs de pronostic. Méthodes :Nous avons procédé à une étude unicentrique portant sur des patients qui ont subi une EPT pour un cancer du rectum au cours d'une période de 10 ans.

Introduction: For medical students, determining which aspects of the Canadian Residency Matching Service (CaRMS) application are the most important when applying to residency programs can be challenging. Due to the lack of current and reliable information on the selection criteria of Canadian urology residency programs, we surveyed each program about which criteria are the most important when selecting future residents in order to provide medical students with more transparency and programs with a better idea of how their criteria compare to those of others. Methods: An electronic survey was sent to all 13 Canadian urology residency programs (both program directors and selection committee members). It asked respondents to rate each aspect of the application on a five-point Likert scale. Following a 100% response rate from program directors, the same survey was sent to selection committee members. A numeric mean score was calculated for each individual aspect surveyed to create an overall rank list of the components. Independent samples t-tests (two groups) were used to compare the scores of program directors vs. program committee members and of francophone programs vs. anglophone programs. Results: Forty-three urologists involved in the application process answered. The three most important aspects were rotation performance at the respondent's institution (4.95±0.21), quality of reference letters from a urologist (4.60±0.62), and interview performance (4.49±0.63). There were no statistically significant differences between program directors and committee members for mean score of any aspect surveyed. Comparatively to anglophone programs, francophone programs gave statistically more significant importance to French proficiency (p<0.001) and pre-clinical academic performance (p=0.0272), while giving less importance to English proficiency (p<0.001). Conclusions: Canadian urology residency programs are similar by ranking “clinical performance during a rotation at their school” as the most important selection criteria when choosing a future urology trainee. Graduate degrees, career plans, and reference letters from non-urologists have less impact when choosing future urology residents. Francophone schools and anglophone schools differ in the importance of language proficiency and pre-clinical grades as selection criteria for urology residency. This study will provide future urology applicants with more information and transparency when applying to urology programs in Canada and be of use to urology residency programs that must now publish their selection criteria.

M.K.S. has nothing to disclose. J.F.S. has nothing to disclose. K.C.L. is a past president of Society for the Study of Male Reproduction and is on the board of directors. J.M.H. owns equity in the following start-up companies unrelated to the submitted work: Stream Dx, Nanonc, and Andro360. S.L. has nothing to disclose. E.D.G. has nothing to disclose. J.C.T. has nothing to disclose. T.J.W. has nothing to disclose. P.N.K. has nothing to disclose. V.D.W.C. has nothing to disclose. A.S.Z. is a shareholder of YAD Tech Neutraceuticals. A.S. has received personal fees from Endo Pharmaceuticals, MD Concepts, and Tims Medical outside the submitted work. M.A.F. has nothing to disclose. T.D. has nothing to disclose. S.I.Z. has nothing to disclose. E.F.F. has nothing to disclose. J.C.H. has nothing to disclose. J.I.S. has nothing to disclose. R.E.B. has nothing to disclose. J.M.D. has received grants from Blue Cross Blue Shield of Michigan outside the submitted work. M.G. has nothing to disclose. E.Y.K. has nothing to disclose. T.-C.M.H. has nothing to disclose. J.M.B. has nothing to disclose. D.S. is on the board of directors of the Society for the Study of Male Reproduction. A.K.N. has nothing to disclose. K.A.J. has nothing to disclose.

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