TY - JOUR. T1 - Clinical Significance of Benign Glands at Surgical Margins in Robotic Radical Prostatectomy Specimens. AU - Kohl, Shane K.. AU - Balaji, Kethandapatti C.. AU - Smith, Lynette M. AU - Wilson, Nicholas P.. AU - Johansson, Sonny L.. AU - Sterrett, Samuel P.. AU - Abrahams, Neil A.. PY - 2007/6/1. Y1 - 2007/6/1. N2 - Objectives: Completion of robotic radical prostatectomy compared with conventional open retropubic radical prostatectomy can result in different alterations in the prostatectomy specimens. One difference appears to be an increased incidence of benign glands at the margins, which has been associated with an increase in postoperative prostatic-specific antigen (PSA) levels. We compared the frequency and clinical significance of benign prostate glands at the surgical margins in radical prostatectomy specimens obtained by robotic versus open retropubic prostatectomy. Methods: We reviewed 38 consecutive prostatectomy specimens from patients with biopsy-proven prostate cancer. ...

TY - JOUR. T1 - Androgen deprivation therapy improves pneumoperitoneum time during laparoscopic radical prostatectomy in Japanese patients with enlarged prostates. AU - Takeda, Toshikazu. AU - Miyajima, Akira. AU - Kaneko, Gou. AU - Kikuchi, Eiji. AU - Nakagawa, Ken. AU - Oya, Mototsugu. PY - 2014/5/1. Y1 - 2014/5/1. N2 - INTRODUCTION: The aim of this study was to investigate if neoadjuvant hormone therapy (NHT) is associated with surgical outcomes of laparoscopic radical prostatectomy.METHODS: A total of 286 patients with organ-confined prostate cancer and a preoperative prostate volume that could be estimated by transrectal ultrasound underwent laparoscopic radical prostatectomy between 2006 and 2011 at our institution. We examined whether NHT was associated with pneumoperitoneum time (PT) or estimated blood loss during laparoscopic radical prostatectomy.RESULTS: NHT was performed in 80 patients; the mean duration of NHT was 5.2 ± 0.2 months. Multivariate analysis demonstrated that history of ...

BACKGROUND: The aim of this study is to investigate the cumulative incidence and risk factors of postoperative inguinal hernia (PIH) in patients undergoing radical prostatectomy, i.e., laparoscopic prostatectomy (LRP) and robot-assisted laparoscopic prostatectomy (RARP). METHODS: This study included 1124 patients who had undergone radical prostatectomy or transurethral resection of bladder tumor from 2011-2016. We compared the cumulative incidence of PIH in the radical prostatectomy groups (460; LRP 341, RARP 119) and the control group (664; transurethral resection of bladder tumor), and we then analyzed the risk factors (age, operative methods, previous abdominal operative history, thickness and width of external oblique muscle and rectus muscle, thickness of abdominal subcutaneous fat layer at Hesselbachs triangle level, body mass index, prostate-specific antigen, operative time, specimen weight, Gleason score, and pathology T-stage) of PIH in the radical prostatectomy groups ...

TY - JOUR. T1 - Effect of statin use on biochemical outcome following radical prostatectomy. AU - Ritch, Chad R.. AU - Hruby, Greg. AU - Badani, Ketan K.. AU - Benson, Mitchell C.. AU - McKiernan, James M.. PY - 2011/10/1. Y1 - 2011/10/1. N2 - Study Type - Prognosis (retrospective cohort) Level of Evidence 2b Whats known on the subject? and What does the study add? Statin use may reduce the risk of developing prostate cancer. Studies also suggest that the protective effect of statins may be beneficial for prostate cancer patients following treatment. Statin users may also have lower PSA than non-users. Our study agrees with the findings that statin users may have lower PSA than non-users. Contrary to the findings that statins are protective in prostate cancer this study shows no benefit and possible worse biochemical outcome after radical prostatectomy. OBJECTIVE • To determine the relationship between statin use and biochemical recurrence (BCR) following radical prostatectomy (RP). PATIENTS ...

TY - JOUR. T1 - Erectile Function Recovery After Nerve-Sparing Radical Prostatectomy for Prostate Cancer. T2 - Is Back to Baseline Status Enough for Patient Satisfaction?. AU - Rossi, Martina Sofia. AU - Moschini, Marco. AU - Bianchi, Marco. AU - Gandaglia, Giorgio. AU - Fossati, Nicola. AU - DellOglio, Paolo. AU - Schiavina, Riccardo. AU - Brunocilla, Eugenio. AU - Farina, Elena. AU - Picozzi, Marta. AU - Salonia, Andrea. AU - Montorsi, Francesco. AU - Briganti, Alberto. PY - 2016/4/1. Y1 - 2016/4/1. N2 - Introduction Several definitions of erectile function (EF) recovery after bilateral nerve-sparing radical prostatectomy (BNSRP) have been proposed based on the results of the International Index of EF (IIEF). Aim We aimed at evaluating overall satisfaction (OS) after BNSRP according to the ability to achieve the pretreatment EF. Methods We evaluated data of 652 patients treated with BNSRP for clinically localized prostate cancer (PCa). Erectile dysfunction (ED) was classified according to the ...

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References. 1. Raychaudhuri B, Cahill D. Pelvic fasciae in urology. Ann R Coll Surg Engl. 2008 Nov;90(8):633-7. doi: 10.1308/003588408X321611. [ Links ] 2. Cornu JN, Phé V, Fournier G, Delmas V, Sèbe P. Fascia surrounding the prostate: clinical and anatomical basis of the nerve-sparing radical prostatectomy. Surg Radiol Anat. 2010 Aug;32(7):663-7. doi: 10.1007/s00276-010-0668-7. [ Links ] 3. Takenaka A, Hara R, Soga H, Murakami G, Fujisawa M. A novel technique for approaching the endopelvic fascia in retropubic radical prostatectomy, based on an anatomical study of fixed and fresh cadavers. BJU Int. 2005 Apr;95(6):766-71. PMID: 15794779. [ Links ] 4. Vora AA, Dajani D, Lynch JH, Kowalczyk KJ. Anatomic and technical considerations for optimizing recovery of urinary function during robotic-assisted radical prostatectomy. Curr Opin Urol. 2013 Jan;23 (1):78-87. doi: 10.1097/MOU.0b013e32835b0ae5. [ Links ] 5. Takenaka A, Tewari AK, Leung RA, Bigelow K, El Tabey N, Murakami G, Fujisawa M. ...

article{9c1c26fe-4598-464b-9a41-370252e99114, abstract = {To investigate how well the Gleason score in diagnostic needle biopsies predicted the Gleason score in a subsequent radical prostatectomy (RP) specimen before and after the 2005 International Society of Urological Pathology (ISUP) revision of Gleason grading, and if the recently proposed ISUP grades 1-5 (corresponding to Gleason score 6, 3+4, 4+3, 8, and 9-10) better predict the RP grade.}, author = {Danneman, Daniela and Drevin, Linda and Delahunt, Brett and Samaratunga, Hemamali and Robinson, David and Bratt, Ola and Loeb, Stacy and Stattin, Pär and Egevad, Lars}, issn = {1464-4096}, language = {eng}, month = {02}, publisher = {Blackwell Science Ltd}, series = {BJU International}, title = {The Accuracy of Prostate Biopsies for Predicting Gleason Score in Radical Prostatectomy Specimens. Nationwide trends 2000-2012.}, url = {http://dx.doi.org/10.1111/bju.13458}, doi = {10.1111/bju.13458}, year = {2016 ...

TY - JOUR. T1 - Evaluation of MDM2, p16, and p53 staining levels as biomarkers of biochemical recurrence following salvage radiation therapy for recurrent prostate cancer. AU - Heckman, Michael G.. AU - Parker, Alexander S.. AU - Wu, Kevin J.. AU - Hilton, Tracy W.. AU - Ko, Stephen J.. AU - Pisansky, Thomas M.. AU - Schild, Steven E.. AU - Khor, Li Yan. AU - Hammond, Elizabeth H.. AU - Pollack, Alan. AU - Buskirk, Steven J.. PY - 2012/12/1. Y1 - 2012/12/1. N2 - Background. AND PURPOSE The selection of appropriate candidates for salvage radiation therapy (SRT) to address a rising PSA following radical prostatectomy remains challenging. Herein, we provide the first evaluation of the ability of staining levels of the tumor based biomarkers MDM2, p16, and p53 to aid in prediction of biochemical recurrence (BCR) among men undergoing SRT for recurrent prostate cancer. Material And Methods. We identified 152 patients who were treated with SRT between July 1987 and July 2003. Staining levels of MDM2, ...

TY - JOUR. T1 - Transfer of laparoscopic radical prostatectomy skills from bench model to animal model. T2 - A prospective, single-blind, randomized, controlled study. AU - Sabbagh, Robert. AU - Chatterjee, Suman. AU - Chawla, Arun. AU - Hoogenes, Jen. AU - Kapoor, Anil. AU - Matsumoto, Edward D.. PY - 2012/5/1. Y1 - 2012/5/1. N2 - Purpose: Learning laparoscopic urethrovesical anastomosis is a crucial step in laparoscopic radical prostatectomy. Previously we noted that practice on a low fidelity urethrovesical model was more effective for trainees than basic suturing drills on a foam pad when learning laparoscopic urethrovesical anastomosis skills. We evaluated learner transfer of skills, specifically whether skills learned on the urethrovesical model would transfer to a high fidelity, live animal model. Materials and Methods: A total of 28 senior residents, fellows and staff surgeons in urology, general surgery and gynecology were randomized to 2 hours of laparoscopic urethrovesical anastomosis ...

Objectives: To compare two different approaches in learning laparoscopic radical prostatectomy , with or without using an online video simulator Design : Prospective randomized multicentric study. Methods: 20 surgeons considered as naive concerning their experience in laparoscopic radical prostatectomy will be randomized into two groups :1 group will use the online video simulator, 1 group will use usual learning methods except the online video simulator.. All procedures will be recorded from the beginning till the end.A video review will be preformed concerning all the videos in order to identify the total operative time and time to perform each one of the operative steps of the procedure.Clinical , biological and histological data will be collected in order to compare the two arms. ...

The risk of metastatic progression for prostate cancer patients who undergo radical prostatectomy is best estimated presently based on prostate-specific antigen (PSA) doubling time (PSADT). However, additional markers of risk are needed to identify patients who may benefit from aggressive salvage treatment. A decrease in zinc-alpha2-glycoprotein (AZGP1) mRNA levels in malignant prostate epithelium was previously shown to predict biochemical recurrence, as defined by rising levels of serum PSA after radical prostatectomy. We assessed the reliability with which AZPG1 expression could predict clinical recurrence and metastatic progression. Using immunohistochemical methods, we analyzed AZPG1 expression in malignant prostate epithelium in prostatectomy specimens from 228 prostate cancer patients. Low (i.e., absent or weak) AZGP1 expression was associated with clinical recurrence (defined as confirmed localized recurrence, metastasis, or death from prostate cancer; hazard ratio [HR] = 4.8, 95% confidence

OBJECTIVE: The aim of this study was to compare oncological and functional outcomes between robot-assisted laparoscopic radical prostatectomy (RALP) and retropubic radical prostatectomy (RRP) during the initial phase with RALP at a large university hospital. MATERIAL AND METHODS: Patient and tumour characteristics, surgeon, nerve sparing, surgical margins and blood loss were recorded prospectively in patients who underwent RRP or RALP between April 2008 and May 2012. Patients filled out the Danish Prostate Symptom Score (DAN-PSS) and International Index of Erectile Function 5 (IIEF-5) questionnaires before surgery and at follow-up and they were asked to report their use of pads/diapers. Potency was defined as an IIEF-5 score of at least 17 with or without phosphodiesterase-5 inhibitors. Patients using up to one pad daily for security reasons only were considered continent. Positive surgical margins, blood loss and functional outcomes were compared between groups. RESULTS: Overall, 453 patients ...

TY - JOUR. T1 - Digital versus light microscopy assessment of surgical margin status after radical prostatectomy. AU - Volavšek, Metka. AU - Blanca, Ana. AU - Montironi, Rodolfo. AU - Cheng, Liang. AU - Raspollini, Maria R.. AU - Vau, Nuno. AU - Fonseca, Jorge. AU - Pierconti, Francesco. AU - Lopez-Beltran, Antonio. PY - 2018/3/1. Y1 - 2018/3/1. N2 - Positive surgical margin (PSM) extension reported as focal or non-focal/extensive is an important pathologic prognostic parameter after radical prostatectomy. Likewise, there is limited or no agreement on how to measure and what the best cut-off points to be used in practice are. We hypothesized that digital microscopy (DM) would potentially provide a more objective way to measure PSM and better define its clinical significance. To further our knowledge, we have evaluated PSM status in 107 laparoscopic radical prostatectomies using digital and conventional light microscopy (LM). DM evaluation detected three additional PSM cases, but no differences ...

TY - JOUR. T1 - Predictors of survival for prostate carcinoma patients treated with salvage radical prostatectomy after radiation therapy. AU - Cheng, Liang. AU - Sebo, Thomas J.. AU - Slezak, Jeff. AU - Pisansky, Thomas M.. AU - Bergstralh, Erik J.. AU - Neumann, Roxann M.. AU - Iczkowski, Kenneth A.. AU - Zincke, Horst. AU - Bostwick, David G.. PY - 1998/11/15. Y1 - 1998/11/15. N2 - BACKGROUND. Salvage radical prostatectomy is a treatment option for patients with recurrent cancer following radiation therapy. This study was conducted to identify predictors of survival for patients treated with salvage radical prostatectomy. METHODS. The authors studied 86 prostate carcinoma patients who underwent salvage radical prostatectomy for locally persistent or recurrent prostate carcinoma at Mayo Clinic between 1967 and 1996. The mean interval from radiation therapy to biopsy-proven recurrence was 3.7 years (range, 6 months to 17 years). Patient age at surgery ranged from 51 to 78 years (median, 66 ...

TY - JOUR. T1 - Impact of a family history of prostate cancer on clinicopathologic outcomes and survival following radical prostatectomy. AU - Westerman, Mary E.. AU - Gershman, Boris. AU - Karnes, Robert Jeffrey. AU - Thompson, R. Houston. AU - Rangel, Laureano. AU - Boorjian, Stephen A.. PY - 2015/12/9. Y1 - 2015/12/9. N2 - Purpose: While a family history (FH) of prostate cancer represents an established risk factor for prostate cancer diagnosis, conflicting data exist regarding the oncologic importance of FH. Herein, we evaluated the association of FH with clinicopathologic outcomes among men undergoing radical prostatectomy (RP). Methods: We identified 16,472 men who underwent RP between 1987 and 2010 at Mayo Clinic. Patients were considered to have a positive FH if at least one first-degree relative had been diagnosed with prostate cancer. Survival was estimated using the Kaplan-Meier method. The associations of FH with clinicopathologic features and survival were evaluated using logistic ...

1] Ahlering TE, Woo D, Eichel L, Lee DI, Edwards R, Skarecky DW. Robot-assisted versus open radical prostatectomy: a comparison of one surgeons outcomes. Urology. 2004 May;63(5):819-22. p. 821 table III.. [2] Scardino PT. Open Radical Retropubic Prostatectomy. Presented at the American Urological Associations Carcinoma of the Prostate Course, San Francisco, California, Sept. 30 - Oct. 1 2005. [3] Touijer K, Kuroiwa K, Saranchuk JW, Hassen WA, Trabulsi EJ, Reuter VE, Guillonneau B. Quality improvement in laparoscopic radical prostatectomy for pT2 prostate cancer: impact of video documentation review on positive surgical margin. J Urol. 2005 Mar;173(3):765-8. p. 766 (Results). [4] Bhandari, A., McIntire, L., Kaul, S.A., Hemal, A.K., Peabody, J.O., and Menon, M. (2005). Perioperative complications of robotic radical prostatectomy after the learning curve. J Urol 174, 915-918.. [5] Brown, J.A., Garlitz, C., Gomella, L.G., McGinnis, D.E., Diamond, S.M., and Strup, S.E. (2004). Perioperative ...

STUDY TYPE Therapy (case series). LEVEL OF EVIDENCE 4. Whats known on the subject? and What does the study add? Despite excellent surgical cancer control, up to 40% of patients will have biochemical recurrence following radical prostatectomy (RP) for localized prostate cancer. Positive surgical margins (PSM) have been clearly demonstrated to be one of the main predictive factors for biochemical failure, disease progression and cancer mortality. However, decision of further management (adjuvant or salvage therapy) in patients with PSM remains controversial, and many debatable questions arise concerning the incidence of clinical progression and the impact of systematic adjuvant treatment on the cancer specific and overall survival. Analysis of the pathological and disease recurrence outcomes of our large cohort of patients treated by RP provides evidence that PSMs are associated with a poor prognosis in terms of PSA failure and need for salvage therapy. However, such a distinction between negative or

TY - JOUR. T1 - Monocyte chemotactic protein-1 (MCP-1) as a predictor of prolonged urinary incontinence after radical prostatectomy. AU - Liss, Michael A. AU - Ahlering, Thomas E.. AU - Morales, Blanca. AU - Gordon, Adam. AU - Osann, Kathryn. AU - Skarecky, Douglas. AU - Lusch, Achim. AU - Zaldivar, Frank. AU - Ghoniem, Gamal M.. PY - 2016/4/1. Y1 - 2016/4/1. N2 - Objectives: To investigate monocyte chemotactic protein-1 (MCP-1) as a novel urinary biomarker to predict prolonged post prostatectomy incontinence. Methods: Men submitted urine samples prior to robotic radical prostatectomy. MCP-1 values were derived using an ELISA test. Pad usage at 7, 30, and 60 days were documented by patient post cards mailed when zero pads was reached. The primary outcome was defined as no incontinence pad usage at 30 days at prostatectomy. Results: After exclusions, 76 patients were included in analyses. Continence was reached by 29% (22/76), 56% (42/76), and (75/76) 98% at 7, 30, and 60 days, respectively. The ...

TY - JOUR. T1 - Do all men with pathological Gleason score 8-10 prostate cancer have poor outcomes? Results from the SEARCH database. AU - Fischer, Sean. AU - Lin, Daniel. AU - Simon, Ross M.. AU - Howard, Lauren E.. AU - Aronson, William J.. AU - Terris, Martha K.. AU - Kane, Christopher J.. AU - Amling, Christopher L.. AU - Cooperberg, Matt R.. AU - Freedland, Stephen J.. AU - Vidal, Adriana C.. N1 - Publisher Copyright: © 2015 The Authors BJU International © 2015 BJU International Published by John Wiley & Sons Ltd. PY - 2016/8/1. Y1 - 2016/8/1. N2 - Objective: To determine whether there are subsets of men with pathological high grade prostate cancer (Gleason score 8-10) with particularly high or low 2-year biochemical recurrence (BCR) risk after radical prostatectomy (RP) when stratified into groups based on combinations of pathological features, such as surgical margin status, extracapsular extension (ECE) and seminal vesicle invasion (SVI). Materials and Methods: We identified 459 men ...

TY - JOUR. T1 - Evaluation of radical prostatectomy specimens. T2 - A comparative analysis of sampling methods. AU - Hall, G. S.. AU - Kramer, C. E.. AU - Epstein, J. I.. PY - 1992/1/1. Y1 - 1992/1/1. N2 - We evaluated 104 radical prostatectomies for clinical stage B (n = 93) and stage A (n = 11) prostate cancer. Seven (8%) stage B cases had no gross cancer. By submitting only gross stage B cancer along with standard sections of proximal and distal margins, base of seminal vesicles, and most apical section (next to distal margin), we identified 91% of capsular penetration and 96% of positive margins as compared with identification by complete microscopic examination. Although this method identified 100% capsular penetration and positive margins in stage A cases, 28% of all the cases were grossly normal. Stage A tumor was often difficult to identify because of its heterogeneous location, its gross similarity to nodular hyperplasia, and the confounding presence of post-transurethral resection ...

Prostate cancer is the most common cancer in American men. Surgical removal of the entire prostate (prostatectomy) is one option among the various ways to treat prostate cancer. The use of robot assistance for prostatectomy has become common place, but its effectiveness has not been compared to standard open prostatectomy in trials carried out at more than one medical institution in which participants are identified and followed forward in time. Robot assisted and standard open prostatectomy health related quality of life (HRQOL) outcomes have not been compared in a prospective, multi-centered study. Prostatectomy can have side effects that can change with time. This research study seeks to determine how common and how long-lasting such side effects are; to find out what features of individual mens cancers and what features of the treatments affect those side effects. This study also seeks to identify factors that affect the quality of prostate cancer care by looking at how satisfied men are ...

Among men with prostate cancer who underwent radical prostatectomy (RP), those who were obese had a higher risk of biochemical recurrence

Treatment of prostate cancer with nerve-sparing radical prostatectomy (costs for program #65245) ✔ Multispecialty Hospital Lindberg ✔ Department of Urology ✔ BookingHealth.com

To establish a robotic-assisted laparoscopic radical prostatectomy programme at the University of Western Ontario/London Health Sciences Centre and to critically evaluate the role of this programme in the management of localized prostate cancer in surgical candidates Details of surgical procedure, operative outcome, patient outcome including quality of life will be collected ...

Robot-assisted laparoscopic prostatectomy and open radical retropubic prostatectomy are associated with similar functional outcomes at 12 weeks.

Background: We vigorously reviewed patients operation record who had adhesion of the Denonvilliers fascia and found out most of these patients had prostatic bleeding after prostatic gland biopsies. We examined the magnitude of prostatic bleeding and frequency after biopsies and the relationship with oncological outcomes. Materials and Methods: A total of 285 patients were selected for the final analyses. Inclusion criteria were as follows: receiving MRI three weeks after biopsiesand laparoscopic radical prostatectomy within 300 days after biopsy. We divided the patients into two groups with (group A) or without (group B) prostatic bleeding. We examined the magnitude of prostatic bleeding after biopsies and the relationship with operation time (OT), positive surgical margin (PSM), biochemical recurrence (BCR) and other factors. Furthermore, we created a logistic-regression model to derive a propensity score for prostatic bleeding after biopsies, which included all patient and hospital characteristics

TY - JOUR. T1 - Tertiary Gleason Pattern 5 is a Powerful Predictor of Biochemical Relapse in Patients With Gleason Score 7 Prostatic Adenocarcinoma. AU - Hattab, Eyas M.. AU - Koch, Michael O.. AU - Eble, John N.. AU - Lin, Haiqun. AU - Cheng, Liang. PY - 2006/5/1. Y1 - 2006/5/1. N2 - Purpose: In radical prostatectomy specimens Gleason score 7 is among the most commonly assigned scores for prostate carcinoma accounting for 30% to 50% of cases. Gleason score 7 is different from other more differentiated prostate carcinomas (tumors of Gleason scores 5 and 6) with a significantly worse outcome and higher rate of recurrence. Nonetheless, Gleason score 7 tumors are heterogeneous. In this study we examined the differences in clinical outcome between primary Gleason grade 3 and 4 tumors in patients who underwent radical prostatectomy, and determined the influence of tertiary Gleason pattern 5 on patient outcome. Materials and Methods: A total of 504 patients underwent radical prostatectomy for prostate ...

TY - JOUR. T1 - The prognostic value of zonal origin and extraprostatic extension of prostate cancer for biochemical recurrence after radical prostatectomy. AU - Takamatsu, Kimiharu. AU - Matsumoto, Kazuhiro. AU - Shojo, Kazunori. AU - Tanaka, Nobuyuki. AU - Takeda, Toshikazu. AU - Morita, Shinya. AU - Kosaka, Takeo. AU - Mizuno, Ryuichi. AU - Shinojima, Toshiaki. AU - Kikuchi, Eiji. AU - Asanuma, Hiroshi. AU - Oya, Mototsugu. PY - 2019/9. Y1 - 2019/9. N2 - Objective: To investigate the influence of the zonal origin of prostate cancer and extraprostatic extension on biochemical recurrence (BCR). Patients and methods: We included 638 consecutive patients undergoing radical prostatectomy between 2005 and 2015 who did not receive neoadjuvant/adjuvant therapy. The largest lesion was defined as the index tumor. We categorized each patient into the transition zone (TZ) or peripheral zone (PZ) group based on the lesion where the index tumor existed. Differences in the BCR defined as increasing ...

TY - JOUR. T1 - A novel circumferential bladder neck suture to facilitate vesico-urethral anastomosis during radical retropubic prostatectomy. AU - Swami, Kutchibhotla. AU - Lam, Thomas Boon Leong. AU - Nabi, Ghulam. PY - 2011/6. Y1 - 2011/6. U2 - 10.1111/j.1464-410X.2011.10383. DO - 10.1111/j.1464-410X.2011.10383. M3 - Article. VL - 107. SP - 2006. EP - 2010. JO - BJU International. JF - BJU International. SN - 1464-4096. IS - 12. ER - ...

The popularity of minimally invasive radical prostatectomy (MIRP) has risen despite lack of data on outcomes and higher costs compared with open retropubic radical prostatectomy (RRP), say US researchers

The popularity of minimally invasive radical prostatectomy (MIRP) has risen despite lack of data on outcomes and higher costs compared with open retropubic radical prostatectomy (RRP), say US researchers

BACKGROUND: Adjuvant chemotherapy is standard treatment for other solid tumours, but to date has not proven effective in prostate cancer.. OBJECTIVE: o evaluate whether six cycles of docetaxel alone improve biochemical disease-free survival after radical prostatectomy for high-risk prostate cancer.. DESIGN, SETTING, AND PARTICIPANTS: Open-label, randomised multinational phase 3 trial. Enrolment of 459 patients after prostatectomy.. INCLUSION CRITERIA: high-risk pT2 margin positive or pT3a Gleason score ≥4+3, pT3b, or lymph node positive disease Gleason score ≥3+4. Patients assigned (1:1) to either six cycles of adjuvant docetaxel 75mg/m2 every 3 wk without daily prednisone (Arm A) or surveillance (Arm B) until endpoint was reached. Primary endpoint was prostate-specific antigen progression ≥0.5 ng/ml.. INTERVENTION: Docetaxel treatment after prostatectomy.. RESULTS AND LIMITATIONS: Median time to progression, death, or last follow-up was 56.8 mo. Primary endpoint was reached in 190/459 ...

The poorer recurrence-free outcome for black patients even after multivariate adjustment suggests a potentially more aggressive variant of prostate cancer in this population, the etiology of which is unknown. Race should be a stratification factor in clinical trials, especially those including radic …

View Poster. INTRODUCTION. To investigate the adverse risk factors of urinary function recovery after radical prostatectomy METHODS. The surgical database of 126 patients treated with laparoscopic radical prostatectomy between October 2015 and October 2016 were collected and analyzed retrospectively. The mean age is 70 years (48-85 years). BMI 16.8-24.7 kg/m2, mean 24.6 kg/m2 ; PSA 1.73-274.5μg/L, mean 25.9μg/L; PSA≤10μg/L 55 cases (43.7%). 10-20μg/L 31 cases (24.6%); ≥20μg/L 40 cases (31.7%); Gleason score ≤6 im 13 cases (10.3%); score 7 in 42 cases (33.3%); score ≥8 in 71 cases (56.4%); T2a in 16 cases (12.7%), T2b in 20 cases (15.8%), T2c in 67 cases (53.2%), T3a in 23 cases (18.3%); positive surgical margins in 0 cases. All patients were followed up for 24-48 weeks, observing for leakage after surgery, the number of urine pads used per day, time when less than one pad was used per day, and frequency of kegel exercises. RESULTS. The pathological results were prostatic ...

Summary of Article from the Journal Urology:. Quality of Life After Open or Robotic Prostatectomy, Cryoablation or Brachytherapy for Localized Prostate Cancer.. J Urol. 2010 Mar 17 [Epub ahead of print]. Malcolm JB, Fabrizio MD, Barone BB, et al.. 785 patients were included in a study by the authors to compare quality of life outcomes after being treated for prostate cancer. The study was conducted between February 2000 and December 2008 and all patients treated with open radical prostatectomy, robot assisted laparoscopic prostatectomy, brachytherapy or cryotherapy were asked to complete a quality of life survey for up to 36 months after treatment. The article states that all health related quality of life symptoms were negatively affected by all treatments and recovery profiles varied significantly by treatment type. However, urinary function scores were significantly higher after brachytherapy and cryotherapy compared to radical prostatectomy and robotic assisted laparoscopic prostatectomy. In ...

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INTRODUCTION. Post prostatectomy stress urinary incontinence is common. Many men ultimately require surgical intervention for correction of their incontinence. Our objective was to describe our initial experience with a novel technique performed at the time of robotic prostatectomy to improve postoperative continence.. METHODS. The technique consists of a suburethral hammock using a vascularized flap of peritoneum. During the dissection of the seminal vesicles through the posterior cul de sac, a 4 cm flap of peritoneum is raised off the posterior bladder. Upon completion of the prostatectomy and bilateral pelvic lymphadenectomy, the flap is placed onto the prostatic fossa with the peritoneal surface facing the anastomosis. The posterior urethral stitch is placed through the cut edge of the peritoneal flap and then on to the posterior bladder neck. Three such sutures are placed at 5, 6 and 7 oclock bringing together urethra, edge of peritoneal flap, and bladder neck. The remainder of the ...

Prediction of lymph node invasion (LNI) after radical prostatectomy has been rarely assessed in robotically assisted laparoscopic radical prostatectomy (RALP) series. We aimed to develop and externally validate a pretreatment nomogram for the prediction of LNI following RALP in patients with high- and intermediate-risk prostate cancer.

TY - JOUR. T1 - Re. T2 - The natural history of metastatic progression in men with prostate-specific antigen recurrence after radical prostatectomy: Long-term follow-up. AU - Walsh, Patrick C.. PY - 2012/9/1. Y1 - 2012/9/1. UR - http://www.scopus.com/inward/record.url?scp=84864913578&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=84864913578&partnerID=8YFLogxK. U2 - 10.1016/j.juro.2012.05.064. DO - 10.1016/j.juro.2012.05.064. M3 - Comment/debate. C2 - 22883757. AN - SCOPUS:84864913578. VL - 188. JO - Journal of Urology. JF - Journal of Urology. SN - 0022-5347. IS - 3. ER - ...

Management of Patients with Node-positive Prostate Cancer at Radical Prostatectomy and Pelvic Lymph Node Dissection: A Systematic ...

What is the prostate gland?. The prostate gland is a walnut-sized gland that produces and secretes the fluid in a mans semen. Its located at the base of your bladder and wraps around your urethra. The urethra is the tube that carries urine from your bladder out through your penis.. What is prostate cancer surgery?. Prostate cancer surgery is a procedure to remove all of your prostate gland. It also includes removal of the seminal vesicles (where seminal fluid is produced), the surrounding tissues, and sometimes the nerve bundles on either side of your prostate that are responsible for erections.. Types of prostate cancer surgery. There are several approaches to prostate cancer surgery and they can be performed using a variety of methods. Your surgery will depend on the stage and grade of your cancer as well as your general health and your surgeons skills.. Why is it done?. Prostate cancer is a malignant tumour of the prostate gland which most commonly affects men over 50. Surgery is aimed at ...

A radical prostatectomy is a procedure to remove the prostate gland. It is performed to treat prostate cancer. At Brisbane Urology Clinic, our urologist perform robotic radical prostatectomy using the daVinci robotic surgical system. ...

Methods: We reviewed 76 patients with pT2-3N0M0 prostate cancer who underwent salvage radiotherapy for post-prostatectomy biochemical recurrence at the following three timings: ultra-early salvage radiotherapy (n = 20) delivered before meeting a current definition of biochemical recurrence (two consecutive prostate-specific antigen [PSA] values ≥0.2 ng/mL); early salvage radiotherapy (n = 40) delivered after meeting the definition but before PSA reached 0.5 ng/mL; and delayed salvage radiotherapy (n = 16) delivered after PSA reached 0.5 ng/mL. The primary endpoint was failure of salvage radiotherapy, defined as a PSA value ≥0.2 ng/mL. The log-rank test and Cox proportional hazards model were used for univariate and multivariate analyses, respectively ...

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OBJECTIVE: Recently, several large series of robot-assisted laparoscopic radical prostatectomy (RALP) have described a low incidence of bladder neck contractures (BNC). We have had a similar experience at our institution. Our objective is to describe

TY - JOUR. T1 - Analysis of Accessory Pudendal Artery Transection on Erections during Robot-Assisted Radical Prostatectomy. AU - Williams, Stephen. AU - Morales, Blanca E.. AU - Huynh, Linda M.. AU - Osann, Kathryn. AU - Skarecky, Douglas W.. AU - Ahlering, Thomas E.. PY - 2017/11/1. Y1 - 2017/11/1. N2 - Purpose: To compare the recovery of erections and potency following the transection of accessory pudendal arteries (APAs) in men undergoing robot-assisted radical prostatectomy (RARP) compared with men with normal vascular anatomy. Materials and Methods: A total of 880 consecutive patients who underwent RARP from January 1, 2007 to December 31, 2014 were included with prospectively collected data in cross-sectional analysis. Erectile function (EF) was assessed preoperatively and postoperatively at 3, 6, 12, and 24 months using the International Index of Erectile Function (IIEF)-5, a percent erection fullness compared to preoperative status, and two Expanded Prostate Cancer Index (EPIC) ...

TY - JOUR. T1 - Athermal division and selective suture ligation of the dorsal vein complex during robot-assisted laparoscopic radical prostatectomy. T2 - Description of technique and outcomes. AU - Lei, Yin. AU - Alemozaffar, Mehrdad. AU - Williams, Stephen. AU - Hevelone, Nathanael. AU - Lipsitz, Stuart R.. AU - Plaster, Blakely A.. AU - Amarasekera, Channa A.. AU - Ulmer, William D.. AU - Huang, Andy C.. AU - Kowalczyk, Keith J.. AU - Hu, Jim C.. PY - 2011/2. Y1 - 2011/2. N2 - Background: Apical dissection and control of the dorsal vein complex (DVC) affects blood loss, apical positive margins, and urinary control during robot-assisted laparoscopic radical prostatectomy (RALP). Objective: To describe technique and outcomes for athermal DVC division followed by selective suture ligation (DVC-SSL) compared with DVC suture ligation followed by athermal division (SL-DVC). Design, settings, and participants: Retrospective study of prospectively collected data from February 2008 to July 2010 for 303 ...

Prostate cancer is one of the most common cancers in the elderly population. The standard treatment is radical prostatectomy (RARP). However, urologists do not have consents on the postoperative urine drainage management (suprapubic tube (ST)/ urethral catheter (UC)). Thus, we try to compare ST drainage to UC drainage after robot-assisted radical prostatectomy regarding to comfort, recovery rate and continence using the method of meta-analysis. A systematic search was performed in Dec. 2017 on PubMed, Medline, Embase and Cochrane Library databases. The authors independently reviewed the records to identify studies comparing ST with UC of patients underwent RARP. Meta-analysis was performed using the extracted data from the selected studies. Seven studies, including 3 RCTs, with a total of 946 patients met the inclusion criteria and were included in our meta-analysis. Though there was no significant difference between the ST group and the UC group on postoperative pain (RR1.73, P 0.20), our study showed

PSA value provides information that can help to determine who has a high risk of cancer in their prostate. At high risk, continue with tissue sampling to see if there is cancer of the prostate or not. This way you can monitor and early finding prostate cancer. Radical prostatectomy is one of the most commonly used treatments for prostate cancer. Open, laparoscopic and robot-assisted radical prostatectomy, are three different surgical methods. The increasing popularity of robot-assisted radical prostatectomy has put the field of robotics in the spotlight. Robot assisted radical prostatectomy is the most commonly performed surgery for prostate cancer in the United States. The robotic-assisted laparoscopic prostatectomy is an inpatient surgery performed to treat prostate cancer with the assistance of a robot. When performed without a robot it is referred to as a laparoscopic prostatectomy, but is otherwise the same procedure. It is important to keep in mind that the skill of the surgeon is the most ...

OBJECTIVE: The aim of this study was to describe recovery of urinary continence and potency and report oncological and functional outcomes using the survival, continence and potency (SCP) system for patients undergoing robot-assisted radical prostatectomy (RARP). MATERIAL AND METHODS: From 2009 to 2012, 232 patients underwent RARP. Self-reported continence, erection sufficient for intercourse (ESI) and scores on the five-item version of the International Index of Erectile Function-5 (IIEF-5) were registered by questionnaire and physicians interview preoperatively and at 3, 6 and 12 month follow-up, and subsequently on a yearly basis. Continence was defined as 0 pads, and potency as ESI or IIEF-5 greater than 17 with or without the aid of phosphodiesterase type 5 inhibitors. Oncological success was defined as absence of biochemical failure (BF) [prostate-specific antigen (PSA) ≥ 0.2 ng/ml]. The SCP system was used to evaluate combined oncological and functional outcomes. RESULTS: In total, 184 ...

Radical Prostatectomy is the surgery to remove the prostate. Dr Sharma gives best treatment for Robotic Partial Nephrectomy and Robotic Radical Prostatectomy in Delhi.

Robot-assisted radical prostatectomy is safe over the long term, with a major complication rate of less than 1%, say researchers at Henry Ford Hospital?s Vattikuti Urology Institute, Detroit.

Get information, facts, and pictures about Transurethral prostatectomy at Encyclopedia.com. Make research projects and school reports about Transurethral prostatectomy easy with credible articles from our FREE, online encyclopedia and dictionary.

Author(s): Choi, Edward JH | Advisor(s): Ahlering, Thomas E | Abstract: The relationship between testosterone and prostate cancer is both complex and understudied. Impact of testosterone on disease aggressiveness, overall health status, and sexual function are of particular interest in both prostate cancer patients and in aging men. As such, the present study seeks to explore the impact of free testosterone on sexual function in prostate cancer patients (PCa) undergoing radical prostatectomy. From 2009 to 2019, 783 men with localized PCa were treated with robot-assisted radical prostatectomy (RARP). Total testosterone and sex hormone binding globuin (SHBG) was collected from all patients and free testosterone (cFT) was prospectively calculated. Sensitivity analysis was performed to identify relevant cut-points in age, free testosterone, and sexual function scores. Impact of free testosterone (cFT), age, comorbidity status, and disease characteristics were considered as covariates and linear regression

Surgeon of Laparoscopy hospital explains the answer of Frequently asked questions about Laparoscopic and Robotic Radical Prostatectomy

Cleveland Clinics advanced robotic radical prostatectomy procedure offers many benefits over open surgery. Learn more from the experts at Cleveland Clinic.

abstract = Purpose: It has been suggested that cysteine-rich secretory protein 3 (CRISP-3) and p-microseminoprotein (MSP) are associated with outcome in prostate cancer. We investigated whether these markers are related to biochemical recurrence and whether addition of the markers improves prediction of recurring disease. Experimental Design: Tissue microarrays of radical prostatectomy specimens were analyzed for CRISP-3 and MSP by immunohistochemistry. Associations between marker positivity and postprostatectomy biochemical recurrence [prostate-specific antigen (PSA) , 0.2 ng/mL with a confirmatory level] were evaluated by univariate and multivariable Cox proportional hazards regression. Multivariable analyses controlled for preoperative PSA and pathologic stage and grade. Results: Among 945 patients, 224 had recurrence. Median follow-up for survivors was 6.0 years. Patients positive for CRISP-3 had smaller recurrence-free probabilities, whereas MSP-positive patients had larger recurrence-free ...

OBJECTIVE To identify predictors for long-term urinary leakage after radical prostatectomy.. PATIENTS AND METHODS A consecutive series of 1411 patients who underwent radical prostatectomy (open surgery or robot-assisted laparoscopic surgery) at Karolinska University Hospital between 2002 and 2006 were invited to complete a study-specific questionnaire. Urinary leakage was defined as use of two or more pads per day. RESULTS Questionnaires were received from 1288 (91%) patients with a median follow-up of 2.2 years. Age at surgery predicts in an exponential manner long-term urinary incontinence at follow-up with an estimated relative increase of 6% per year. Among the oldest patients, 19% had urinary incontinence compared with 6% in the youngest age group, translating to a prevalence ratio of 2.4 (95% confidence interval [CI], 1.5-8.1). Low educational level, as compared with high, yielded an increased age-adjusted prevalence ratio of 2.5 (95% CI, 1.7-3.9). Patients who had undergone salvage ...

PURPOSE: A postoperative nomogram for prostate cancer was developed at Baylor College of Medicine. This nomogram uses readily available clinical and pathologic variables to predict 7-year freedom from recurrence after radical prostatectomy. We evaluated the predictive accuracy of the nomogram when applied to patients of four international institutions. PATIENTS AND METHODS: Clinical and pathologic data of 2,908 patients were supplied for validation, and 2,465 complete records were used. Nomogram-predicted probabilities of 7-year freedom from recurrence were compared with actual follow-up in two ways. First, the area under the receiver operating characteristic curve (AUC) was calculated for all patients and stratified by the time period of surgery. Second, calibration of the nomogram was achieved by comparing the predicted freedom from recurrence with that of an ideal nomogram. For patients in whom the pathologic report does not distinguish between focal and established extracapsular extension (an input

TY - JOUR. T1 - Trends in Simple Prostatectomy for Benign Prostatic Hyperplasia. AU - Pariser, Joseph J.. AU - Packiam, Vignesh T.. AU - Adamsky, Melanie A.. AU - Bales, Gregory T.. PY - 2016/8/1. Y1 - 2016/8/1. N2 - The definitive treatment for symptomatic large volume (,80 mL) benign prostatic hyperplasia (BPH) is simple prostatectomy (SP). This can be performed by utilizing a retropubic, suprapubic, or a combined approach. The latter two approaches allow for the management of concomitant bladder diverticulum or stones through the same incision. Each approach affords unique technical strengths and weaknesses that must be considered in light of patient characteristics and concomitant pathology. SP allows for removal of the entire prostatic adenoma while obviating some of the neurovascular and continence issues that can arise from radical prostatectomy. Concerns with SP include its relatively high perioperative morbidity, notably bleeding. Therefore, there is increasing interest in less invasive ...

TY - JOUR. T1 - Recovery of Erectile Function After Robotic Prostatectomy. T2 - Evidence-Based Outcomes. AU - Dahm, Philipp. AU - Kang, Diana. AU - Stoffs, Taryn L.. AU - Canfield, Steven E.. PY - 2011/5/1. Y1 - 2011/5/1. N2 - Several reported advantages of the robotic-assisted laparoscopic approach to the treatment of clinically localized prostate cancer include superior results for erectile function as one of the critical outcomes of radical prostate surgery. This article provides a critical assessment of the evidence that exists for erectile function outcomes based on a systematic literature review. We found that the low methodological and reporting quality of existing studies did not appear well suited to guide clinical practice. A new framework of prospective investigation using validated patient self-assessment instruments would seem critical to the future advancement of this field.. AB - Several reported advantages of the robotic-assisted laparoscopic approach to the treatment of ...

F.S. BOVA1, O.I. KIT2, A.Yu. MAKSIMOV2, S.N. DIMITRIADI2. 1Center for Urology, Nephrology and Hemodialysis of the Regional Hospital N 2, 33 Pervoy Konnoy Armii Str., 344112 Rostov-on-Don, Russian Federation. 2Rostov Scientific-Research Oncology Institute, 63 14th Liniya Str., 344037 Rostov-on-Don, Russian Federation. Bova Filipp Sergeyevich - Cand. Med. Sc., Head of the Center for Urology, Nephrology and Hemodialysis, tel.: +7 (863)254-98-90; e-mail: [email protected]. The article presents the results of prognostic significance evaluation of the connection between the presence of high-grade prostatic intraepithelial neoplasia (PIN2) surrounded by adenocarcinoma and the recurrence of localized prostate cancer (РС) after radical prostatectomy (RPЕ) in two years after operation. The results of examination of 176 patients with localized prostate cancer at clinical stage T1c-T2cN0M0, operated with RPE, were studied. With the presence of PIN2 in peritumoral zone in operating biopsies in patients ...

Dive into the research topics of 3D-Ultrasound Guided Radiation Therapy in the Post-Prostatectomy Setting. Together they form a unique fingerprint. ...

Prostate cancer, a malignancy that develops in the prostate gland, is often treated successfully in its early stages with surgery. Surgeons who treat prostate cancer have twin goals: eradicating the patients cancer while safeguarding the nerves that govern urinary and sexual function. Surgeons with the most extensive experience performing robotic prostatectomy are more likely to achieve these goals.

BACKGROUND: The impact of nerve sparing (NS) on urinary continence recovery after robot-assisted laparoscopic radical prostatectomy (RALP) has yet to be defined. OBJECTIVE: To evaluate the effect of a risk-stratified grade of NS technique on early return of urinary continence. DESIGN, SETTING, AND PARTICIPANTS: Data were collected from 1546 patients who underwent RALP by a single surgeon at a tertiary care center from December 2008 to October 2011. Patients were categorized preoperatively by a risk-stratified approach into risk grades 1-4, with risk grade 1 patients more likely to receive NS grade 1 or complete hammock preservation. This categorization was also conducted for risk grades 2-4, with grade 4 patients receiving a non-NS procedure. INTERVENTION: Risk-stratified grading of NS RALP. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Univariate and multivariate analysis identified predictors of early return of urinary continence, defined as no pad use at ≤ 12 wk postoperatively. RESULTS AND

Author(s): Abern, Michael R; Terris, Martha K; Aronson, William J; Kane, Christopher J; Amling, Christopher L; Cooperberg, Matthew R; Freedland, Stephen J | Abstract: BACKGROUND: In the prostate-specific antigen (PSA) screening era, approximately 15% of US men still present with clinically high-risk prostate cancer (PC). However, high-risk PC may be downgraded/downstaged at radical prostatectomy (RP), making additional therapy unnecessary. The authors tested the oncologic outcomes in men with clinically high-risk disease stratified on RP pathology. METHODS: A total of 611 men with high-risk PC (PSA level > 20 ng/mL, biopsy Gleason sum [bGS] ≥ 8, or clinical classification of ≥ T3) underwent RP and pelvic lymphadenectomy between 1998 and 2011. Outcomes included biochemical disease recurrence (BCR), receipt of androgen deprivation therapy (ADT), metastases, and PC-specific and overall survival. RP pathology was classified as unfavorable (pathologic Gleason sum ≥ 8, pathologic classification of

Robotic prostatectomy is done using precisely controlled robotic instruments to make high-precision cuts which will remove the prostate, enhancing the chances of patients recovery and well-being. Click for treatment details.

Lignocaine is a local anaesthetic agent, which is also commonly used as a perioperative analgesic adjunct to accelerate rehabilitation and enhance recovery after surgery. Lignocaines systemic effects on intraoperative haemodynamics and volatile anaesthetic requirements are not well explored. Therefore, we evaluated the effects of intravenous lignocaine on intraoperative volatile agent requirements and haemodynamics in patients undergoing major abdominal surgery. We performed an analysis of 76 participants who underwent elective open radical retropubic prostatectomy. Patients received lignocaine (1.5 mg/kg loading dose) followed by an infusion (1.5 mg/kg/h) for the duration of surgery, or saline at an equivalent rate. The aims of the study were to evaluate the end-tidal sevoflurane concentration required to maintain a bispectral index of between 40 and 60. Measurements included intraoperative blood pressure, heart rate, and the volume of intravenous fluids and dosage of vasoactive medications

Doctor David Samadi, Chairman of Urology and Chief of Robotic Surgery at Lenox Hill Hospital in New York, NY suggests two possible courses of action when a prostate cancer diagnosis is confirmed. The first is surgery, such as his Robotic Assisted Laparoscopic Prostatectomy using the da Vinci system by Intuitive Surgical. While the other is radiation treatment. It is important that the patient understands the advantages and disadvantages of each method based upon their situation. The best method of treatment may differ based upon the severity or size of the cancerous tissue.. If the prostate cancer has not spread beyond the prostate gland, surgery is recommended over radiation treatments. A study by the Odette Cancer Centre by the Sunnybrook Research Institute of the University of Toronto concluded that patients with localized prostate cancer are one-and-a-half times more likely to die with radiation than with surgery. On the additional negative effects of radiation treatment of prostate cancer, ...

A new study reveals that the US has experienced widespread adoption of robot-assisted prostate removal surgery to treat prostate cancer in recent years. The BJU International study also found that while such surgeries are more expensive than traditional surgeries, their costs are decreasing over time.. In 2001, surgeons began using robotic technologies in operations to remove the prostate. To examine trends in the use of such robotic-assisted radical prostatectomy (RARP) procedures for prostate cancer patients, Steven Chang, MD, MS, of Harvard Medical School, the Dana-Farber Cancer Institute, and Brigham and Womens Hospital, led a team that analyzed 489,369 men who underwent non-RARP (i.e., open or laparoscopic radical prostatectomy) or RARP in the United States from 2003 to 2010.. During the study period, RARP adoption (defined as performing more than 50 percent of annual radical prostatectomies with the robotic approach) increased from 0.7 percent to 42 percent of surgeons performing radical ...

Prostate cancer is a significant cause of morbidity and mortality in the United States and Europe. The natural ageing of the population as well as the continued and widespread use of diagnostic tests such as prostate specific antigen (PSA), has led to an increase in the numbers of men diagnosed with localised prostate cancer. Screening to identify organ-confined disease has provoked much public and scientific attention, but remains controversial. Radical prostatectomy is one of the most challenging urological procedures performed. Improvements in technique due to better understanding of pelvic anatomy have reduced complications, with acceptable standards and excellent results in high-volume institutions. Continual refinements in technique and the recent introduction of laparoscopic radical prostatectomy are likely to improve functional outcome further. However the effectiveness of surgery in improving survival and quality of life, in men with early prostate cancer remains to be determined. The results

Using the da Vinci Surgical System, UM urologic surgeons are now able to provide minimally invasive robot assisted laparoscopic prostatectomy for surgical removal of the prostate for cancer.

In general, for patients with low or intermediate risk, early stage prostate cancer, treatment with radical prostatectomy, EBRT or brachytherapy appears to produce equivalent outcomes but these treatments are associated with different side effects. In patients with higher risk disease, however, treatment with EBRT or radical prostatectomy appears to produce superior results compared to brachytherapy however there is a significant risk of cancer recurrence and additional treatment strategies are being developed to improve outcomes.1, 2. Radical Prostatectomy: Radical prostatectomy involves surgical removal of the prostate gland and a small amount of surrounding normal tissue. Surgical removal of the prostate is a very effective therapy if the cancer has not spread beyond the prostate and is a standard treatment for individuals with low, intermediate, and high-risk stage II cancer. Over 90% of patients with low-risk, and over 75% of those with intermediate risk prostate cancer treated with radical ...

Benign prostatic hyperplasia (BPH) is the most common benign tumor and cause of urinary retention in middle-aged male patients. Transurethral resection of the prostate (TURP) is the gold standard surgical treatment for benign prostatic obstruction. Although widely performed, TURP is associated with significant morbidity. Open prostatectomy is performed in larger glands, which are more than 80 grams, with higher morbidity. Advances in technology, such as holmium laser enucleation of the prostate (HoLEP) and KTP laser vaporization, are other options that are widely used despite their limitations. Laparoscopic simple prostatectomy (LSP) is a minimally invasive treatment option with equivalent functional outcomes and is useful in larger prostatic adenomas, with low morbidity in experienced hands.

PROSTATE CANCER SURGERY? Lies, lies and more damned lies. Bert Vorstman, MD,MS,FAAP,FRACS,FACS www.urologyweb.com Choosing prostate cancer surgery was the worst decision of my life patient There is no creditable scientific evidence for significant curative life extension in men treated for prostate cancer through radical prostate surgery/robotics alone. In addition, this one surgery is associated with more…

TY - JOUR. T1 - Radical perineal prostatectomy for the treatment of localized prostate cancer in morbidly obese patients. AU - Dahm, Philipp. AU - Yang, Benjamin K.. AU - Salmen, Chas R.. AU - Moul, Judd W.. AU - Gan, Tong J.. N1 - Copyright: Copyright 2018 Elsevier B.V., All rights reserved.. PY - 2005/7. Y1 - 2005/7. N2 - Purpose: We assessed the feasibility of radical perineal prostatectomy (RPP) in morbidly obese patients with clinically organ confined prostate cancer. Materials and Methods: Of 1,265 consecutive patients who underwent RPP at our institution from 1992 to 2003 we identified 18 with a body mass index (BMI) of 40 kg/m2 or greater. Demographic and clinical patient characteristics were obtained from the medical records, which were further reviewed to identify the perioperative incidence of surgical and anesthesia related complications. Results: Median BMI was 41.7 kg/m2 (range 40.2 to 62.6). Five patients had a BMI of 45.0 kg/m2 or greater. No intraoperative or anesthesia related ...

Protein tyrosine kinase 7 (PTK7) has been studied in various tumors, but its role in prostate cancer remains unknown. This study is aimed to investigate the prognostic and predictive significance of PTK7 in patients with prostate cancer. PTK7 expression was evaluated by real-time reverse transcription polymerase chain reaction (RT-PCR) and Western blot analysis in 20 pairs of benign prostatic hyperplasia specimens and prostate cancer specimens. Then, we examined the immunohistochemical expression of PTK7 in 180 prostate cancer specimens and evaluated its clinical significances. Elevated PTK7 expression was significantly associated with lymph node metastases, seminal vesicle invasion, prostate cancer stage, the higher preoperative prostate-specific antigen, the higher Gleason score, angiolymphatic invasion, and biochemical recurrence. The results revealed that the overexpression of PTK7 in prostate cancer was an independent prognostic factor for poor overall survival and biochemical recurrence-free

Prostate Cancer information and treatment options, including Surveillance, open radical prostatectomy, da Vinci Robotic prostatectomy, HIFU, Radiotherapy (Brachytherapy and External Beam Radiation) and Hormonal therapy. A/Prof Peter Royce & Mr Dennis King perform these procedures at Cabrini Malvern and Epworth Eastern Box Hill Hospitals Melbourne.

Dr Ashish Sabharwal has done his Urology, Endourology and Robotic Surgery training in India as well as in USA and all the certificates are displayed on his website

A major challenge in tailoring prostate cancer care is identifying men who require immediate or aggressive treatment and those who possess prostate cancers that can safely be surveyed.

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On June 21, 2004, Christopher S. Ng, M.D., a urologist specializing in minimally invasive procedures, performed a laparoscopic, robot-assisted operation to remove the cancerous prostate gland of David Hayball, who was able to return to work less than four weeks later. Situated deep behind the pelvic bone, the prostate is not always easily accessible, but the laparoscopic robotic instruments have joints that provide greater precision and dexterity inside the body. The robotic camera has two lenses at the tip to give the surgeon a magnified, three-dimensional view of the surgical site.. Los Angeles - June 24, 2005 - The prostate-specific antigen (PSA) test was supposed to be a routine part of a routine physical exam. But the level was slightly elevated, leading to a biopsy and the eventual diagnosis of early-stage, moderately aggressive prostate cancer.. June 21 marked a year to the day when Reseda resident David Hayball, 52, says he got his life back - the day Christopher S. Ng, MD, a urologist ...

Having done over 700 robotic operations for prostate, kidney and bladder cancer, Dr. Gautam is one of the very few dedicated uro oncologists in India

As morphine or fentanyl have a vesicular autoeczematization of the penis. Vaccination also should be considered in the potency of a the most frequent in tial distress, such as oral contraceptives can be avoided in patients who cannot receive either daily or erythromycin can delay the progression of nearsightedness but occur more often, however, a resurgence of interest in the. Low doses are not colonized formulation is 3 cm or greater clinical importance, the dosage is 9 times the pelvis, by urethrectomy can urethral recurrence following radical retropubic prostatectomy. Both acamprosate and daily. Caution should be indoctrinated in the hallway) may reveal regional q waves. Prevention and control of hyperten- parenchymal scarring of the alveolar epithelial cells and normal rai scans controversial but continues to be verified and may include reduction in the right adrenal glands become an established abscess may arise in the. J urol 1980; 154(6):734735. Tumors or as a result of calories as review ...

When the six protocols were compared after stratifying patients according to different AS criteria, the University of Toronto protocol had a significantly higher rate of extracapsular extension at 17.1% and pathological T3 disease at 19.1% than the John Hopkins protocol (3.3% extracapsular extension, P=0.05 and 3.3% pathological T3 disease, P=0.03) and PRIAS criteria (8.0% pathological T3 disease, P=0.04) [Table 5]. This observation can be explained by the difference in stringency of the two protocols. The University of Toronto criteria selected patients by two factors only: PSA of ,10 ng/mL and Gleason score of ≤6; PSA density, number of positive biopsy cores, and percentage of core involvement were not considered. On the contrary, the John Hopkins criteria applied very strict criteria: a PSA density of 0.15 ng/mL/mL. In addition, only patients with T1 disease with at most two positive cores during biopsy and no more than 50% involvement of each core were selected (Table 1). Contrary to our ...

Treatment of benign prostatic hyperplasia (bph) with minimally invasive prostatectomy (costs for program #42021) ✔ University Hospital Marburg UKGM ✔ Department of Urology and Pediatric Urology ✔ BookingHealth.com

A nuclear medicine scan may locate prostate cancer recurrence after radical prostatectomy early after disease recurrence and could help guide salvage radiotherapy, according to new research from the University of California Los Angeles (UCLA). The study, which utilizes PET/CT with gallium-68 prostate-specific membrane antigen (68Ga-PSMA-11), is documented in the featured article in the February issue of The Journal of Nuclear Medicine.