Prostate cancer, reconstructive urology

BACKGROUND: Multimodal therapy has improved survival in genitourinary (GU) rhabdomyosarcoma (RMS), a rare pediatric cancer. However, little is reported regarding postoperative complications and long-term urinary and sexual function and quality of life. METHODS: We reviewed records from 1970-2018 to identify patients with GU RMS of the bladder, prostate, pelvis, vagina, and uterus. We assessed modes of therapy, and if surgical, the type of resection, reconstruction, and reoperation...

PURPOSE: The aim of this study was to assess the clinical feasibility of magnetic resonance imaging (MRI) T1 mapping using T1FLASH for assessment of prostate lesions. METHODS: Participants with clinical suspicion for prostate cancer (PCa) were prospectively enrolled between October 2021 and April 2022 with multiparametric prostate MRI (mpMRI) acquired on a 3 T scanner. In addition, T1 mapping was accomplished using a single-shot T1FLASH technique with inversion recovery, radial undersampling, and iterative reconstruction...

BACKGROUND: In the era of mpMRI guided target fusion biopsy (FB), the role of concomitant standard biopsy (SB) in naïve patients still remains under scrutiny. The aim of this study was to compare the detection rate (DR) of clinically significant prostate cancer (csPCa) in biopsy naïve patients with positive mpMRI who underwent FB alone (Arm A) vs FB+SB (Arm B). Secondary objectives were to compare the incidence of complications, the overall PCa DR and the biopsy results with final pathological findings after robotic prostatectomy (RARP)...

OBJECTIVE: To evaluate the impact of sustainable functional urethral reconstruction (SFUR) on early recovery of urinary continence (UC) after robot-assisted radical prostatectomy. PATIENTS AND METHODS: Overall, 96 patients with primary prostate cancer were randomised into the SFUR or standard group (n = 48 each). The primary outcome was the 1-month UC recovery. Secondary outcomes included short-term (≤3 months) UC recovery, urinary function, micturition-related bother, perioperative complications, and oncological outcomes...

BACKGROUND: When urinary diversion is necessary for benign indications, the defunctionalized bladder is at risk of a number of severe complications such as bleeding, pain, pyocystis and secondary urothelial carcinoma. These complications occur in 54-80% of patients left with native bladder after diversion, and these patients go on to require completion cystectomy 20-25% of the time. Rowley et al. at the University of Michigan reported their experience in open simple cystectomy in 2011 in a series of 23 patients...

OBJECTIVE: Primary urethral carcinoma (PUC) is a rare malignant carcinoma but with limited therapeutic options. This review aims to provide an overview of the current strategies on this patient settings. METHODS: Recent literature ranging from January 1987 and December 2021 was assessed through PubMed search to assess the diagnostic and therapeutic principles of PUC. RESULTS: A complete of examination including cystoscopy, imaging, and biopsy should be conducted for these patients...

BACKGROUND: Robot-assisted radical prostatectomy (RARP) is a widely used treatment method for patients with clinically localized prostate cancer. Posterior reconstruction of urethrovesical anastomosis (UVA) is one of the techniques that provides early recovery of urinary continence after surgery. Changes in the technique of performing posterior reconstruction of UVA may contribute to further improvement of functional results. AIM: To evaluate the functional results of early removal of the urethral catheter (after 3 days) after RARP using a modified surgical technique of performing posterior reconstruction of UVA compared with the standard catheterization time (7 days after surgery)...

INTRODUCTION: In recent years, new treatments have been approved for nonmetastatic castration-resistant prostate cancer (M0CRPC). Because direct comparisons between these treatments are not available to guide treatment decisions, indirect comparisons can be of interest. METHODS: Our analysis evaluated second-generation hormone treatments proposed for M0CRPC. We searched multiple databases for articles published between 2010 and 2022. Phase-III clinical trials that studied these agents in M0CRPC patients were eligible...

BACKGROUND: Rhabdomyosarcoma (RMS) is the most common paediatric soft-tissue sarcoma. Approximately 15-20% of RMS cases arise from the bladder and prostate (B/P). The optimal treatment strategy for B/P RMS remains unclear. OBJECTIVE: To retrospectively evaluate the applicability of our procedure performed to treat paediatric patients with B/P RMS. DESIGN, SETTING, AND PARTICIPANTS: This is a retrospective analysis from a single tertiary referral hospital...

OBJECTIVE: To show a total transabdominal robotic approach to an extensive recalcitrant vesicourethral anastomotic stenosis (VUAS) after open radical prostatectomy (ORP) with end-to-end anastomosis. While there is very little literature on the matter and even fewer videos showing the actual surgical view with a step-by-step explanation in complex cases, VUAS robotic transabdominal surgery provides better view and reach, with potentially better continence results, without the need for pubectomy...

PURPOSE: In pediatric bladder/prostate-rhabdomyosarcoma, the rate of bladder preservation after neoadjuvant chemotherapy is high, with an excellent oncological outcome. Information about functional urological long-term outcomes is rare. METHODS: Data of all patients who had undergone bladder-preserving surgery with or without brachytherapy at our institution between 2009 and 2020 were analyzed retrospectively. Detailed urological function was assessed focusing on age-related continence, bladder capacity and urodynamic findings...

PURPOSE: To evaluate the role of 3D models on positive surgical margin rate (PSM) rate in patients who underwent robot-assisted radical prostatectomy (RARP) compared to a no-3D control group. Secondarily, we evaluated the postoperative functional and oncological outcomes. METHODS: Prospective study enrolling patients with localized prostate cancer (PCa) undergoing RARP with mp-MRI-based 3D model reconstruction, displayed in a cognitive or augmented-reality fashion, at our Centre from 01/2016 to 01/2020...

OBJECTIVE: To investigate the impact of extirpative surgery for pubic bone osteomyelitis with pubovesical fistula on prostate cancer survivors' physical and mental health. MATERIALS AND METHODS: The Short Form 12 (SF-12) is a validated instrument for assessing health-related quality of life (HRQOL). We reviewed a prospectively maintained database of patients treated with extirpative surgery for pubovesical fistula from 2017-2021 who completed the SF-12. Wilcoxon signed-rank and McNemar's tests were used to analyze changes in SF-12 following surgery...

OBJECTIVE: To describe local recurrence rates and patient-reported outcomes when Mohs micrographic surgery with cytokeratin-7 immunostains (MMS-CK7) is included in the interdisciplinary management of extramammary Paget's disease (EMPD) METHODS: A retrospective study was conducted of EMPD treated with MMS-CK7 as part of an interdisciplinary team at an academic medical center between 2009 and 2016. Local recurrence rates and patient-reported outcomes were determined by record review and patient surveys...

PURPOSE: To evaluate urinary outcomes of pelvic construction and lateral capsule sparing techniques in robot-assisted radical cystectomy with orthotopic ileal neobladder (RARC-OIN). METHODS: A total of 107 male patients who underwent RARC-OIN during January 2017 and February 2021 in Sun Yat-sen Memorial Hospital were analyzed retrospectively. Standard RARC-OIN with or without nerve sparing technique was performed in 44 patients (standard group), lateral prostate capsule sparing technique was performed in 20 patients (LCS group), combined pelvic reconstruction (CPR) technique including anterior suspension and posterior reconstruction were performed in 43 patients (CPR group)...

Objectives: To compare the short-term and 1-year follow-up functional outcomes of modified anatomical structure preserving and Retzius - repairing robot-assisted radical prostatectomy (APR-RARP) compared with Retzius-sparing (RS) RARP. Methods: Eighty consecutive patients 40-75 years of age with low-intermediate risk prostate cancer were prospectively randomized to APR-RARP or RS-RARP. Urinary continence (UC) recovery rates were evaluated from catheter removal up to 1 year follow-up. Postoperative UC was defined as 0 pads/one security pad per day...

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Near-infrared fluorescence imaging with indocyanine green has emerging applications in urologic surgery. This technology is strongly used in robotic surgery for several ablative and reconstructive procedures. On the contrary, it is not used at all in the urological laparoscopic surgery. To date, bilateral pelvic lymph node dissection represents the most accurate and reliable staging procedure for the detection of lymph node invasion in prostate cancer and bladder cancer. However, it is not devoid of complications...

Over this last year, urology has progressed both in oncology and reconstructive surgery. Genomic tests have been since quite a few years foreseen as very promising prognostic factors of prostate cancer, however remaining not clearly convincing. At last, the present data available seem to favour their contribution to improve selecting patients for active surveillance. For the same cancer, but at a metastatic stage resistant to androgenic deprivation, therano stics is providing an elegant targeting of disseminated tumor cells using a PSMA radio-active ligand fatal for the latter...

OBJECTIVE: To describe the current landscape of first and last female authorship in urology journals relative to the journals' impact factor. We hypothesized that women would have a smaller proportion of publications in journals with higher impact factors. METHODS: Eighteen urology journals were divided into groups based on impact factor accordingly: from 33.2 to 6.2 were classified as high (European Urology, Nature Reviews Urology, The Journal of Urology, BJU International, Prostate Cancer and Prostatic Diseases, and The Journal of Sexual Medicine), from 5...