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Prostate cancer, reconstructive urology

Francesco Porpiglia, Riccardo Bertolo, Daniele Amparore, Enrico Checcucci, Walter Artibani, Prokar Dasgupta, Francesco Montorsi, Ashutosh Tewari, Cristian Fiori
3D reconstruction of the standard two-dimension cross-sectional imaging has known increasing diffusion. It may represent one of the key points for a tailored treatment planning. Along these lines, we used a novel software for augmented-reality robot-assisted radical prostatectomy (AR-RARP) at our Institution. 3D virtual models of the prostate and the prostate cancer were reconstructed from high resolution (1-mm slices) multi-parametric Magnetic Resonance Imaging (mp-MRI) by M3dics (Turin, Italy). The innovation in the study is represented by the software-based integration of the virtual model inside the Da Vinci (Intuitive, Sunnyvale, CA, USA) robotic console during robotic prostatectomy...
April 2018: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Kari A O Tikkinen, Samantha Craigie, Arnav Agarwal, Reed A C Siemieniuk, Rufus Cartwright, Philippe D Violette, Giacomo Novara, Richard Naspro, Chika Agbassi, Bassel Ali, Maha Imam, Nofisat Ismaila, Denise Kam, Michael K Gould, Per Morten Sandset, Gordon H Guyatt
CONTEXT: Pharmacological thromboprophylaxis involves a trade-off between a reduction in venous thromboembolism (VTE) and increased bleeding. No guidance specific for procedure and patient factors exists in urology. OBJECTIVE: To inform estimates of absolute risk of symptomatic VTE and bleeding requiring reoperation in urological non-cancer surgery. EVIDENCE ACQUISITION: We searched for contemporary observational studies and estimated the risk of symptomatic VTE or bleeding requiring reoperation in the 4 wk after urological surgery...
February 2018: European Urology
E Charles Osterberg, Alex J Vanni, Thomas W Gaither, Mohannad A Awad, Joshua A Broghammer, Scott C Pate, Hadley Wyre, Jeremy B Myers, Sean P Elliott, Suprita Krishna, Lee C Zhao, Christopher McClung, Bradley A Erickson, Benjamin N Breyer
PURPOSE: To characterize anterior urinary fistulae following radiotherapy for prostate cancer. METHODS: Over 10 years, 31 men were identified to have an anterior urinary fistula. A retrospective database was created to evaluate patient demographics, presentation, diagnostic procedures, operative interventions, outcomes, and complications. Comparisons between men who underwent cystectomy versus bladder-sparing surgeries were performed. RESULTS: At a median age of 73 (interquartile range (IQR) 68...
July 2017: World Journal of Urology
Catherine R Harris, Jack W McAninch, Anthony R Mundy, Leonard N Zinman, Gerald H Jordan, Daniela Andrich, Alex J Vanni, Ramón Virasoro, Benjamin N Breyer
PURPOSE: Rectourethral fistula is a known complication of prostate cancer treatment. Reports in the literature on rectourethral fistula repair technique and outcomes are limited to single institution series. We examined the variations in technique and outcomes of rectourethral fistula repair in a multi-institutional setting. MATERIALS AND METHODS: We retrospectively identified patients who underwent rectourethral fistula repair after prostate cancer treatment at 1 of 4 large volume reconstructive urology centers, including University of California-San Francisco, University College London Hospitals, Lahey Clinic and Devine-Jordan Center for Reconstructive Surgery, in a 15-year period...
January 2017: Journal of Urology
Yu Guang Tan, Grace Tan, David Tan, Claramae S Chia, Dun Yong Ang, Melissa C C Teo
BACKGROUND: In locally advanced pelvic malignancies, there is often involvement of urological organs, necessitating resection and reconstruction, which can be associated with significant complications. METHODS: We retrospectively reviewed 20 patients undergoing urological reconstructions during pelvic oncological surgeries from January 2004 to December 2013. All patients had imaging-proven involvement of at least one urological organ preoperatively. Primary outcome was urological complication rate...
September 2017: Asian Journal of Surgery
Vikram M Narayan, Kristin Chrouser, Robert B Haynes, Rick Parrish, Philipp Dahm
OBJECTIVES: To determine the publication sources of urology articles within EvidenceUpdates, a second-order peer review system of the medical literature designed to identify high-quality articles to support up-to-date and evidence-based clinical decisions. MATERIALS AND METHODS: Using administrator-level access, all EvidenceUpdates citations from 2005 to 2014 were downloaded from the topics 'Surgery-Urology' and 'Oncology-Genitourinary'. Data fields accessed included PubMed unique reference identifier, study title, abstract, journal and date of publication, as well as clinical relevance and newsworthiness ratings as determined by discipline-specific physician raters...
June 2016: BJU International
Güray Toğral, Murat Arıkan, Erdem Aktaş, Recep Öztürk, Oğuz Güven, Fatih Eksioğlu
OBJECTIVE: The purpose of this study was to evaluate symptomatic bone metastases from urological malignancies and the efficacy of surgical treatment of bone metastases in achieving local tumor control. METHODS: This was a retrospective observational study of patients diagnosed with bone metastases from urological malignancies who died from their diseases between 2002 and 2013. Data on clinicopathology, number and sites of bone metastasis, time to first and subsequent metastasis, survival after metastasis, nature of metastasis (blastic, mixed, lytic), type of surgical reconstruction, systemic affections, and visceral organ metastasis for 70 bone metastases from deceased urological malignancies patients (55 male, 15 female) with evidence of bone metastasis were statistically analyzed...
2015: Acta Orthopaedica et Traumatologica Turcica
Daniel Ramirez, Homayoun Zargar, Peter Caputo, Jihad H Kaouk
The robotic platform has revolutionized the management of prostate cancer over the last 15 years. Several techniques have been developed to improve functional and oncologic outcomes, including meticulous apical and posterior dissection, nerve sparing techniques, bladder neck and urethral length sparing, and anastomotic reconstruction. Future developments involving novel single-site, robotic technology will undoubtedly further the field of minimally invasive urology. These topics are reviewed within this article...
December 2015: Journal of Surgical Oncology
Lindsey A Herrel, Zaojun Ye, David C Miller
PURPOSE: Because proposed funding cuts in the Patient Protection and Affordable Care Act may impact care for urological patients at safety net hospitals, we examined the use, outcomes and costs of inpatient urological surgery at safety net vs nonsafety net facilities prior to health care reform. MATERIALS AND METHODS: Using the Nationwide Inpatient Sample we performed a retrospective cohort study of patients who underwent inpatient urological surgeries from 2007 through 2011...
November 2015: Journal of Urology
Sarah Fraumann Faris, Douglas F Milam, Roger R Dmochowski, Melissa R Kaufman
OBJECTIVE: To characterize the presentation and symptom progression culminating in urinary diversion after radiotherapy for prostate cancer at a tertiary care reconstructive urology practice. MATERIALS AND METHODS: Retrospective review of electronic medical records was performed for all patients between 2005 and 2011 who underwent urinary diversion for urologic complications of radiation therapy for treatment of prostate cancer. We analyzed demographics, type of radiation, presenting symptoms, diagnostic evaluation, and surgical interventions...
September 2014: Urology
Riccardo Autorino, Homayoun Zargar, Jihad H Kaouk
The aim of the present review is to summarize recent developments in the field of urologic robotic surgery. A nonsystematic literature review was performed to retrieve publications related to robotic surgery in urology and evidence-based critical analysis was conducted by focusing on the literature of the past 5 years. The use of the da Vinci Surgical System, a robotic surgical system, has been implemented for the entire spectrum of extirpative and reconstructive laparoscopic kidney procedures. The robotic approach can be applied for a range of adrenal indications as well as for ureteral diseases, including benign and malignant conditions affecting the proximal, mid, and distal ureter...
October 2014: Fertility and Sterility
Wojciech Polom, Kazimierz Krajka, Tomasz Fudalewski, Marcin Matuszewski
INTRODUCTION: The repair of complex urethrorectal fistulas, which can be the result of treating prostate cancer with radical prostatectomy, is a big problem in urology and its final result is not always satisfactory. There are no universally accepted methods for repairing such fistulas. In our work we present a retrospective analysis of patients treated for urethrorectal fistulas after previous radical prostatectomy. The methods used were the initial excision and suture of the fistula, or a gracilis muscle flap interposition...
2014: Central European Journal of Urology
Emma F P Jacobs, Ronald Boris, Timothy A Masterson
Since the introduction of robot-assisted radical prostatectomy (RALP), robotics has become increasingly more commonplace in the armamentarium of the urologic surgeon. Robotic utilization has exploded across surgical disciplines well beyond the fields of urology and prostate surgery. The literature detailing technical steps, comparison of large surgical series, and even robotically focused randomized control trials are available for review. RALP, the first robot-assisted surgical procedure to achieve widespread use, has recently become the primary approach for the surgical management of localized prostate cancer...
2013: Prostate Cancer
Elisa De Lorenzis, Carlotta Palumbo, Gabriele Cozzi, Michele Talso, Marco Rosso, Beatrice Costa, Franco Gadda, Bernardo Rocco
In urology, the main use for the robotic technique has been in radical prostatectomy for prostate cancer. Robotic surgery for other organs, such as the kidneys and bladder, has been less explored. However, partial nephrectomy or radical nephroureterectomy can be difficult for inexperienced laparoscopic surgeons. The advent of the da Vinci robot, with multijointed endowristed instruments and stereoscopic vision, decreases the technical difficulty of intracorporeal suturing and improves the reconstructive steps...
2013: Ecancermedicalscience
Christopher Kane
UNLABELLED: What's known on the subject? and What does the study add? Urinary incontinence is one of the major drawbacks of radical prostatectomy, regardless of the procedure used (i.e. open, laparoscopic or robotic-assisted). Several technical modifications have been described to improve postoperative continence, highlighting the role of puboprostatic ligaments and posterior reconstruction of the rhabdomyosphincter. The results obtained are inconsistent when applied to robotic surgery...
February 2013: Urologic Oncology
Michael Musch, Lukas Hohenhorst, Anne Pailliart, Heinrich Loewen, Yadollah Davoudi, Darko Kroepfl
UNLABELLED: WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Open reconstructive surgery of the lower ureteric segment in adults often requires large incisions, as the basic prerequisite for such complex procedures is wide exposure. Published experience on minimally invasive techniques in this challenging surgical field, e.g. conventional laparoscopy or robot-assisted laparoscopy, still remains limited. We report our experience from one of the largest single institution series on robot-assisted reconstructive surgery of the distal ureter in adults, with a special focus on technical aspects of the different surgical procedures...
May 2013: BJU International
M I Vasil'chenko, N F Sergienko, D A Zelenin, I V Semeniakin
Surgeons of the clinic of P.V. Mandryka Central Military Hospital have rich 10-year experience in creation of neobladders after cystectomy. So, from 2000 to 2009 a total of 90 cystectomies were made for different diseases of the urinary bladder and prostatic gland as well as in cancer of the other pelvic organs. Vesicoplasty, both heterotopic and orthotopic, was performed from an iliac segment by an original technique with creation of antireflux bypass with the ureters. The examination of the patients in different terms after operation (up to 10 years later) provided information about changes in the neobladder under the influence of urine and systemic changes in the body...
November 2011: Urologii︠a︡
Daniela E Andrich, Anthony R Mundy
PURPOSE OF REVIEW: This study provides an overview of current thinking about urethroplasty. RECENT FINDINGS: There have been a number of recent developments, principally to minimize the trauma of anterior urethroplasty and to address the posterior urethral complications of the treatment of prostate cancer. There also have been significant developments in the assessment of the outcome of urethroplasty and specifically of patient reported outcome measures. SUMMARY: These trends are likely to continue...
November 2011: Current Opinion in Urology
Mathieu Rouanne, Christophe Vaessen, Marc-Olivier Bitker, Emmanuel Chartier-Kastler, Morgan Rouprêt
BACKGROUND: Urethrorectal fistula formation is a rare but devastating complication after radical prostatectomy. Reconstructive surgery is usually required, and one surgical option is the York Mason procedure. OBJECTIVE: We present our experience with a modified York Mason technique for the surgical management of urethrorectal fistula. DESIGN: Retrospective review of medical records. SETTING: Tertiary care university medical center...
August 2011: Diseases of the Colon and Rectum
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