81 otherwise healthy men with an average age of 67 years and verified prostatic hypertrophy were randomized into two groups for either ‘minimal’ or ‘total’ transurethral prostatic resection (TUR-P). Interviews on sexual life were made preoperatively and 6 and 12 months postoperatively. 58 men (72%) were prior to the operation sexually active. 18 (31%), mainly men of advanced age, discontinued sexual activity following TUR-P. 40 (69%) remained active. 19 had retrograde ejaculation. No significant difference was found between ‘minimal’ and ‘total’ TUR-P concerning the effect on sexual activity and the occurrence of retrograde ejaculation.
A follow-up investigation of 19 patients with carcinoma in situ per se of the urinary bladder (Tis) has been performed. Ten patients developed invasive cancer during a mean observation period of about 4 years. The natural history is unpredictable and therapeutic management of this potentially malignant neoplasm should be individualised. Early radical cystectomy is advocated in selected cases of Tis.
Primary urethral cancer in male subjects is briefly described, and a case is presented in which the formation of a scrotal abscess was the unusual presenting symptom.
A retrospective analysis of external radiation therapy of 43 patients with carcinoma of the prostate limited to the pelvis is presented. The tumours were classified according to the UICC TNM system and in the range T2-4, Nx, 0-2, MO; 86 per cent had extracapsular disease. The 5-year crude survival rate was 52 per cent, the corrected survival 62 per cent compared with an expected survival of 81 per cent. Eight patients (18%) had clinical recurrence, all with distant metastases in bones and one with local recurrence as well. After 6 months mild side effects were found in 10 patients (23 %), severe complications in none. In conclusion, external radiation therapy offers the possibility of partial or complete regression of carcinoma of the prostate limited to the pelvis and apparently improves the 5-year survival. If radical prostatectomy and lymphadenectomy is not used or impossible, external radiation therapy is recommended instead of hormone therapy with oestrogens.
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