No abstract

Ex vivo, 80 W KTP laser vaporization is a virtually bloodless ablative procedure, giving rise to hemostasis that is highly superior to conventional TURP-like tissue resection. However, the novel procedure is considerably more time-consuming.

BACKGROUND The authors evaluated the role of 5‐aminolevulinic acid (5‐ALA)‐induced fluorescence endoscopy (AFE) in the detection of flat urothelial lesions in light of the suggestions made for flat neoplastic lesions within the 1999 World Health Organization (WHO) classification of urinary bladder tumors. METHODS From 1995 to 2000, 713 patients underwent 1414 AFE procedures for the detection of transitional cell carcinoma of the bladder (TCCB). Fluorescence imaging was performed with an incoherent light source (D‐light; 380–440 nm) that was filtered for efficient protoporphyrin IX excitation and with cystoscopes partially blocking reflected excitation light to enable fluorescence evaluation by a red/blue color contrast 2–3 hours after 50 mL of a 3% solution of 5‐ALA was instilled into the bladder. In total, 3834 biopsy specimens (mean, 2.7 specimens per AFE procedure) were taken. RESULTS Malignant disease was found in 1250 (32.6%) of all biopsies, with 304 biopsies (24.3%) showing carcinoma in situ (cis) and dysplasia II° (dys II) according to the previous diagnostic criteria of the WHO. Under prior conventional white‐light endoscopy, 30.3% of specimens with dys II and 52.8% of specimens with cis had been missed. CONCLUSIONS The current results suggest that 5‐ALA may be more effective in the detection of flat urothelial lesions than the current diagnostic devices. Cancer 2002;95:1234–8. © 2002 American Cancer Society. DOI 10.1002/cncr.10821

No abstract

Study Type – Therapy (case series)
Level of Evidence 4 OBJECTIVE To retrospectively analyse the long‐term follow‐up of 54 patients treated with organ‐preserving laser therapy for penile carcinoma, as such therapy provides excellent cosmetic and functional results, but recurrence rates are high, which might impair the oncological outcome and worsen tumour‐related survival. PATIENTS AND METHODS Between 1979 and 2008, 54 patients with penile carcinoma were treated with the neodymium‐doped yttrium‐aluminium‐garnet (Nd:YAG) laser at our institution; 11 were classified as having carcinoma in situ (Tis), 39 as T1 and four as T2. RESULTS There was local recurrence in 16 patients (42%); the mean (range) time to local recurrence was 53 (9–132) months. In half the patients the time to local recurrence was >53 months, with the latest recurrence at 132 months after initial therapy of primary tumour. There was no statistically significant difference in recurrence rates with Tis or invasive penile carcinoma. In lymph‐node‐negative patients at initial presentation, there were no newly developed positive lymph nodes during the follow‐up. CONCLUSIONS Organ‐preserving laser therapy showed a relatively high recurrence rate in patients with a long‐term follow up, but the oncological outcome and survival were not compromised by local recurrence. Therefore, laser therapy appears to be appropriate for treating premalignant lesions and early stages of penile carcinoma. Patients should be informed about the potential for late recurrence.

We feel that open prostatectomy remains an excellent technique for large prostate adenomas and should always be offered in such cases as a true alternative to endoscopic techniques. Having a well-trained urologist perform the procedure is the best guarantee of minimal blood loss and minimal complication rates. Therefore, open prostatectomy should be part of the education program of all prostate centers and urological departments.

No abstract

The case report demonstrates that in certain select cases of large tumors, organ-preserving surgery could be an alternative approach in combining complete tumor removal with preservation of graft function.