The likelihood of biochemical recurrence was similar between groups when stratified by known risk factors of recurrence. Surgical approach was not a significant predictor of biochemical recurrence in the multivariate model. Our analysis is suggestive of comparable effectiveness for robot assisted laparoscopic prostatectomy, although longer term studies are needed.

Study Type – Therapy (individual cohort)
Level of Evidence 2b OBJECTIVE To determine whether robotic‐assisted laparoscopic radical prostatectomy (RALP) is associated with a lower transfusion rate than radical retropubic prostatectomy (RRP). PATIENTS AND METHODS In this cohort study, we evaluated 1244 consecutive patients who underwent RALP (830) or RRP (414) between June 2003 and July 2006. Demographics, clinical characteristics, pathology, blood loss and transfusion data were collected prospectively. Groups were compared for baseline characteristics, blood loss, change in haematocrit and transfusion using univariate statistics, and an exploratory multivariate model was developed. RESULTS RALP was associated with lower blood loss (median 100 vs 450 mL, P < 0.001) and a smaller change in haematocrit (median 7% vs 10%, P < 0.001) than RRP. Although both groups had low transfusion rates, the RALP group required fewer transfusions than the RRP group (0.8% vs 3.4%, P= 0.002). On univariate analysis, surgical approach (RRP vs RALP), estimated blood loss ≥500 mL and change in haematocrit ≥10% were the only the significant predictors of transfusion. In the exploratory multivariate model RALP was the only significant predictor of reduced need for transfusion, with an odds ratio of 0.23 (95% confidence interval 0.09–0.58; P= 0.002). CONCLUSIONS This study shows that RALP is associated not only with less blood loss and a smaller decrease in haematocrit, but also a decreased need for transfusion.

A solitary positive apical margin was associated with worse biochemical recurrence but on multivariate analysis it was not an independent predictor of recurrence. Models to predict biochemical recurrence after radical prostatectomy should account for differences in the prognostic significance of different positive margin sites.

We investigated the risk factors for community acquired/onset urinary tract infections due to extended spectrum beta-lactamase (ESBL)-positive Escherichia coli or Klebsiella pneumoniae in 62 patients who were followed-up from August 1, 2003 to September 1, 2006. Sixty patients with community-acquired urinary tract infections caused by ESBL-negative E. coli or K. pneumoniae who were followed-up during the same dates were included as a control group. Age (> or =65 or <65 years old), sex, bladder cancer, benign prostate hypertrophy (BPH), prostate cancer, urolithiasis, urethral catheter, previous urological operation, diabetes mellitus, use of antibiotics during the last 3 months and hospitalization during the last 3 months were investigated as risk factors. The presence of previous urological operation and quinolone or cephalosporin use for any infection during the last 3 months were found to be independent risk factors. Knowing the risk factors for community acquired/onset urinary tract infections caused by ESBL-positive E. coli or K. pneumoniae is of great importance in planning empirical antibiotic therapy.

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Levobupivacaine infiltration through the nephrostomy tract in combination with intravenous paracetamol infusion was shown to be safe and efficacious as an analgesia method after PCNL.

Taq I t allele of the VDR gene may be a risk factor for severe urolithiasis and recurrent stone disease.