Radical retropubic prostatectomy: A review of outcomes and side-effects

Hugosson, Jonas; Stranne, Johan; Carlsson, Sigrid

doi:10.3109/0284186x.2010.535848

Cited by 42 publications

(27 citation statements)

References 68 publications

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“…Due to widespread use of prostate-specific antigen (PSA) testing, patients operated today are often younger and have organ-confined disease, justifying a more preservative surgery (35). Contracture of the bladder neck at the level of the anastomosis between the bladder and the membranous urethra is a well-recognized complication after RP, reportedly occurring in 0.4-32% of patients (36,37,38,39 The majority of comparative studies report low and overlapping rates of anastomotic stricture in open RP (mean: 7.2%; range: 1.8-16%) and laparoscopic RP (mean: 3.0%; range: 0-6.4%).…”

Section: Stricture After Radical Prostatectomymentioning

confidence: 99%

Urethral Stricture is an Unpleasant Complication after Prostate Surgery: A Critical Review of Current Literature

Söğütdelen¹,

Haberal²,

Guliyev³

et al. 2016

jus

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Prostatectomy is one of the main causes of surgery in aging male population. Besides traditional techniques, novel minimally invasive approaches may also end up with certain complications following prostate surgery. Transurethral procedures may cause iatrogenic urethral trauma. Factors that may influence the development of iatrogenic endoscopic urethral strictures include "electrical dispersion" generated by unipolar current and the "diameter of the instruments" used. Those complications not only bother quality of life of the patients but also may cause various adjunctive procedures with an economical impact.Urethral stricture is the abnormal narrowing of any segment of the urethra surrounded by corpus spongiosum. It specifically means varying degrees of spongiofibrosis that refers to scarring of the corpus spongiosum (1). Any inflammation of the urethra can result in scarring that can lead to a stricture or a narrowing of the urethra. Besides prostate surgery, trauma, infections, tumors or any other cause of scarring may trigger urethral stricture (2). A recent metaanalysis including 732 patients showed that idiopathic and iatrogenic etiologies were by far the most common, accounting for 33% and 33% of all cases, respectively. Inflammatory and posttraumatic etiologies were found in only 15% and 19% of patients, respectively (3).Here, we tried to review the incidence and the basic risk factors that cause urethral stricture following prostate surgery. ÖZÜretral striktür enflamasyona bağlı olarak skarlaşma sonrası üretradaki daralmadır. Elli yaş üzeri erkeklerde benign ve malign hastalıklara bağlı olarak yapılan prostatektomiler oldukça yaygın olarak uygulanmaktadır. Prostatın transüretral rezeksiyonu sonrası farklı serilerde %19'a kadar çıkan oranlarda üretral darlık ve mesane boynu kontraksiyonu görülmektedir. Lazer prostatektomi sonrası üretral darlık prostatın transüretral rezeksiyonuna oranla daha az olarak görülmektedir, yaklaşık olarak %3,6 oranındadır. Açık prostatektomi en eski yöntem olmasına rağmen büyük prostat boyutlu hastalarda oldukça mantıklı bir alternatiftir. Açık prostatektomi sonrası yaklaşık olarak %1,9-4,8 oranında darlık bildirilmiştir. Radikal prostatektomi (RP) lokalize prostat kanseri tedavisinde bütün dünyada en yaygın olarak uygulanan yöntemdir. RP sonrası anastomoz seviyesinde mesane boynu kontraksiyonu olması iyi bilinen bir komplikasyondur ve yaklaşık olarak hastaların %0,4-32'sinde görülmektedir. Darlık büyük oranda endoskopik yöntemlerle tedavi edilmektedir, nadiren komplike olgularda bukkal mukoza greftli üretroplasti gerekebilmektedir. Anahtar Kelimeler: Üretral darlık, prostat cerrahisi, transüretral rezeksiyon, açık prostatektomi, radikal prostatektomi ABSTRACTUrethral stricture is narrowing of the urethra due to inflammation that results in scarring. Prostatectomies for benign and malign prostatic diseases are common surgical procedures among men mainly after their fifties. Urethral stricture or bladder neck contraction following transurethral resection of the prostate (TURP)...

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Section: Stricture After Radical Prostatectomymentioning

confidence: 99%

Urethral Stricture is an Unpleasant Complication after Prostate Surgery: A Critical Review of Current Literature

Söğütdelen¹,

Haberal²,

Guliyev³

et al. 2016

jus

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“…In 2008, BPH was the second most frequently diagnosed cancer in men worldwide with an estimated 899,000 new cases (13% of all new cancer cases) (3-7). These tumors can be managed in different ways.…”

Section: Introductionmentioning

confidence: 99%

Local Administration of Tranexamic Acid During Prostatectomy Surgery: Effects on Reducing the Amount of Bleeding

et al. 2016

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BackgroundOne of the issues in prostatectomy surgery is bleeding. Although tranexamic acid (TRA) is an antifibrinolytic agent for reducing bleeding, controversies surround its use.ObjectivesIn this study, the effect of local administration of TRA on reducing bleeding during prostatectomy surgery was evaluated.MethodsA total of 186 patients who underwent prostatectomy surgery were assessed in this clinical trial study. Patients were divided randomly into two groups. After prostate removal, TRA (500 mg TRA with 5 mL total volume) to the intervention group and normal saline to the control group were sprayed with the same volume. At the end of surgery, the prescribed blood bags were measured and recorded. Hemoglobin and platelet levels were recorded 6 hours after the test. Moreover, the amounts of blood inside the blood bags in the first 24 hours, the second 24 hours, and the total length of hospital stay were recorded and compared in each group.ResultsBy comparing the measured values before and after surgery, we found that the amounts of hemoglobin, hematocrit, and platelet decreased. The mean blood loss in the intervention group was recorded at 340 mL and that in the control group was 515 mL. The maximum bleeding in the control group was almost twice as much as that in the intervention group. Blood loss in the intervention group with the administration of TRA was significantly lesser than that in the control group (P = 0.01). The decrease in platelet level in the intervention group was significantly lower than that in the control group (P = 0.03).ConclusionsThe present study showed that local administration of TRA significantly reduces bleeding after prostatectomy surgery and is effective in preventing postoperative hemoglobin decrease.

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“…The most common treatment after a positive diagnosis for PCa is radical prostatectomy (RP, excision of the prostate), which requires surgery with an associated risk of infections, urinary incontinence, and impotence. 5 Given the limits of current diagnostic and treatment methods, new ultrasound-based prostate cancer localization techniques, like elastography and contrast enhanced ultrasound, are emerging to enable targeted biopsy and focal therapy. [6][7][8] However, accurate validation of these methods is required prior to introduction into clinical practice.…”

Section: Introductionmentioning

confidence: 99%

3D registration of histology and ultrasound data for validation of prostate cancer imaging

et al. 2013

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Several ultrasound (US) prostate cancer localization methods are emerging, opening opportunities for targeted biopsies and focal therapy. However, before any of these methods, like elastography or contrast-enhanced US, can be introduced into clinical practice, accurate validation is required. The current gold standard for validation is histological assessment of the prostate after radical prostatectomy. Therefore, a 3D registration of histological and US data is required. This task is complicated by misalignment between histology slices and ultrasound imaging planes, pressure caused by the adopted transrectal US probe, and deformation and volume change during fixation in formalin solution. In this work, we introduce a dedicated 3D algorithm, automatically registering histology and ultrasound data. Because there is no information available between histology slices, and internal landmarks are not consistently present in US images, registration is based on outer-contours shape only. A 3D surface model of the prostate in constructed, based on manually outlined contours in a transrectal sweep video and a longitudinal image. Also, a similar model is constructed from the histology slices, including cancerous areas marked by a pathologist. Registration of the models is then performed in three steps: affine registration, elastic surface registration, and internal registration. In-vitro validation of the algorithm was performed by inserting rubber wires into four prostate mimicking phantoms and applying probe pressure. The resulting registration accuracy was 1.6 mm, which is considerably smaller than the histology slicing resolution of 4 mm.

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Radical retropubic prostatectomy: A review of outcomes and side-effects

Cited by 42 publications

References 68 publications

Urethral Stricture is an Unpleasant Complication after Prostate Surgery: A Critical Review of Current Literature

Urethral Stricture is an Unpleasant Complication after Prostate Surgery: A Critical Review of Current Literature

Local Administration of Tranexamic Acid During Prostatectomy Surgery: Effects on Reducing the Amount of Bleeding

3D registration of histology and ultrasound data for validation of prostate cancer imaging

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