987 MRI As A Guide for Prostatectomy Planning

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
P Vanalia
Keyword(s):  
Prostate Cancer ◽  
Teaching Hospitals ◽  
Nerve Sparing ◽  
P Value ◽  
Tumour Grading ◽  
Planning Meeting ◽  
Chi Squared ◽  
Tumour Location ◽  
Location Mapping

Abstract Introduction NICE guidelines suggest that PSA, mp-MRI and targeted biopsies should be used for the diagnosis of prostate cancer. This audit looked at several aspects of prostate cancer assessment and diagnosis at our trust, however we will be focusing on the use of MRI. Method A retrospective cohort study was performed at Lancashire Teaching Hospitals and this included 49 patients. We compared the pre-operative MRI tumour location and tumour grading with post-operative histology tumour location and tumour grading of prostate cancer patients. The statistical analysis was performed using Chi-squared testing. Results Prostate tumour location mapping based on MRI was accurate in 70% of the cases, these results were statistically significant (p-value <0.01). However, the tumour grading according to the MRI was only accurate in 45% of the cases (p-value <0.05). Conclusions Tumour grading based on the MRI result should not be routinely used to stratify risk and plan treatment. However, a prostate planning meeting would be recommended prior to the surgery and this can use the MRI location of the tumour along with the patient’s baseline regarding urinary and erectile function to help plan nerve sparing and surgical margins, this would help improve outcomes for patient's post-operative quality of life.

Quality of life after brachytherapy or bilateral nerve-sparing robot-assisted radical prostatectomy for prostate cancer: a prospective cohort

2017 ◽  
Vol 121 (4) ◽  
pp. 540-548 ◽  
Author(s):  
Pierre Blanchard ◽  
John W. Davis ◽  
Steven J. Frank ◽  
Jeri Kim ◽  
Curtis A. Pettaway ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Prospective Cohort ◽  
Nerve Sparing ◽  
Robot Assisted

scholarly journals Anatomy of the neurovascular bundle and methods of its preservation with nerve-sparing prostatectomy

2018 ◽  
Vol 5 (3) ◽  
pp. 53-66
Author(s):  
H. S. Gevorgyan ◽  
A. A. Kostin ◽  
N. V. Vorobyev ◽  
K. М. Nyushko ◽  
A. G. Muradyan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Prostate Gland ◽  
Neurovascular Bundle ◽  
Diagnostic Methods ◽  
High Tech ◽  
Nerve Sparing ◽  
High Quality

Providing a high quality of life for a man after performing radical prostatectomy for prostate cancer is currently one of the topical problems of urology and andrology. Nervous-protective radical prostatectomy is one of the high-tech operations in urology and the surgeon’s task is not only to remove the tumor of the prostate gland, but also to ensure a high quality of life for the patient. The importance and urgency of this problem is evidenced by the fact that most of the issues that arise in patients in conversation with a surgeon before surgical intervention are devoted to it.The National Institute of Health of the USA shows that the incidence of prostate cancer is about 9.5% per year, and the localized form began to occur in younger men. In this regard, the surgeon faces the task not only to cure the patient of malignant education, but also to maintain the erectile function and the continent’s indicators, thereby improving the quality of life.At the present stage, diagnostic methods make it possible to detect early prostate cancer much more often, so that the identification and treatment of such patients become more accessible and allows the use of this operation. However, for the preservation of the neurovascular bundle, it is mandatory to know the anatomical features of this zone.Over the past few decades, anatomical studies have been conducted that described the neuroanatomy of the prostate and the adjacent tissue. This article summarizes the latest results of studies of neuroanatomical studies, some of which contradict the established consensus on pelvic anatomy.

scholarly journals Penile Rehabilitation and Neuromodulation

2009 ◽  
Vol 9 ◽  
pp. 652-664 ◽  
Author(s):  
Fernando Facio ◽  
Arthur L. Burnett
Keyword(s):  
Prostate Cancer ◽  
Nerve Sparing ◽  
Prostate Cancer Treatment ◽  
Definitive Evidence ◽  
Rehabilitation Programs ◽  
Clinical Trial Evidence ◽  
Trial Evidence ◽  
Penile Rehabilitation

Erectile dysfunction (ED) following treatment for clinically localized prostate cancer, particularly radical prostatectomy (RP), is a major quality of life issue that remains unsatisfactorily addressed. With the introduction and use of cavernous nerve–sparing procedures over the past 25 years, many men recover erections postoperatively that enable sexual intercourse unlike in the prior surgical era, when permanent ED postoperatively was certain. Despite this advance, 26–100% of these patients may never recover normal erectile function (EF). Recent advances in the understanding of ED after RP have stimulated great attention to develop penile rehabilitation programs and neuromodulation. The purpose of penile rehabilitation is to prevent adverse corpus cavernosal tissue structural alterations and thereby maximize the chances of recovering functional erections. Rehabilitation programs are common in clinical practice, but there is no definitive evidence to support their efficacy. Neuromodulation represents another strategy for promoting erection recovery postoperatively. This therapy involves the application of neuroprotective interventions, conceivably targeting biological elements involved in the erection response that are affected by neuropathic injury. Well-conducted, controlled trials with adequate follow-up are required in order to determine the erection preservative benefits of these therapeutic strategies. The purpose of this essay is to describe the mechanisms related to post-RP ED, assess the need for penile rehabilitation and neuromodulation following surgery, and analyze the basic science and clinical trial evidence associated with these applications for preserving EF following prostate cancer treatment.

scholarly journals EFFECT OF PROPOSED PROGRAM OF PATIENT SAFETY ON NURSE’S KNOWLEDGE AND QUALITY OF CARE AT KOSTI AND RABAK TEACHING HOSPITALS-SUDAN

2019 ◽  
Vol 7 (2) ◽  
pp. 10-17
Author(s):  
Hayat Fadllalah Mukhtar ◽  
Mohammed Ibrahim Osman Ahmed
Keyword(s):  
Patient Safety ◽  
Training Program ◽  
Teaching Hospitals ◽  
P Value ◽  
Quality Health ◽  
The Impact ◽  
Self Administered Questionnaire ◽  
Nurses Knowledge

Background: The profession of Nursing has been at the forefront of patient safety taking special attention to the training and education of its workforce. Internationally, the International Council of Nurses (ICN) has been tackling this issue with force since it established that Patient safety is fundamental to quality health and nursing care Aim: To study the impact of a design propose program   for nurses about patient safety and evaluate the impact of it on nurses knowledge. Methodology: This was quiz experimental study, one hundred eight nurses were included as all the entire population meeting the inclusion criteria taken as a sample, using census to achieve a desirable level of precision, the data was collected in four phases using a self-administered questionnaire, phase one include an orientation about the training program. Phase two (pretest data), in which the questionnaire was distributed for nurses and each one was allowed sufficient time to fill it. After collection of pretest data the nurses were received the training program, the training was continued for four months. Phase three: A posttest was obtained from the participants at the end of the program, the same self-administrative questionnaire. Follow up phase include the same process in phase three after one, two and three months to make sure of the consistency. The data was analyzed by (SPSS) program with (P. value, mean, standard deviation, T. test and chi squire test). Results: The present study revealed that the nurse’s knowledge were improved affected by the proposed training program. The mean of  nurse’s knowledge regarding maintain  patient safety was  improved  ,in pre intervention ( 3.77 +/- Std 1.24 ) to be ( 4.44 +/- Std 0.60 )  in posttest I which get better to ( 4.93 +/- Std 0.283 )  in posttest II , and it was ( 4.13 +/- Std 0.613 )  in posttest III,  there was highly statistically significant association between the nurses knowledge and application of training program (p=0.000). Recommendations: Great emphasis should be directed towards the educational aspects on patient safety by providing educational posters, guidelines, pamphlets, manual and modern educational facilities, collaboration should be encourage between institutions and federal ministry of health to formalize a protocol of patient safety.

Androgen deprivation therapy and statin therapy in prostate cancer patients.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 205-205
Author(s):  
Kin Chung Lai ◽  
Toiya Turknett ◽  
Parminder Singh
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Androgen Deprivation Therapy ◽  
Cox Regression ◽  
Androgen Deprivation ◽  
P Value ◽  
Primary Therapy ◽  
Significant Difference ◽  
Chi Squared ◽  
Statin Use

205 Background: Metastatic prostate cancer (mPC) is treated with androgen deprivation therapy( ADT). Duration of response to ADT predicts patient’s survival. It has been shown in observational studies that concurrent statin use may prolong response to ADT. Studies in mice have shown negative interactions. We wanted to examine the effect of this interaction in patients being followed at Mayo Clinic Arizona (MCA). Methods: We examined 441 patients with mPC, who received ADT and were treated at MCA from year 2011 to 2017. . Our study evaluated the time to progression (TTP) and overall survival(OS) for patients with mPC on ADT with or without concurrent statin use. Among the patients who were evaluated, there was a subset of 156 patients taking abiraterone (ABI). Characteristics were compared between statin users and nonusers using Chi squared test and Wilcoxon rank-sum tests. The primary outcome was TTP defined as the duration from ADT initiation to disease progression. The association between statin use and TTP was analyzed by multivariable Cox regression to estimate hazard ratios (HRs) and 95% Conference Interval (CI), and adjusted for Gleason score, primary therapy type, prior ADT, metastatic status, and PSA at ADT initiation. Results: There was no significant difference in TTP when comparing patients with statin to those without a statin. The HR for statin use vs no statin use is 1.049 with CI (0.838, 1.314) and p-value is 0.677. There was no significant difference in overall survival when comparing statin vs no statin use. The HR for statin use vs no statin use was 0.928(CI 0.642, 1.342) with p-value at 0.693. In the ABI population, there was no significant difference in TTP for patients with statin vs no statin. HR was 1.00 CI (0.725, 1.377) with p-value at 0.998. For overall survival, there was no significant difference with HR at 0.852 (CI 0.502, 1.446) with p-value at 0.553. Conclusions: Despite retrospective studies showing benefit of use of statin in men with prostate cancer, our study observed no difference in long term outcomes. Possible explanations could be smaller sample size, inability to verify data as medication intake was not verified directly. Also, patient’s compliance with medications could be a confounding variable.

scholarly journals A Comparison of Radical Perineal, Radical Retropubic, and Robot-Assisted Laparoscopic Prostatectomies in a Single Surgeon Series

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Moben Mirza ◽  
Kevin Art ◽  
Logan Wineland ◽  
Ossama Tawfik ◽  
J. Brantley Thrasher
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Tumor Volume ◽  
Surgical Margin ◽  
Nerve Sparing ◽  
Positive Surgical Margin ◽  
Life Outcomes ◽  
Robot Assisted ◽  
Estimated Blood Loss

Objective. We sought to compare positive surgical margin rates (PSM), estimated blood loss (EBL), and quality of life outcomes (QOL) among perineal (RPP), retropubic (RRP), and robot-assisted laparoscopic (RALP) prostatectomies.Methods. Records from 463 consecutive men undergoing RPP (92), RRP (180), or RALP (191) for clinically localized prostate cancer were retrospectively reviewed. Age, percent tumor volume, Gleason score, stage, EBL, PSM, and QOL using the expanded prostate cancer index composite (EPIC) were compared.Results. PSM were similar when adjusted for stage, grade, and volume. EBL was significantly less in the RALP (189 ml) group compared to both RPP (475 ml) and RRP (999 ml) groups. When corrected for nerve sparing, there were no differences in erectile function and sexual function amongst the three groups. Urinary summary and pad usage scores showed no significant differences.Conclusion. RPP, RRP, and RALP offer similar surgical and QOL outcomes. RALP and RPP demonstrate less EBL compared to RRP.

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