scholarly journals Open Radical Retropubic Prostatectomy as a Saviour in the Era of Robotics- A Single Surgeon Experience

2020 ◽  
pp. 1-7
Author(s):  
Khawaja Abdul Rouf ◽  
Rouf Malik Abdul ◽  
Dar Yasir ◽  
Malik Tariq ◽  
Sofi Khalid ◽  
...  
Keyword(s):  
Erectile Function ◽  
Cancer Control ◽  
Radical Retropubic Prostatectomy ◽  
Nodal Status ◽  
Salvage Radiotherapy ◽  
Perioperative Outcomes ◽  
Urinary Continence ◽  
Retropubic Prostatectomy ◽  
Surgeon Experience

Background Outcome of its safety, perioperative outcomes, functional outcomes, oncologic outcomes in open radical retropubic prostatectomy for organ confined prostate cancers in the era of robotic surgery. Methods A prospective study of radical retropubic prostatectomy performed at SKIMS between 2013 and 2020 was conducted. Work up of the patients in the study (n=42) included age, comorbidities, serum prostate-specific antigen levels, digital rectal examination, MPMRI prostate, prostatic biopsy (Gleasons score), bone scan and optional PSMA PET scan. Intraoperative findings and pathological variables -T stage, nodal status, any extraprostatic extension, apical margin, bladder neck, seminal vesical invasion, lymph nodal status, post operative BCR need for any hormonal and salvage radiotherapy were recorded. On follow up particular emphasis was given on trifecta as cancer control, urinary continence, erectile function and overall satisfaction. Results Out of 42 patients 7 patients were continent at 1 month follow up, 27 at 3 months, 39 at 6 months and 41 at 12 months. One patient continued to be incontinent at 1 year. Out of 16 patients with nerve sparing RPP 10 patients were potent with PD 5 inhibitor assistance at 6 months and all at 1 year ( Potency was defined as the ability to have erections adequate enough for penetration more than 50% of the times). Three patients had Biochemical recurrence on follow up and both were subjected to hormonal and salvage radiotherapy. Thirty nine patients were disease free at last follow up. Conclusions Radical prostatectomy is the standard of care for organ confined prostatic carcinoma. Aim of the procedure is trifecta as cancer control, urinary continence, and erectile function. Minimally invasive techniques as Robotics should not be a limiting factor especially when affordablity and non availability is concern.

Bladder neck preservation versus bladder neck excision during radical retropubic prostatectomy: Clinical results

1996 ◽  
Vol 63 (1_suppl) ◽  
pp. 109-111
Author(s):  
G. Muto ◽  
F. Bardari ◽  
D. Piras ◽  
R. Leggero
Keyword(s):  
Bladder Neck ◽  
Clinical Stage ◽  
Cancer Control ◽  
Radical Retropubic Prostatectomy ◽  
Urinary Continence ◽  
Retropubic Prostatectomy ◽  
Anastomotic Strictures ◽  
Group A ◽  
Group B ◽  
Neck Preservation

We evaluated recovery of urinary continence and incidence of vesical neck contractures following radical retropubic prostatectomy in a series of 120 patients with clinical stage A-B-C prostate cancer. 58 patients (group A) underwent radical retropubic prostatectomy with bladder neck preservation and 62 patients (group B) with bladder neck excision and reconstruction. In group A there were no anastomotic strictures and in group B, 6.4%. In the first group we noticed an earlier return of continence, but there were no statistically significant differences in urinary continence between the two groups. Bladder neck preservation does not compromise cancer control as assessed by local or PSA-only failure rates.

Safety and feasibility of salvage robot-assisted radical prostatectomy for recurrent prostate cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15171-e15171
Author(s):  
Andre Luis de Castro Abreu ◽  
Sanket Chauhan ◽  
Adrian Stuart Fairey ◽  
Ignacio Camacho ◽  
Alvin Goh ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Erectile Function ◽  
Cancer Control ◽  
Biochemical Failure ◽  
Perioperative Outcomes ◽  
Urinary Continence ◽  
Recurrent Prostate Cancer ◽  
Robot Assisted ◽  
Short Term

e15171 Background: The safety and feasibility of salvage robot-assisted radical prostatectomy (sRARP) for recurrent prostate cancer is unclear. Herein we report short-term cancer control, functional, and perioperative outcomes in a multi-institutional cohort. Methods: Between July 2007 and October 2011, 38 consecutive men underwent sRARP for recurrent prostate cancer at the University of Southern California (n=14) or Global Robotics Institute (n=24). Failed primary therapy was varied (external beam radiotherapy [EBRT; n=14]; interstitial brachytherapy [IBT; n=11]; EBRT + IBT [n=5]; high-intensity focused ultrasound [n=3]; cryoablation [n=3]; other [n=2]). The main outcomes were immediate biochemical failure (IBF), positive surgical margins (PSM), urinary continence and erectile function at 3 months, and complications within 90 days of surgery. Immediate biochemical failure was defined as a PSA > 0.2 ng/ml. Urinary continence was defined as the use of no pads and erectile function was defined as a SHIM score > 21. Complications were classified and graded using the Clavien system. Results: The median age was 68 years (50-83 years) and median preoperative PSA was 4.1 ng/ml (0.4-15.2 ng/ml). Preoperative biopsy Gleason score was ≤6 (n=7), 7 (n=18), and ≥8 (n=12). All procedures were completed without the need for open conversion. No patient experienced an intra-operative complication. Median estimated blood loss was 100 ml (30-300 ml) and operative time was 1.5 h (1-6h). Median length of hospital stay was 1 day (1-7 days). The median duration of urethral catheterization was 12 days (4-48 days). IBF occurred in 9 (29%) patients and PSM occurred in 7 (18%) patients. Urinary continence and erectile function occurred in 9 (34%) and 0 patients, respectively. One or more postoperative complications occurred in 12 (31%) patients. Low grade (I-II) and high grade (III-IV) complications occurred in 8 (21%) and 4 (10%) patients, respectively. No patient died. Conclusions: Salvage robot-assisted radical prostatectomy is safe and feasible. Short-term cancer control and perioperative morbidity were acceptable; however, functional recovery was poor. To date, this is the largest series worldwide.

scholarly journals Modified radical retropubic prostatectomy: Personal technical variation “tension free continuum-urethral anastomosis (T.F.C.U.A)” with optical magnification in the preservation of the bladder neck, and estimation of the urinary continence

2013 ◽  
Vol 85 (4) ◽  
pp. 170 ◽  
Author(s):  
Alberto Roggia ◽  
Emilio Pozzi ◽  
Guglielmo Mantica ◽  
Maurizio Salvadore ◽  
Dimitrios Choussos ◽  
...  
Keyword(s):  
Histopathological Examination ◽  
Bladder Wall ◽  
Muscle Layer ◽  
Radical Retropubic Prostatectomy ◽  
Optical Systems ◽  
Urinary Continence ◽  
Tension Free ◽  
Optical Magnification ◽  
Retropubic Radical Prostatectomy

Objective: To reassess the double continence technique for open retropubic radical prostatectomy, proposed by Malizia and employed by Pagano et al., with the “tension free continuum-urethral anastomosis” (T.F.C.U.A.) personal modification and the use of image magnification optical systems and appropriate and delicate surgical tools. Materials and methods: A total of 173 radical retropubic prostatectomies, performed by the same surgeon, were evaluated in terms of early and late continence. Results: The presence of residual prostate cancer cells within the muscle layer was always excluded by the histopathological examination that also demonstrated that the muscle layer was well represented; satisfactory outcomes were obtained in terms of both early urinary continence (60%) and urinary continence at 6-12 month follow-up (92.4% for the whole series and 97.2% for the last series of patients). Conclusions: The “tension free” anastomosis obtained by the suspension of the anterior bladder wall to the the pubis along the median line allowed to achieve satisfactory outcomes in terms of urinary continence, even if these data obviously need to be confirmed by other series and comparative trials.

Predictive Factor to Regain Erectile Function after Bilateral Nerve Sparing Radical Retropubic Prostatectomy in Korean Men

2007 ◽  
Vol 48 (3) ◽  
pp. 283
Author(s):  
In Ho Chang ◽  
Jun Hyun Han ◽  
Ji Hyeong Yu ◽  
Byung Kyu Han ◽  
Seong Jin Jeong ◽  
...  
Keyword(s):  
Predictive Factor ◽  
Erectile Function ◽  
Radical Retropubic Prostatectomy ◽  
Nerve Sparing ◽  
Retropubic Prostatectomy
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