Radikal Perineal Prostatektomi Sonrası Erektil Fonksiyonun Değerlendirilmesi

PURPOSE: Radical prostatectomy (RP) is the gold standard treatment option for localized prostate cancer (Pca) treatment. In this study, we aimed to evaluate the potance condition of patients who completed the first year after the radical prostatectomy operation with the perineal approach . PATİENTS AND METHODS: The study included 107 preoperatively potant patients who underwent RPP for localized PCA between April 2006 and September 2009. Besides to 65 patients with a preoperative International Index of Erectile Function (IIEF)- 5 score of 21 or over, 42 patients who were evaluated with their partners, even though whose preopeative IIEF-5 score was between 16-20; however, answered yes to the SEP 2 and SEP 3 questions, were considered as potant. RESULTS: The mean age of the patients was 62.4 years. The mean preoperative PSA value was 6.5 ng/dL. The mean prostate volume was 48cc (15-70). Eighty-one (75.7%) of all patients were able to continue their sexual life with or without medication at postoperative 12th month. Forty-four (54.3%) patients were normal in terms of sexual function without any need for additional treatment CONCLUSİON: We evaluated that erectile function was preserved in 81 of 107 (75.7%) patients after 1 year from surgery with or without medical therapy.

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Examination of necessity for pelvic drain placement after robot-assisted radical prostatectomy

10.21203/rs.3.rs-501754/v1 ◽

2021 ◽

Author(s):

Hiroaki Iwamoto ◽

Yoshifumi Kadono ◽

Hiroshi Yaegashi ◽

Masashi Iijima ◽

Shohei Kawaguchi ◽

...

Keyword(s):

Prostate Cancer ◽

Urinary Tract Infection ◽

Radical Prostatectomy ◽

Gold Standard ◽

Large Scale ◽

Standard Treatment ◽

Perioperative Complications ◽

Node Dissection ◽

Robot Assisted ◽

Effect Of Pd

Abstract PurposeRadical prostatectomy is the gold standard treatment for clinically localised prostate cancer. Pelvic drain (PD) placement is commonly performed after RARP to prevent the formation of urinary cysts, pelvic hematomas and lymphoceles that would require further treatment. RARP has been reported to have few perioperative complications, and the need for PD placement is not clear. This study aimed to assess the need for PD placement after robot-assisted radical prostatectomy (RARP). MethodThis retrospective uncontrolled before-after study analysed the effect of PD placement on postoperative complications in patients who underwent RARP between May 2009 and April 2018.ResultsAll patients prior to October 1, 2016 had a PD placed; those after did not. Of the 308 study patients, 231 received a PD (PD group) and 77 did not (ND group). The incidence of ileus, urinary tract infection and anastomotic leak did not differ significantly between the groups; nor did the incidence of asymptomatic and symptomatic lymphocele at 2 weeks and 1 year after surgery. Multivariate analysis showed that lymph node dissection is a predictor of asymptomatic lymphocele development two weeks after surgery.ConclusionPD placement is not necessary after RARP. Future large-scale studies are required to identify patients that would benefit from PD placement.

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Results of tadalafil treatment in patients following an open nerve-sparing radical prostatectomy

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2016.1.4 ◽

2016 ◽

Vol 88 (1) ◽

pp. 4

Author(s):

Erkan Hirik ◽

Aliseydi Bozkurt ◽

Mehmet Karabakan ◽

Özkan Onuk ◽

Mustafa Bahadır Can Balcı ◽

...

Keyword(s):

Radical Prostatectomy ◽

Adverse Effects ◽

Erectile Function ◽

Nerve Sparing ◽

Ultrasound Evaluation ◽

Significant Difference ◽

Daily Dose ◽

The Mean ◽

Positive Effect

Purpose: To evaluate the effect of postoperatively administering a low daily dose of tadalafil on the erectile function of patients who underwent a nerve-sparing radical prostatectomy(NSRP) due to localized prostate cancer (PCa). Materials and Methods: Of 138 patients, who underwent NSRP due to PCa between 2012 and 2014, 55 patients who had not had pre-operative erectile dysfunction (ED) were included in the study. The mean age of the patients was 64 (54-72). On the 15th day after surgery, after ultrasound evaluation, all 55 patients started on a daily dose of 5 mg tadalafil that was continued for 2.5 months. The erectile function of patients was evaluated pre-operatively, post-operatively, and at the 3rd and 6th month after surgery using the International Index of Erectile Function (IIEF-5) test. None of the patients was treated with hormonal therapy or radiotherapy before or after surgery. Results: Three patients were excluded from the study due to the adverse effects of tadalafil and two patients elected to discontinue the treatment. Of the remaining 50 patients whose pre-operative erectile function had been found normal, at 3 months after surgery, 36 (72%) had normal erectile function; of the remaining patients in the study six (12%) presented with mild, two (4%) with moderate, and six (12%) with severe ED. Six months after surgery, 35 patients (70%) had normal erectile function while seven (14%) had mild, three (6%) moderate and five (10%) severe ED. There was no statistically significant difference between the results obtained at the 3rd and 6thmonth follow-up (p > 0.05). Three patients reported adverse effects with tadalafil including flushes in 2 (3.6%) and a headache in 1 (1.8%). Conclusions: The administration of a 5 mg post-operative dose of tadalafil to patients that had undergone a bilateral NSRP was found to have a positive effect on the recovery and maintenance of erectile function. However, there is still a need to investigate a larger series of cases.

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The effect of vesicourethral anostomosis technique on functional results in retropubic radical prostatectomy

10.22541/au.161607237.74744302/v1 ◽

2021 ◽

Author(s):

Fuat Kizilay ◽

Serdar Kalemci ◽

Adnan Simsir

Keyword(s):

Radical Prostatectomy ◽

Erectile Function ◽

Functional Results ◽

Decisive Factor ◽

Significant Difference ◽

Retropubic Radical Prostatectomy ◽

Continence Status ◽

Oncological Results ◽

The Mean ◽

Mean Time

Aim We aimed to compare the functional results of two different vesicourethral anostomosis (VUA) techniques used in retropubic radical prostatectomy (RRP). Methods A total of 476 patients including the first group with 4 focal VUA at 12-, 3-, 6-, and 9-o’clock positions (n = 288) and the second group with 6 focal VUA at 12-, 2-, 4-, 6-, 8- and 10-o’clock (n = 188) were included in the study. Perioperative data and erectile function and continence status over a 12-month period were compared. Results Demographic and perioperative data were similar between the two groups. The proportion of patients with VUA stricture in the first group was significantly higher than in the second group (5.1% vs 3.2%, p = 0.017). The mean time to stricture development was also shorter in the first group (48.9 vs 74.3 days, p = 0.002). In the second group, the proportion of continent patients at the sixth and twelfth months was higher than the first group (79.3% vs 62.8%, p <0.001; 92.4% vs 81.3%, p = 0.032, respectively). There was no significant difference between the two groups in terms of the proportions of potent patients (p = 0.194 for 6 months and p = 0.351 for 12 months). Conclusions Better continence results can be obtained with the six-focus VUA compared to the four-focus technique. The number of anostomotic sutures in VUA can affect functional results and may be a decisive factor for surgeons who focus on functional results as well as oncological results.

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Prognostic factors for erectile function recovery in patients after radical prostatectomy.

Experimental and Сlinical Urology ◽

10.29188/2222-8543-2020-13-5-60-62 ◽

2020 ◽

Vol 13 (5) ◽

pp. 60-62

Author(s):

R.A. Veliev ◽

◽

E.I. Veliev ◽

E.A. Sokolov ◽

◽

...

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Erectile Function ◽

Prostate Gland ◽

Young Patients ◽

Sexual Life ◽

Nerve Sparing ◽

Scientific Publications ◽

Factors Affecting ◽

Surgical Access

Introduction. In recent years, there has been an increase in the number of young patients diagnosed with prostate cancer. Therefore, it is important to maximize the preservation of erectile and sexual function for this category of patients after treatment with prostate cancer. Materials and methods. This article presents an analysis of data from 117 patients after radical prostatectomy for prostate cancer 6 months after surgery. We evaluated the effect of surgical access, the use of nerve-saving techniques (NST), and other factors on the restoration of erectile function (ЕF). Results. In addition to the younger age of patients at the time of surgery, as well as the use of nerve-sparing techniques, predictors of better erectile function after surgery include a higher level of erectile function before surgery on the IIEF-EF scale, as well as surgical access - we have revealed the advantage of robotic-assisted surgery on the prostate gland. Discussion. Currently, many scientific publications are devoted to identifying factors affecting the rеcovery of EF after radical prostatectomy, while the authors emphasize the positive effect of the relatively young age of the patient, preserved erectile function before surgery and the absence of concomitant diseases on the restoration of EF. Our study also confirms the importance of the RP method: the best results in the rehabilitation of sexual life were obtained when performing a robot-assisted radical prostatectomy and using a nerve-sparing technique. Conclusions. Further monitoring of patients is required to determine the dependence of the restoration of erectile function on the time elapsed after surgery, as well as to assess the role of risk factors at a later date after surgery.

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From gold standard to platinum standard in BPH surgery: a perspective from a tertiary care center of the Indian subcontinent

International Surgery Journal ◽

10.18203/2349-2902.isj20181137 ◽

2018 ◽

Vol 5 (4) ◽

pp. 1499

Author(s):

Rajeev T. P. ◽

Yashasvi Singh ◽

Sasanka Kumar Barua ◽

Debanga Sarma ◽

Manash Pratim Kashyap

Keyword(s):

Transurethral Resection ◽

Gold Standard ◽

Patient Population ◽

Prostate Volume ◽

Indian Subcontinent ◽

Care Center ◽

Tertiary Care ◽

Hemoglobin Level ◽

The Mean ◽

Group B

Background: For last eight decades, transurethral resection of the prostate (TURP) has remained the mainstay of surgical treatment for BPH, due to the procedure’s excellent, well-documented and long- lasting treatment efficacy. Patients with clinically bothersome LUTS suggestive of BPH not relieved with medical treatment benefit from transurethral resection/vaporization of prostate using various energy sources. Monopolar TURP has been the main form of treatment for many years in men with BPH and remains the gold standard against which other treatments are evaluated. The aim of this article is to review the role of m-TURP in contemporary BPH management.Methods: This retrospective study included 275 patients with bothersome LUTS and histologically confirmed BPH, who underwent m-TURP at Deprtment of Urology and Renal Transplantation between July 2010 and July 2015 and were in follow up for at least 24 months in the Urology OPD. The most frequent indication (50-60%) for TURP is LUTS refractory to medical therapy.Results: A total of 274 patients were divided into 3 groups based on prostate volume of less than 40 gram (Group A), 40 to 80 grams (Group B) and more than 80gm (Group C). Statistically, deranged EFG was significantly associated and correlated with Group B). The mean preoperative hemoglobin level for the entire patient population was 13.14±1.26 whereas the post-operative hemoglobin level was 12.22±1.39gm/dl. Similarly, the mean preoperative sodium level for the entire patient population was 137±4.26 whereas the post-operative level was 130±5.04mEq/L.Conclusions: M-TURP is adequate for its intended use as an effective learning tool and as a substantial practical tool for managing BPH; m-TURP results depend on surgeons’ experience, the patient’s prostate volume- and comorbidities.

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Cryotherapy for low risk prostate cancer, oncological and functional medium term outcomes: A three center prospective study

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2017.2.97 ◽

2017 ◽

Vol 89 (2) ◽

pp. 97 ◽

Cited By ~ 1

Author(s):

Valerian Ciprian Lucan ◽

Franco Lugnani ◽

Salvatore Butticè ◽

Emre Sener ◽

Christopher Netsch ◽

...

Keyword(s):

Prostate Cancer ◽

Standard Deviation ◽

Erectile Function ◽

Functional Outcomes ◽

Prostate Volume ◽

Low Risk ◽

Medium Term ◽

Risk Prostate Cancer ◽

Low Risk Prostate Cancer ◽

The Mean

Objectives: Analyze the oncologic and functional outcomes in patients affected by low risk prostate cancer underwent prostate cryotherapy. Materiasl and methods: It’s a prospective tricentric study of 434 patients treated with prostate cryoablation for low risk prostate cancer. By low risk we refer to the D'Amico’s risk classification. Two cycles of freezing/thawing are run for each patient following the technique described by Onik. Results: For the 434 patients, the median age was 66 years with a standard deviation of ± 6.68, the average PSA was 6.17 ng/d/L, the median 5.55 with a standard deviation of ± 2.13, the mean prostate volume was 35.59 cc, the median 34.00 cc, with a standard deviation of ± 7.89. Biochemical failure occurred in 67 patients (15.4%). Pre-operative erectile function in men was distributed as follows: severe in 95 patients (19.2%), moderate in 95 (19.2%), medium-moderate in 180 (36.4%), mild in 92 (18.6%), with no dysfunction in 32 (6.5%) patients. Post-operative erectile function, measured 1 month after cryotherapy, was distributed as follows: severe in 321 (65%) patients, moderate in 69 (14%), medium-moderate in 79 (16%), mild in 23 (4.7%), and no dysfunction in only 2 patients (0.4%). Post-operative erectile function after 3 months was distributed as follows: severe in 233 (47.2%) patients, moderate in 66 (13.4%), medium-moderate in 122 (24.7%), mild in 65 (13.2%), and no dysfunction in 8 patients (1.6%). Urinary incontinence was present in 21 patients (4.8%) after 3 months while it dropped to 13 patients (2.9%) after 6 months. Conclusions: Cryotherapy in the treatment of prostate cancer remains a viable alternative. The availability of new cryoprobes and the use of new diagnostic means such as fusion magnetic resonance will make this more precise and more effective method.

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TURP in the Young Man: Is it Possible to Preserve the Anterograde Ejaculation?

Urologia Journal ◽

10.5301/ru.2013.10719 ◽

2013 ◽

Vol 80 (1) ◽

pp. 64-69 ◽

Cited By ~ 1

Author(s):

Alessandro Del Rosso ◽

Stefano Masciovecchio ◽

Pietro Saldutto ◽

Giuseppe Paradiso Galatioto ◽

Carlo Vicentini

Keyword(s):

Sexual Function ◽

Bladder Neck ◽

Operative Time ◽

Standard Treatment ◽

Prostate Volume ◽

Retrograde Ejaculation ◽

Safe Procedure ◽

The Mean ◽

Prostatic Cyst

Introduction LUTS are fairly common in young men. BPO and intra-prostatic cyst localized near the bladder neck can determine a BOO in men younger than 50 years too. TURP remains the gold standard treatment, but the retrograde ejaculation or the decreased ejaculate volume after TURP was associated with considerable bother. In our study we have evaluated the possibility of obtaining a prostatic disobstruction without affecting the patient's sexual function and, specifically, the retrograde ejaculation, evaluating the sexual function after a 1-year follow-up. Materials and Methods 18 patients were enrolled in the study. Mean age of the patients at time of surgery was 41 years. Erectile and sexual functions have been evaluated according to the self-administered IIEF and MSHQ. Endoscopic procedure was performed with a resection of the bladder neck at 6 o'clock position followed by a resection at the 12 o'clock position. The same questionnaires were administered at 6 months and 1 year after endoscopic surgery. Results The mean baseline prostate volume was 36 mL, with a mean operative time of 22 minutes. No statistical differences were reported in IIEF and MSHQ domains at baseline and after 1 year. Qmax increased from 7.4 mL/s preoperatively to 23.6 mL/s at 1-year follow-up. Conclusion In young and selected patients with prostatic obstruction, it is possible to perform a mini-invasive surgery: “Minimally Invasive Nonexpensive TURP”, an effective and safe procedure, not affecting sexual function, and particularly, retrograde ejaculation.

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