In addition to the two cell patterns that help determine the Gleason score, if a third, small area of highly aggressive cancer is seen on biopsy, it is associated with a worse prognosis for men with otherwise moderately aggressive disease, according to a study from Brigham and Women’s Hospital published in JAMA (2007; 298:1533-8).
Laparoscopic surgery for urologic malignancy is associated with a low perioperative complication rate, and the rate has decreased over time despite the increasing performance of more challenging cases.
Percutaneous insertion of permanent metal stents appears to offer a safe and reasonably effective, minimally invasive technique for long-term patency restoration in patients with extrinsic ureteral obstruction.
A new study has produced solid evidence that sacral neuromodulation affects the central nervous system.
A team of German researchers is pursuing promising research on oncofetal fibronectin as a potential marker for bladder cancer.
Patient factors, level of surgeon training, and certain surgical steps appear to represent impediments to learning hand-assisted laparoscopic donor nephrectomy (HALDN).
Initial experience with laparoscopic management of post-urologic surgical hemorrhage suggests its feasibility as a minimally invasive alternative to open laparotomy.
When performed by experienced prostate cancer surgeons at a center of excellence, laparoscopic radical prostatectomy (LRP) and open retropubic radical prostatectomy (RRP) have comparable outcomes in the treatment of clinically localized prostate cancer.
Use of a novel articulated needle driver in combination with a three-dimensional imaging system appears to offer a viable method for facilitating suturing in laparoscopic urologic surgery.
Researchers surveyed nine high-volume institutions that use the da Vinci surgical robot (Intuitive Surgical, Sunnyvale, CA) and learned that the failure rate for these devices during prostatectomies was 0.3%.
Use of an extraperitoneal approach for either laparoscopic or robot-assisted radical prostatectomy yields excellent results and has significant advantages over performing these minimally invasive procedures via a transperitoneal route.
A retrospective study of more than 2,100 laparoscopic surgeries performed over 12 years confirmed what many urologists have long suspected: Overall laparoscopic conversion rates are low, and conversion rates fall toward zero as laparoscopic surgeons gain experience.
Where botulinum toxin A (Botox) is injected to treat idiopathic detrusor overactivity makes a difference-not right away, but in the long term.
An analysis of experience with nerve-sparing robot-assisted radical prostatectomy (RARP) in more than 2,600 men having up to 5.5 years of follow-up indicates that the procedure provides good cancer control and functional outcomes that are comparable to those achieved with open surgery.
A third-generation intra-abdominal surgery technique in which endoscopic access is gained through natural orifices using a combined transgastric and transvesical approach has been shown feasible in the hands of Portuguese surgeons.
Laparoscopic surgery for urologic malignancy is associated with a low perioperative complication rate, and the rate has decreased over time despite the increasing performance of more challenging cases.
Donna Moonda, the Mercer County, PA, woman convicted of hiring her lover to kill her husband, Gulam Moonda, MD, a former Mercer County urologist, was sentenced to life in prison without the possibility of parole on Sept. 21, the Pittsburgh Tribune-Review reported.
The National Institute of Diabetes and Digestive and Kidney Diseases, along with several other National Institutes of Health divisions, said it will commit up to $7.5 million per year starting in the summer of 2008 for a 5-year project to study interstitial cystitis/painful bladder syndrome (IC/PBS), chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), and related conditions.
NexMed, Inc., a developer of transdermal products based on its proprietary NexACT drug delivery technology, has filed a new drug application for its topically applied alprostadil cream for the treatment of erectile dysfunction.
EDAP TMS S.A. (Vaulx-en-Velin, France) announced the continuation of its U.S. phase II/III clinical trial of treatment using high-intensity focused ultrasound (HIFU) in men with prostate cancer. An additional two patients have been treated at Virginia Urology Center, Richmond, where Anthony Sliwinski, MD, and David Miller, MD, are leading the study.
Spouses of prostate cancer patients report similar physical and emotional quality of life as the patient, suggests a study from researchers at the University of Michigan Comprehensive Cancer Center in Ann Arbor. The factors having the greatest impact on emotional distress in both patients and spouses were a new diagnosis, facing a recurrence, or living with advanced disease, the researchers reported in the Journal of Clinical Oncology (2007; 25:4171-7).
The investigational compound ZD4054, an endothelin-A receptor antagonist, appears to positively impact overall survival in patients with hormone-resistant prostate cancer, according to the results of a randomized, double-blind, placebo-controlled, phase II study presented at the European Congress of Clinical Oncology in Barcelona.
FDA has approved the use of the 5-day, once-daily regimen of levofloxacin (Levaquin), 750 mg IV and oral, for the treatment of complicated urinary tract infections and acute pyelonephritis.
Recent investigations of medications, diet, and the molecular understanding of prostate cancer are defining potential prevention strategies for the disease and herald a new stage in its management, according to a review to be published in Cancer.
october art
Lymphadenectomy in conjunction with radical cystectomy (RC) is the standard approach for surgical management of high-grade, invasive bladder cancer. Approximately 25% of patients undergoing RC will be found to have lymph node-positive disease.
A staging system that accounts for interactions among tumor stage and grade and patient performance status offers a reliable and reproducible means for predicting mortality after surgery for renal cell carcinoma.
In patients with metastatic renal cell carcinoma, baseline levels of vascular endothelial growth factor (VEGF) predicted overall and progression-free survival, providing additional support for therapies that target VEGF.