Pelvic magnetic resonance imaging parameters predict urinary incontinence after robot ‐assisted radical prostatectomy
ObjectiveUrinary incontinence (UI) is a major prostate cancer (PCa) treatment ‐related morbidity. It has been reported that post‐prostatectomy UI is related to the width of the pelvic floor muscles (PFM) and the length of the urethra. However, the details of these anatomical parameters are unknown. The aim of this study was to investigate whether preoperative pelvic param eters or anatomical parameters of the urethra, as measured by magnetic resonance imaging (MRI), are correlated with UI.MethodsBetween 2010 and 2017, 571 patients with localized PCa underwent robot ‐assisted radical prostatectomy (RARP) at Okayama University Hospital. Patients treated by a single experienced surgeon were included in the study. Preoperative prostate volume, obturator internal muscle, anal sphincter muscle, levator ani muscle (LAM), urethra wall thickness (UWT), and membranous urethral length (MUL) were measured by MRI. Patients were divided into two groups depending on leakage status 1 year after RARP using Expanded Prostate Index Composite Item 1.ResultsSeventy patients were included in this retrospective study. Based on leakage status, 37 and 33 patients were allocated to the no ‐leakage and leakage groups, respectively. There were significant differences between the two groups in age (P = 0.03), MUL (P
Authors: Huh JS, Kim YJ, Kim SD, Park KK Abstract PURPOSE: To analyze the clinical parameters correlated with early recovery of urinary continence after radical prostatectomy, with a focus on urethral mobility during pelvic contraction at catheter removal. METHODS: We prospectively analyzed 67 patients who underwent prostatectomy for prostate cancer at Jeju National University Hospital from January 2015 to June 2018. At the time of catheter removal, a cystography was performed in 67 men (median age, 65 years; range, 55-76 years) who had undergone robot-assisted laparoscopic prostatectomy. The vertical length of...
CONCLUSIONS: Higher dose volumes for the bladder and rectum predicted for poorer PR-QOL. In contrast to prostate brachytherapy data, neither prostate volume nor urethral dosimetry at this dose schedule correlated with urinary symptoms. PMID: 31584457 [PubMed - as supplied by publisher]
A, Sancho Pardo G, Zapatero A, Álvaro PC Abstract BACKGROUND: Brachytherapy (BT) is widely used for salvage therapy in patients with biochemical failure (BF) after radiotherapy for prostate cancer (PCa). Although low-dose-rate (LDR) and high-dose-rate (HDR) BT are both used for salvage therapy, it is not clear whether there are any differences between these two approaches in terms of efficacy or toxicity in this setting. Therefore, we review the institutional experience of the members of the Urological Tumour Working Group (URONCOR) of the Spanish Society of Radiation Oncology (SEOR) to compare these two te...
ConclusionThe most severe complications of ATOMS implantation were primary wound infection and cutaneous erosion, especially in the presence of previous radiotherapy. Particular focus on performing hygienic and accurate implantation techniques is recommended.
ConclusionsOur data demonstrate a promising new strategy to predict PPI through the perfusion quality of pelvic muscle structures with contrast media kinetics. This may facilitate preoperative patient consulting and decision-making.
AbstractIntroductionTo investigate whether the implantation of a hydrogel spacer (SpaceOAR) reduces long ‐term rectal toxicity for prostate cancer patients treated with intensity‐modulated radiotherapy (IMRT).MethodsPatients with localised prostate cancer treated with 81 Gy in 45 fx of IMRT over 9 weeks were retrospectively compared: 65 patients with SpaceOAR and 56 patients without SpaceOAR. Planning aims restricted rectal doses to V40 Gy
Medical device companies attempting to market a new treatment in the U.S. often make the erroneous assumption that winning FDA approvalÂ is the final destination, and success is theirs. In fact, going through the regulatory process is only the halfway point. The grueling path from FDA approval to reimbursement is like a treacherous walk through Death Valley and many companies donât make it through. In this case study, I discussÂ the trials and triumphs of bringing robotic high intensity focused ultrasound (HIFU), a non-invasive procedure for localized prostate cancer, to the U.S.&Aci...
CONCLUSION: Hemiablation HIFU is an alternative to whole gland therapy in patients with unilateral radio- recurrent prostate cancer, which offers limited urinary and rectal morbidity, and preserves functional outcomes. LEVEL OF EVIDENCE: 3. PMID: 31400963 [PubMed - as supplied by publisher]
CONCLUSIONS: In our study a comprehensive evaluation of preoperative patient's QL, assessed by the EORTC QLQ-C30 questionnaire, can predict the early and long-term moderate/severe incontinence risk in RARP treated patients. Further studies should confirm our results. PMID: 31326315 [PubMed - as supplied by publisher]
Conclusions: To avoid fecal incontinence it is important to limit the portion of the anal canal irradiated. Our analysis confirms that rectal bleeding is a function of similar spatial dose parameters for patients treated with IMRT, compared to previous studies on patients treated with three-dimensional conformal radiotherapy. PMID: 31298076 [PubMed - as supplied by publisher]