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Biomedical subjects

Soichi Arakawa

Publications and source records attributed to Soichi Arakawa.

At least 19 recordsLinked to original sources

Establishment of a prostatic small-cell carcinoma cell line (SO-MI).

BACKGROUND: Prostatic small-cell carcinoma is an extremely rare, highly aggressive disease. We established a cell line from this tumor. MATERIALS AND METHODS: Tumor tissue obtained from a 24-year-old Japanese man was used to establish the cell line. Cultured cells and tumors transplanted into nude mice were characterized by histologic, immunohistologic, immunocytologic, and molecular biologic methods. RESULTS: An immortal culture cell line (SO-MI) was successfully established. SO-MI cells adhered weakly to plastic surfaces in vitro, showing a 52- to 72-hr doubling time. SO-MI cells were heterotopically and orthotopically transplantable in nude mice. The cells were immunoreactive for NSE, chromogranin A, and NCAM, but not for ACTH, calcitonin, serotonin, gastrin, insulin, glucagons, LCA, EMA, PAP, PSA, androgen receptor, and p53. SO-MI cells secreted NSE in vitro and in vivo. SO-MI cells at passage 30 contained 50-59 chromosomes with a modal number of 55. PCR suggested that the p53 gene was deleted in SO-MI cells. RT-PCR detected no mRNA encoding androgen receptor in these cells. CONCLUSIONS: SO-MI cells retain the neuroendocrine nature of the original tumor, and should be useful in studying possible etiologies and new treatments.

Adult↗

Complete resection of synovial sarcoma of prostatic fascia.

Synovial sarcomas primarily occur chiefly in the para-articular regions of the extremities and extremely rarely in the prostatic region. We report a patient with synovial sarcoma of the prostatic fascia. The patient underwent retropubic radical prostatectomy and at 6 months of follow-up, no evidence of another lesion or local recurrence was found.

Antineoplastic Combined Chemotherapy Protocols↗

Male genital malformations associated with right renal agenesis.

A 30-year-old man visited our department complaining of discomfort on micturition. Hypoplasia of the bilateral epididymis, impalpable vas deferens, and prostatic tenderness were noted. Diagnostic imaging revealed agenesis of the right kidney, cystic dilation of the right seminal vesicle, and a prostatic utricle cyst. Examination of the genital tract confirmed aplasia of the left seminal vesicle and vas deferens and hypoplasia of the right seminal vesicle. On the basis of postoperative extravasation of contrast medium to the right epididymis, cystic dilation of the right seminal vesicle was diagnosed.

Adult↗

Usefulness of MR-seminography using Gd-DTPA in intermediate magnetic field MRI equipment.

T(2)-weighted fast advanced spin-echo imaging with gadolinium (hereinafter referred to as "MR-seminography") of the genital tract was evaluated for its usefulness in non-invasive investigation into the morphology of these organs. Twenty healthy male volunteers who are confirmed as free of genital tract obstruction were entered into the study. The genital tract was imaged using the 0.5 T MRI system by fast advanced spin echo (FASE) method. Based on quantitative evaluation, visibility evaluation, and the visualization of the genital tract in each subject, the contrast-enhanced images were assessed in comparison with those at pre-injection of the contrast agent by four specialists. Also examined were the morphology of the seminal vesicle according to age group using "Ishigami-Mori's classification," and the age angle of the main ducts. MR-seminography produced high contrast images and revealed a significantly decreased signal in the pelvic organs under investigation. In the analysis of individual subjects, the area from the proximal portion of the vas deferens to the ampulla and the seminal vesicles was on the whole well visualized except for the distal portion of the vas deferens and the ejaculatory duct. With regard to seminal vesicle morphology, type II was predominant. The age angle showed a trend toward widening with age. MR-seminography is non-invasive, useful, and therefore a highly recommended procedure for observation of the morphology in the area from the proximal portion of the vas deferens to the seminal vesicle.

Adult↗

Clinical outcome of conservative therapy for stage T1, grade 3 transitional cell carcinoma of the bladder.

BACKGROUND: The objective of this study was to retrospectively investigate the effectiveness of transurethral resection of bladder tumor (TURBT) and intravesical instillation therapy for stage T1, grade 3 (T1G3) transitional cell carcinoma (TCC) of the urinary bladder. METHODS: Between January 1995 and December 1997, 97 patients with T1G3 TCC of the urinary bladder were treated by TURBT and adjuvant intravesical instillation with bacillus Calmette-Guérin (BCG) or other anticancer agents. The recurrence-free survival rates were evaluated according to several clinicopathological factors. The cases that progressed to muscle invasive disease were also analysed. RESULTS: In this series, the median follow-up period was 25 months (range, 5- 41) after the initial TURBT. Intravesical recurrence was noted in 44 patients (45%), and the 1, 2, and 3 year recurrence-free survival rates were 72%, 58%, and 42%, respectively. Multivariate analyses revealed that the risk of intravesical recurrence was significantly higher for patients who did not receive BCG therapy, irrespective of age, gender, tumor size, multiplicity, pathological stage, concomitant carcinoma in situ, and lymphovascular involvement. Moreover, after a median of 10 months, disease progression occurred in seven patients (7%), of which only one patient was treated by BCG therapy after initial TURBT. CONCLUSION: These findings suggest that intravesical instillation with BCG combined with TURBT is an effective conservative treatment for T1G3 TCC of the bladder. Patients with negative prognostic factors should be treated by BCG rather than other anticancer agents after TURBT.

Adjuvants, Immunologic↗

Diverse patterns of acid-base abnormalities associated with a modified sigmoid neobladder.

In this study, we analyzed the pattern of metabolic acidosis in patients following the construction of a sigmoid neobladder and then search for the risk factors which affecting this. In 23 men aged 43-73 years and nine women aged 49-74 years who underwent sigmoid neobladder surgery, we performed physical examinations and blood tests every 3 months for 13-75 months (38.7+/-16.6: mean+/-SD). We monitored acid-base balance, serum electrolytes, creatinine, lipid and liver function in patients for up to 6 years postoperatively. Creatinine clearance over 24 h was determined preoperatively. According to pH and base excess measured during follow-up, patients were classified into three groups (normal, 17 patients; temporary acidosis, eight patients; persistent acidosis, seven patients). Patients with temporary acidosis could compensate spontaneously by 1 year without being given sodium bicarbonate; those with persistent acidosis could not compensate spontaneously and five of them required medication with sodium bicarbonate after 1 year. Serum creatinine in patients with persistent acidosis was consistently higher during follow-up than in the other two groups. Preoperative creatinine clearances in the normal, temporary, and persistent groups were 94.25+/-27.47, 95.19+/-18.63, and 69.18+/-16.18 ml/min/1.73 m(2), respectively, being significantly lower in the persistent group ( P<0.05). In this group, patients with creatinine clearances less than 70 ml/min/1.73 m(2) could not compensate for metabolic acidosis. Normal and temporary groups showed different changes of serum chloride and bicarbonate during follow-up (respectively higher and lower) although the renal functions of the two groups were similar. Chloride and bicarbonate varied reciprocally with pH and base excess. Temporal hyperchloremic metabolic acidosis was observed until a year after surgery. In conclusion, temporary acidosis can be caused in some patients in spite of normal renal function, although it is difficult to predict it. In addition, careful follow-up is required, especially in patients with a creatinine clearance <70 ml/min/1.73 m(2) who can encounter persistent acidosis.

Acid-Base Equilibrium↗

Long-term outcome of focal segmental glomerulosclerosis after Japanese pediatric renal transplantation.

Focal segmental glomerulosclerosis (FSGS) is known to recur in some patients after renal transplantation. Over a prolonged period, we followed 13 pediatric patients with FSGS who had undergone transplantation from living-related donors, analyzing risk factors for recurrent disease. Native nephrectomies were performed bilaterally in all patients at least 1 month prior to transplantation. Immunosuppressive therapy consisted of cyclosporine (CyA), mizoribine, prednisone, and antilymphocytic globulin or deoxyspergualin. We examined age at onset, time in months between diagnosis and end-stage disease (dialysis or transplantation), the duration of dialysis, age at transplantation, time since nephrectomy, doses of immunosuppressive agents, and HLA mismatch. Five patients (42.8%) developed recurrent disease in the graft; all showed proteinuria within 24 h of transplantation. However, all allografts have functioned well for 34-156 months following transplantation despite the recurrences, although 1 of these patients now shows proteinuria. The remaining 8 patients have had no recurrence for 104.6+/-30.4 months (mean+/-SD). The serum level of creatinine in patients with recurrence and without recurrence was 1.1+/-0.42 mg/dl and 0.98+/-0.29 mg/dl, respectively. The interval from diagnosis to initiation of dialysis was significantly shorter in patients with recurrence than those without recurrence ( P<0.05), but no other variables differed between these two groups. No recurrence of FSGS was observed in the protocol biopsy at 100 days after transplantation. We believe that CyA and native nephrectomy may limit or reverse progression of recurrent FSGS in renal allografts of Japanese pediatric patients, although this is a limited study.

Adolescent↗

Over expression of clusterin is an independent prognostic factor for nonpapillary renal cell carcinoma.

PURPOSE: Recent studies have revealed the powerful anti-apoptotic activity of clusterin in several types of malignant tumors. However, the significance of clusterin expression in human renal cell carcinoma has not been well characterized. We determined whether the expression level of clusterin in nonpapillary renal cell carcinoma may be used as predictor of tumor progression and prognosis. MATERIALS AND METHODS: Total RNA was extracted from 93 nonpapillary renal cell carcinomas obtained at surgery and expression levels of clusterin messenger (m)RNA in these specimens were measured by Northern blot analysis. Findings were analyzed with respect to several clinicopathological factors. RESULTS: There were 48 cases (52%) with strong clusterin mRNA expression and 45 (48%) in which it was weak or nonexistent. The expression level of clusterin mRNA did not significantly correlate with patient gender, age, tumor grade or size, or histological cell type, whereas pathological stage and the incidence of tumor recurrence were closely associated with clusterin expression (p <0.005 and <0.01, respectively). The recurrence-free and overall survival rates in patients with strong clusterin expression were significantly lower than in those with weak or no expression (p <0.05). Furthermore, multivariate analyses revealed that strong expression of clusterin was an independent predictor of tumor recurrence and overall survival (p <0.05). CONCLUSIONS: These findings suggest that the over expression of clusterin may be a useful prognostic parameter in patients with nonpapillary renal cell carcinoma after radical nephrectomy.

Adult↗

Growth hormone releasing hormone test for infertile men with spermatogenetic maturation arrest.

PURPOSE: Growth hormone has an important role in the function of the male reproductive system. We investigated infertile men with impaired growth hormone secretion. MATERIALS AND METHODS: Growth hormone status was studied in 8 fertile men and 9 infertile men with azoospermia due to spermatogenetic maturation arrest. Growth hormone releasing hormone, the specific stimulatory neurohormone, was used in the growth hormone stimulation test. A dose of 100 microg. of growth hormone releasing hormone was infused intravenously and serum growth hormone concentrations were measured at 0, 15, 30, 60, 90 and 120 minutes. Serum follicle-stimulating hormone, luteinizing hormone, prolactin, testosterone and estradiol were also measured before the test. RESULTS: Serum follicle-stimulating hormone concentrations were significantly increased in the azoospermic group and basal levels of growth hormone were similar to those in the control group. Serum growth hormone concentrations increased after injection of growth hormone releasing hormone and the levels of growth hormone peaked after 30 minutes in both groups. At time 30 minutes growth hormone levels had decreased significantly more in the azoospermic group than in the controls. Men with azoospermia due to spermatogenetic maturation arrest had a low response to the growth hormone releasing hormone test. CONCLUSIONS: Relative growth hormone insufficiency, which may be caused by reduced reactivity to growth hormone releasing hormone in pituitary growth hormone secretory cells, is strongly related to spermatogenic dysfunction.

Adult↗

Conventional versus microdissection testicular sperm extraction for nonobstructive azoospermia.

PURPOSE: We established a practical and safe strategy for testicular sperm extraction (TESE) in patients with nonobstructive azoospermia and compared conventional with microdissection TESE. MATERIALS AND METHODS: In a retrospective comparative study 46 patients, including 22 with obstructive and 24 with nonobstructive azoospermia, underwent conventional TESE. Another 100 patients, including 26 with obstructive and 74 with nonobstructive azoospermia, underwent microdissection TESE. Conventional TESE was performed via 3 small 5 mm. incisions in the tunica albuginea. Microdissection TESE was performed by making a 3 to 4 cm. incision in the tunica albuginea under operating microscopy, avoiding the underlying testicular artery. Seminiferous tubules that appeared dilated and opaque were harvested. Sperm recovery rates were compared, as were complication rates assessed by ultrasonographic and endocrinological evaluations. RESULTS: In obstructive azoospermia cases the sperm recovery rate was 100% for each procedure. In nonobstructive azoospermia cases sperm were recovered in 16.7% and 44.6% by conventional and microdissection TESE, respectively (p = 0.0271). In cases of histologically diagnosed maturation arrest the sperm recovery rate was 37.5% and 75%, respectively (p = 0.22585). In cases of the Sertoli-cell-only syndrome the sperm recovery rate was 6.3% and 33.9%, respectively (p = 0.0494). We identified dilated and opaque seminiferous tubules containing spermatozoa under operating microscopy in 22.2% of patients with maturation arrest and in 63.2% with the Sertoli-cell-only syndrome. The complication rate was significantly lower for microdissection than for conventional TESE. CONCLUSIONS: In nonobstructive cases, especially those of the Sertoli-cell-only syndrome, microdissection TESE can effectively retrieve spermatozoa and minimize the risk of complications.

Humans↗

Increased serum carcinoembryonic antigen level in patients undergoing colon neobladder replacement compared with ileal neobladder replacement.

OBJECTIVES: To compare the serum and urinary carcinoembryonic antigen (CEA) levels for assessment of possible risk of malignant transformation in patients with orthotopic neobladder. METHODS: The serum and urinary levels of CEA, nutritional status, and acid-base and electrolyte balances were studied in 87 patients after radical cystectomy (22 with ileal neobladder, 28 with colon neobladder, and 37 with ileal conduit). The results of these groups were compared. RESULTS: The serum CEA level in patients with colon neobladder, ileal neobladder, and ileal conduit was 5.4 +/- 3.0, 3.7 +/- 1.6, and 3.1 +/- 1.5 ng/mL, respectively. The serum CEA level in the colon neobladder group was significantly higher than the levels in the remaining two groups (P <0.05); 16 patients (57%) with colon neobladder had elevated serum CEA values (ie, greater than 5 mg/mL). Elevated serum CEA was observed in only 5 (23%) and 3 (8%) patients with ileal neobladder or ileal conduit, respectively. The serum CEA value in these patients was associated with the urinary CEA value (P <0.001), but not the other factors examined. CONCLUSIONS: These findings suggest that colon bladder replacement caused significantly increased serum CEA values compared with ileal neobladder or ileal conduit; however, the elevated serum CEA level correlated with the urinary CEA level, irrespective of other clinical factors. Therefore, the elevated serum CEA in the colon neobladder group may have been due to reabsorption of CEA in urine rather than to an association with malignant changes in the bowel segments used for neobladder creation.

Acid-Base Equilibrium↗

Quality of life of living kidney donors: the short-form 36-item health questionnaire survey.

OBJECTIVES: To determine the psychological and social effects of kidney donation on kidney donors by using the short-form 36-item health survey (SF-36) as the quality-of-life questionnaire. METHODS: A total of 104 living donor nephrectomies have been performed at Kobe University Hospital and Nishinomiya Prefectural Hospital. We mailed the questionnaires to donors or handed them out directly at the outpatient clinic. The first part of the questionnaire consisted of the SF-36 (limitations on physical functioning because of health problems) and the second part consisted of 15 questions about donation-related stress, expenses incurred, physical changes, and pre-existing factors such as relationship to the recipients. RESULTS: The SF-36 and the questionnaire about donor satisfaction were completed by 69 donors (48 women and 21 men; mean age 52.1 +/- 8.2 years), only 6 of whom (9%) reported minor complications with the donor operation. The SF-36 scores of our donors were not significantly different from that of the general U.S. population and U.S. donors. In some categories (physical functioning, role-physical, bodily pain, general health, vitality, and mental health), our donors scored slightly higher than the U.S. general population. Although 97% of the donors would make the same choice again, 3% believed that donating had had a negative impact on their health, and 16% reported negative financial consequences. CONCLUSIONS: The quality of life for kidney donors was not affected by donor nephrectomy. Living kidney transplantation seems to be suitable for the rescue of patients with end-stage renal disease. Better psychological and technical preparation for surgery and more consistent follow-up may reduce the negative outcomes even further.

Activities of Daily Living↗

Surgical management of the urinary tract in patients with locally advanced colorectal cancer.

OBJECTIVES: To review cases of colorectal cancer requiring urologic management to clarify the role the urologist should play in the surgical procedures. A deterrent to radical surgery for advanced colorectal carcinoma with urinary involvement is the technical complexity and associated morbidity and mortality of this procedure. METHODS: Thirty-six tumors in 35 patients, including 19 sigmoid cancers (Stage II, 17; Stage III, 2), 12 rectal cancers (Stage II, 11; Stage III, 1), and 5 local recurrences of colorectal carcinoma in the pelvis were reviewed. All tumors had invaded the bladder, prostate, or ureter. The demographic and clinical characteristics, type of operative procedure, and postoperative complications were analyzed. RESULTS: Of the patients with a sigmoid tumor, partial cystectomy was performed in 15 patients who underwent a bladder-sparing procedure; an ileal conduit and ileal neobladder were created in 2 patients each who required cystectomy. Four patients with rectal cancer underwent a bladder-sparing procedure: partial cystectomy in 1, partial cystectomy with ileal ureter in 1, and prostatectomy in 2. The remaining 8 patients underwent cystectomy with the following types of reconstruction: colonic neobladder in 1, ileal neobladder in 4, Indiana pouch in 1, ileal conduit in 1, and ureterocutaneostomy in 1 patient. The bladder was spared in a greater percentage of patients with sigmoid cancer than in those with rectal cancer. The incidence of complications was greater in patients with rectal cancer and local recurrence than in those with sigmoid tumors. The complication rate was especially low in patients who underwent a bladder-sparing procedure (10.5%) compared with patients who required cystectomy (58.3%). The survival in patients with sigmoid cancer who underwent bladder-sparing surgery also was better than in those who underwent cystectomy. CONCLUSIONS: The treatment of advanced colorectal cancer is best managed by a committed team that includes an experienced urologist. Urologists play a critical role in determining the surgical options and creating appropriate urinary diversions to achieve curative resection with the highest quality of life.

Adult↗

Neoadjuvant androgen withdrawal prior to external radiotherapy for locally advanced adenocarcinoma of the prostate.

BACKGROUND: It is unclear whether positive interactions between radiation and androgen withdrawal for patients with locally advanced prostate cancer is synergistic or additive. The present study aimed to clarify the significance of neoadjuvant androgen ablation prior to external radiotherapy in a human prostate LNCaP tumor model and in patients with locally advanced prostate cancer. METHODS: Comparisons were made between the effect of castration prior to radiation on the growth of subcutaneous LNCaP tumors implanted into male nude mice and their serum prostate-specific antigen (PSA) levels, and the results of castration or radiation alone. Twenty-nine patients with histologically proven and locally advanced adenocarcinoma of the prostate were treated with luteinizing hormone-releasing hormone analog at least 3 months before, during, and after external radiation therapy with a total dose of 70 Gy. The toxicity and response to this therapy were evaluated. RESULTS: Treatment combining castration and radiation resulted in synergistic inhibition of LNCaP tumor growth and a significant delay in the emergence of androgen-independent recurrence as opposed to either treatment alone. The external radiotherapy was completed in 28 patients (96.6%), resulting in a reduction of serum PSA levels in all 28 patients to below 1.0 ng/mL. All patients were alive after a mean follow-up period of 34 months (range 11-53) with a 3-year PSA relapse-free survival rate of 83.7%. Among several factors examined, only the Gleason score was significantly associated with PSA relapse-free survival in univariate analysis, but not in multivariate analysis. Thirteen of 28 patients (46%) and 7 of 28 (25%) also showed at least one form of gastrointestinal or genitourinary toxicity, respectively. Of these patients, 8 with gastrointestinal toxicities, and 1 with genitourinary toxicity, experienced acute complications higher than grade 3. CONCLUSION: The experimental findings objectively suggested the use of neoadjuvant androgen withdrawal prior to radiation therapy. Although our clinical experience is preliminary, combined androgen ablation and radiation therapy may also be effective in controlling locally advanced prostate cancer, with tolerable side-effects.

Adenocarcinoma↗

Comparison of surgical stress between laparoscopy and open surgery in the field of urology by measurement of humoral mediators.

BACKGROUND: Recently, laparoscopic procedures have become more common in urological surgery, and are suggested to be less stressful compared with open surgery; however, little data on objective evaluation of surgical stress after laparoscopic surgery are available. The objective of this study was to compare surgical stress between laparoscopic and open surgery in the field of urology by measurement of humoral mediators. METHODS: Blood samples were obtained from 25 patients who underwent laparoscopic surgery (laparoscopic radical prostatectomy, 10; retroperitoneoscopic nephrectomy or nephroureterectomy, seven; laparoscopic adrenalectomy, five; and hand-assisted laparoscopic radical nephrectomy, three) and 10 who underwent open surgery (retropubic radical prostatectomy, four; radical cystectomy, three; and radical nephrectomy, three), 48 h before surgery, during surgery, and 24, 48 and 96 h after surgery. Serum levels of interleukin (IL)-6, IL-10 and granulocytic elastase in these samples were measured, and the results were analyzed with respect to several clinical factors. RESULTS: In both groups, IL-6 and granulocytic elastase levels increased during surgery and reached maximum levels 24 h after surgery; the increase in granulocytic elastase tended to be prolonged compared with that of IL-6. Changes in IL-10 levels in the open surgery group were similar to those of IL-6 and granulocytic elastase levels, whereas IL-10 levels in the laparoscopic surgery group reached a maximum level during surgery and then decreased to the same level as at 48 h before surgery, on the first postoperative day. The maximum levels of these three mediators in the laparoscopic surgery group were significantly lower than those in the open surgery group. IL-6 was closely associated with the interval of fasting and duration of hospitalization after surgery. CONCLUSION: Although the present study was based on retrospective and non-randomized analysis, the findings suggest that serum levels of IL-6, IL-10 and granulocytic elastase are useful as objective markers of surgical stress, and that laparoscopic surgery is markedly less stressful than open surgery.

Female↗

D-xylose absorption after urinary orthotopic bladder replacement: colon neobladder compared with ileal neobladder.

BACKGROUND: To evaluate the digestive and absorptive status using the D-xylose test in patients who underwent radical cystectomy and orthotopic bladder replacement either by colon or ileal segment. METHODS: D-xylose serum levels after an oral load, nutritional status, plasma vitamin B12 levels, and acid-base and electrolyte balances were studied in 18 patients with colon neobladder and 12 patients with ileal neobladder. Mean follow-up period was 51 months. Results of both types of bladder replacement and a healthy control group were compared. RESULTS: Although no significant difference in the changes of plasma levels of D-xylose after oral load was observed between patients with colon neobladder and healthy controls, plasma levels of D-xylose 90 min after oral load in patients with ileal neobladder were significantly lower than those with colon neobladder. In contrast, there was no significant difference in nutritional status, plasma levels of vitamin B12, and acid-base and electrolyte balances between patients with colon and ileal neobladders. CONCLUSION: Despite acceptable nutritional status, intestinal malabsorption might be present in patients with ileal neobladder, as indicated by the plasma levels of D-xylose, while the colon neobladder group showed no significant differences compared with normal controls. Therefore, absorptive and metabolic status should be carefully monitored after ileal neobladder creation.

Administration, Oral↗

Feasibility and usefulness of laparoscopic radical prostatectomy: Kobe University experience.

OBJECTIVES: The objective of this study was to present the clinical outcomes of 26 patients who underwent laparoscopic radical prostatectomy at our institution. METHODS: We performed laparoscopic prostatectomy on patients who were clinical stage T1 or T2. The mean age was 70 years old (range: 52-76). The mean level of pre-treatment prostate-specific antigen (PSA) was 8.7 ng/mL (range: 3.3-45). The Gleason score of the needle biopsy was < 7 in 21 patients and > or = 7 in five patients. Clinical stage was T1c in 17 patients, T2a in 6 patients and T2b in 3 patients. Operative techniques followed those of the French groups. Five trocars were introduced into the peritoneal cavity. The vas deferens and seminal vesicles were dissected to reach the posterior wall of the prostate and the retroperitoneal space was dissected around the urinary bladder. Incision of endopelvic fascia and dorsal vein complex (DVC) ligation were performed. The bladder neck and prostate were divided, then the distal urethra was cut. The lateral pedicles of the prostate were cut and the entire prostate was removed. Vesico-urethral anastomosis was performed at eight points. RESULTS: Mean operation time was 7 h 30 min. Mean bleeding volume (including urine volume) was 850 mL (range: 32-3135). All patients underwent autologous blood transfusion. Only one patient required further blood transfusion. Gleason scores of resected specimens were < 7 in 10 patients, and > or = 7 in 16 patients. Pathological stage was T0 in 1 patient, T2a in 6 patients, T2b in 13 patients, T3a in 5 patients and T3b in 1 patient. The PSA value was undetectable in all patients one month after surgery. Ten patients who survived for 6 months after surgery had complete urinary continence without a pad. In 7 of the 12 patients who were potent before surgery, neurovascular bundles were preserved, and 5 of them (71%) achieved complete or incomplete erection 3 months after surgery. However, only one patient (14%) could have sexual intercourse. CONCLUSION: Although longer follow-up is necessary to evaluate this surgical technique, laparoscopic prostatectomy seems to be a reasonable option in the treatment of organ-confined prostate cancer.

Aged↗