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PubMedDate not supplied

[Results of prostatectomy in the treatment of obstructive benign prostatic hypertrophy].

Aimed to evaluate the results of surgery in patients with obstructive prostatic hypertrophy, we studied the clinical and flow measure results from 51 patients undergoing prostatectomy (31 TUR, and 20 retropubic prostatectomies). It was shown that prostatectomy significantly improved the irritation (63% of patients), and most importantly, the obstructive (89%) symptoms. Peak flow increased in 100% of patients while maximum flow percentile in 92% of patients. Post-operative results showed no correlation to the patients' age, duration of evolution or severity of urinary symptoms, weight of prostate removed or histology of the prostate. Our results were compared with those obtained with other therapeutical options, and it was demonstrated that prostatectomy (both retropubic and RUT) are, clinically and urodynamically, the most effective procedure in the treatment of obstructive prostate hypertrophy.

Aged↗
PubMed1992

Problems of comorbidity in mortality after prostatectomy.

OBJECTIVE: In recent studies of patients with benign prostatic hyperplasia (BPH), men undergoing transurethral resection of the prostate (TURP) had higher long-term mortality than men undergoing open prostatectomy. We tested the hypothesis that the higher mortality for patients undergoing TURP could have occurred if these patients were older and sicker at the time of surgery than patients undergoing open prostatectomy. DESIGN AND SETTING: Retrospective cohort study at Yale-New Haven (Conn) Hospital. PATIENTS: Two hundred fifty-two men who underwent TURP or open prostatectomy from 1979 through 1981 for the treatment of BPH. MAIN OUTCOME MEASURES: Five-year mortality adjusted for age and severity of comorbid illness at the time of surgery. RESULTS: The crude 5-year mortality rates were 17.5% (22 of 126 patients) for the TURP group and 13.5% (17 of 126 patients) for the open group. At the time of surgery, however, patients in the TURP group were sicker and older than patients in the open group. As the detail and quality of the assessment of comorbidity increased, the adjusted risk of TURP decreased. Improved classifications of comorbidity in three different forms of statistical analysis did not show an effect of type of prostatectomy on long-term mortality (Mantel-Haenszel relative risk, 1.03; 95% confidence interval, 0.57 to 1.87). CONCLUSIONS: These results suggest that TURP does not increase long-term mortality after surgery for the treatment of BPH. Inadequate accounting for severity of illness may also affect other statistical "adjustments" used in research concerned with patient outcomes.

Age Factors↗
PubMed1992

Effects of serum acid phosphatase [correction of phosphate] elevation following transurethral prostatectomy on long-term mortality.

Studies of surgery for symptoms of bladder outlet obstruction in men suggest that a possible higher long-term mortality occurs in patients having transurethral prostatectomy compared with patients having an open prostatectomy. It is the purpose of this study to determine if intraoperative factors affect the long-term survival of patients having transurethral prostate resection for benign prostate hypertrophy. In 158 consecutive patients having transurethral prostatectomy for benign adenoma who were followed for eight years, 28 patients died during the follow-up period. In comparing those patients who are alive with those patients who have died, there was no significant difference at the time of surgery in intraoperative irrigant absorption as indicated by changes in serum sodium and there was no significant difference in the intraoperative absorption of prostate tissue substances as indicated by changes in serum acid phosphatase. The only factor in this study associated with long-term survival was age of the patient at the time of surgery with older patients having a higher long-term mortality. This study suggests that age of the patient rather than intraoperative factors is associated with long-term survival following transurethral prostatectomy.

Acid Phosphatase↗
PubMed2004

Salvage prostatic fossa radiation therapy for biochemical failure after radical prostatectomy: the Sheba experience.

BACKGROUND: The role of prostatic fossa radiation as salvage therapy in the setting of a rising prostate-specific antigen following radical prostatectomy is not well defined. OBJECTIVES: To study the efficacy and safety of pelvic and prostatic fossa radiation therapy following radical prostatectomy for adenocarcinoma. METHODS: A retrospective review of the charts of 1,050 patients treated at the Sheba Medical Center for prostate cancer between 1990 and 2002 identified 48 patients who received post-prostatectomy pelvic and prostatic fossa radiotherapy for biochemical failure. Two patients were classified as T1, T2A-9, T2B-19, T3A-7 and T3B-11. Gleason score was 2-4 in 9 patients, 5-6 in 22 patients, 7 in 10 patients and 8-10 in 7 patients. Positive surgical margins were noted in 28 patients (58%) of whom 18 had single and 10 had multiple positive margins. Radiation was delivered with 6 mV photons using a four-field box to the pelvis followed by two lateral arcs to the prostatic fossa. RESULTS: At a median follow-up of 34.3 months (25th, 75th) (14.7, 51.3) since radiation therapy, 32 patients (66%) are free of disease or biochemical failure. Exploratory analysis revealed that a pre-radiation PSA less than 2 ng/ml was associated with a failure rate of 24% compared with 66% in patients with a pre-radiation PSA greater than 2 ng/ml (chi-square P < 0.006). CONCLUSIONS: For patients with biochemical failure following radical prostatectomy early salvage radiation therapy is an effective and safe treatment option.

Humans↗
PubMed2004

[Suprapubic prostatectomy by preset removable pouch suture and male sexual function].

OBJECTIVE: To evaluate the effect of suprapubic prostatectomy by preset removable pouch suture on the sexual function of patients with benign prostate hyperplasia (BPH). METHODS: Retrospective study was made on 110 cases of BPH that underwent suprapubic prostatectomy by preset removable pouch suture between Jan. 2000 and Sep. 2003. The sexual function changes were evaluated before and after surgery by IIEF-5. RESULTS: Twelve cases of post-operative ED (7 mild, 5 severe) post operative were found in 58 cases with normal sexual function pre-operatively. Among the 30 cases of mild pre-operative ED, 4 severe after operation, 5 restored to normal erection (>21 scores according to IIEF-5), and 21 had no significant change, Of the 22 cases in with severe pre-operative ED, 7 had higher IIEF-5 scores (4 became mild, and 3 had >21 scores). The changes of IIEF-5 scores before and after operation were not statistically different, which could be observed in morning erection (68% pre-operatively and 75% post-operatively). Post-operative retrograde ejaculation was found in 16 case (19%). Eighty percent of the patients thought that the suprapubic prostatectomy by preset removable pouch suture had no effect on male sexual function. CONCLUSION: Suprapubic prostatectomy by preset removable pouch suture affects very little male's sexual function and is a safe method for the treatment of BPH patients.

Aged↗
PubMed2004

[Radical prostatectomy as monotherapy for locally advanced prostate cancer (T3a): 12 years follow-up].

OBJECTIVES: To evaluate the oncological and functional results of radical prostatectomy as monotherapy for stage T3a prostate cancer. METHODS: We include our initial and consecutive series of 83 patients with prostate cancer (studied by digital rectal examination and transrectal ultrasound) who had not received neoadjuvant treatment undergoing radical prostatectomy from July 1988 to December 2003. No patient received adjuvant treatment, and deferred intermittent androgen blockade was used when patients with biochemical progression exceeded a PSA of 4ng/ml. Up RESULTS: After a mean follow-up of 68.7 (1-139) months: overall and specific survival 97.6% and 100% respectively; biochemical progression 36.1% (22 pT2 (0%), 41 p T3a (36.6%), 13 pT3b (61.5%) and 7pT4a (100%)). Positive margins 61.4% (41.2% unifocal with a progression rate of 23.8%). 96.4% achieved continence and 39.6% recovered potency. Among 30 patients with biochemical progression, 19 required treatment with deferred intermittent androgen blockade (one cycle in 10 patients, two cycles in six, and three cycles in the remaining three). CONCLUSIONS: Our results support the indication of radical prostatectomy as single therapy without neoadjuvant treatment as a curative indication for locally advanced prostate cancer (T3a) whenever complete excision is expected: Gleason 7 T3 tumors without diffuse extension on ultrasound. 26.5% of these T3a patients were overstaged and resulted to be organ-confined (pT2). Ten-year probability of biochemical progression-free survival was 100% for pT2 and 81.9% for the lower risk pT3a (well or moderately-differentiated with negative surgical margins or unifocal). Functional results for T3a were similar to the ones of the clinically-localized (T2) series for both retropubic and perineal approaches. 30 patients had developed biochemical progression at the time of study closure and were free of hormonal treatment during 81.6% of the total follow-up time with our deferred intermittent androgen blockade treatment line, so that we consider we can offer it as the first treatment option for progression providing a maximal quality of life and allowing ulterior second line therapies. Patients who mainly benefited were those on progression who have recovered sexual function: 41.7% of potent patients after radical prostatectomy recovered potency again over the second phase (no treatment) of the deferred intermittent androgen blockade.

Aged↗
PubMed2005

[Pre- and post-prostatectomy variation and supplement of sexual hormones in patients with benign prostatic hyperplasia].

OBJECTIVE: To explore the variation of sexual hormones (T and fT) before and after prostatectomy and their post-operative supplement in patients with benign prostatic hyperplasia (BPH). METHODS: Sixty-four cases of BPH were randomly divided into a treatment group (Group I, n = 25) and a control group (Group II, n = 39). Plasma LH, FSH, T and fT were measured by radioimmunoassay a week before and two weeks after prostatectomy. After operation, Group I received supplement of testosterone undecanoate, while Group II received none. RESULTS: The variations of plasma LH, FSH, T and fT were not statistically significant in the two groups before prostatectomy (P > 0.05), but obviously less in Group I than in Group II after operation (P < 0.01). CONCLUSION: Testosterone supplement is a useful therapy for post-prostatectomy patients with androgen deficiency.

Aged↗
PubMed2004

Robotic prostatectomy - a review.

OBJECTIVE: To review the current medical literature on robotic prostatectomy (RP) and report clinical outcomes of this newly developed technique. DATA SOURCE: A MEDLINE search was performed using the following headings: prostate cancer, radical prostatectomy, robotics, robot assisted, laparoscopy, telesurgery. In addition, recently published abstracts on RP were reviewed. STUDY SELECTION: Studies that reported clinical and pathological variables of patients undergoing RP were included in this meta-analysis. DATA EXTRACTION: Data were extracted from published articles and abstracts. DATA SYNTHESIS: Robotic systems enhance surgeons' technical abilities and offer the potential of precise surgical technique. Short-term follow-up studies demonstrate that RP is at least comparable in efficacy to open and laparoscopic prostatectomy, including clinical and pathologic parameters. RP has benefits of minimal invasiveness, decreased blood loss, and quicker recovery compared with open surgery. Functional and cancer control results are still immature, but most studies reported favorable outcomes. CONCLUSIONS: RP is a promising minimally invasive surgical approach for men with prostate cancer. Short-term clinical and pathological results are comparable to those with open and laparoscopic prostatectomy.

Humans↗
PubMed2005

A population-based study of the waiting times for prostatectomy in Ontario.

INTRODUCTION AND OBJECTIVE: Despite the high incidence of prostate cancer in Canada, there is currently limited information describing how these patients are being managed. The aim of this study was to review the surgical waiting times for radical prostatectomy in Ontario, utilizing existing population-based cancer databases, and to describe factors associated with prolonged waiting times. METHODS: This is a retrospective, population-based, observational study of men diagnosed with prostate cancer in Ontario between 1980 and 2000. The sources of data include the Ontario Cancer Registry linked to hospital discharge data, as well as census data from Statistics Canada. Study variables include age, county of residence, teaching hospital status, hospital surgical volume, area-level median household income and cause-specific survival. Waiting times were compared across study variables using univariate and graphical methods. Survival was compared across geographic regions with differing average wait times. RESULTS: We identified 9524 men treated with radical prostatectomy in Ontario over the study period and found the percentage of all patients with the disease who were treated surgically increasing from 3% to 20% over the last 2 decades. The overall time to prostatectomy has almost doubled with a median waiting time of 55 days in earlier eras to 91 days in 1996-2000. A few counties had significantly different wait times, whereas age and socio-economic factors were not associated with wait times across most eras. In the most recent eras, acute care hospitals and hospitals with higher surgical volumes had significantly higher waiting times (up to 20 days longer in 1996-2000, p<0.0001). Patients living in regions with the shortest wait times had statistically significant worse survival (p=0.02), implying that triaging has a greater impact than the potential effect of prolonged waits. CONCLUSIONS: The observed increases in waiting times for radical prostatectomy from this study are similar to the known increases in waiting times for radiotherapy. This increased time to treatment is an illustration of the stress on the health care system in Ontario.

Aged↗
PubMed2005

Radical prostatectomy in high-risk prostate cancer.

OBJECTIVE: Different treatment modalities are considered in treating locally advanced prostate cancer in men. This review discusses the long-term follow-up data of patients who underwent radical prostatectomy with or without adjuvant therapy. The value of an (extended) pelvic lymphadenectomy in these patients is also discussed. METHODS: Relevant information was identified through a literature search of published studies and review articles. RESULTS: Radical prostatectomy alone in locally advanced prostate cancer seems to produce acceptable results. A nerve-preserving procedure in these patients, however, is not an option. Pretreatment with hormonal therapy does not seem to result in prolonged, progression-free or disease-specific survival. Adjuvant therapy after surgery seems to provide good survival rates. CONCLUSIONS: Although no guidelines exist for the treatment of high-risk prostate cancer patients, real benefit seems to occur from radical prostatectomy to control the local tumor and prevent morbidity associated with tumor growth. Since studies clearly demonstrated the benefits of adjuvant therapy along with radical prostatectomy, this should be the preferred course of action.

Humans↗
PubMedDate not supplied

p27(kip1) and Ki-67 (MIB1) immunohistochemical expression in radical prostatectomy specimens of patients with clinically localized prostate cancer.

The immunohistochemical expressions (IE) of p27(kip1) and Ki-67 (MIB-1), both involved in cell cycle regulation and cell proliferation, and their ability to predict biochemical failure, were assessed in patients with clinically localized prostate cancer who had underdone radical prostatectomy of curative intent. In addition, p27(kip1) and Ki-67 (MIB1) expressions were correlated with several pre-operative and post-operative parameters, such as Gleason score, extracapsular extension, seminal vesicle involvement, pelvic lymph nodes metastasis, positive surgical margins, coexistence of high-grade prostatic intraepithelial neoplasia, tumour size, prostate volume and PSA levels. Our analysis involved 130 consecutive radical prostatectomy specimens. A statistically significant correlation of low p27(kiP1) IE with seminal vesicles involvement, increased tumour volume and high pre-operative PSA values was documented. Low p27(kiP1) IE was significantly correlated with an increased likelihood of biochemical failure after radical prostatectomy. In addition, the increased IE of Ki-67 (MIB1) correlated significantly with metastatic disease in the pelvic lymph nodes and was a significant predictor of biochemical failure. Cox regression analysis, which included p27(kip1) expression, Ki-67 (MIB1) expression and all the pre-operative and post-operative parameters, showed that pelvic lymph node involvement and Ki-67 (MIB1) IE were independent prognostic markers of biochemical failure after radical prostatectomy.

Aged↗
PubMed2005

Autoimmune phenomena following prostatectomy.

BACKGROUND: Benign prostatic hypertrophy is the most common benign tumor in males, resulting in prostatectomy in 20-30% of men who live to the age of 80. There are no data on the association of prostatectomy with autoimmune phenomena in the English-language medical literature. OBJECTIVES: To report our experience with three patients who developed autoimmune disease following prostatectomy. PATIENTS: Three patients presented awith autoimmune phenomenon soon after a prostectomy for BPH or prostatic carcinoma: one had clinically diagnosed temporal arteritis, one had leukocytoclastic vasculitis, and the third patient developed sensory Guillian-Barré syndrome following prostatectomy. CONCLUSIONS: In view of the temporal association between the removal of the prostate gland andthe autoimmune process, combined with previously known immunohistologic features of BPH, a cause-effect relationship probably exists.

Aged↗
PubMed2005

Prospective comprehensive assessment of sexual function after retropubic non nerve sparing radical prostatectomy for localized prostate cancer.

OBJECTIVES: This prospective study was undertaken to assess sexual function according to a multidisciplinary comprehensive approach in patients with localized prostate cancer who were treated with radical prostatectomy. MATERIALS AND METHODS: Patients with localized prostate cancer scheduled to undergo retropubic radical non nerve sparing prostatectomy participated to the study. International Index of Erectile Function (IIEF) and Self-rating Depression Scale (SDS) questionnaires were administered and patients were interviewed by a psychologist about their sexual function before and 1 month and 3 months after surgery and underwent nocturnal penile tumescence (NPT) monitoring for 3 nights before and 3 months after radical prostatectomy. After surgery patients were offered sexual counselling and were encouraged to experiment with oral treatment for erectile dysfunction. At 24 month follow up patients were interviewed asking for information PSA value, continence and sexual status. RESULTS: At basal IIEF score showed erectile dysfunction at various degree in 40%, SDS score demonstrated a mild depression in 10% and NPT tests showed a number or erectile episodes less than 3 in 30%, a total time of erection less than 60 minutes in 43% and a degree of rigidity less than 70% in 66%. IIEF scores were inversely related to SDS scores (r = -0.43, p < 0.012) and SDS scores were inversely related to time of erection at NPT (r = -0.44, p = 0.016). The mean basal IIEF score was significantly higher than the 1-month IIEF (p = 0.000) and 3-month IIEF score (p = 0.001) and the mean basal SDS score was significantly higher than the 3-month SDS score (p = 0.011). The mean degree of erections (p = 0.000), total time of erection (p = 0.004) and degree of erection (p = 0.003) at basal were significantly higher than at 3-month follow up. At 24 month follow up five patients replied that they were not able to achieve any erection (group A), 4 were able to achieve an erection only after intracorporeal injection of prostaglandins (group B), 3 were able to achieve erection after oral treatment with sildenafil and only one stated to be able to achieve spontaneously an erection sufficient to sexual intercourse (group C). The mean values of basal IIEF and SDS score at basal and the degree of erection at basal were not significantly different in the three groups whereas the mean number of erections and the mean total time of erection at basal NPT tests were significantly higher in group C than in group A and B. CONCLUSION: Severe erectile dysfunction was observed in most patients after retropubic radical non nerve sparing prostatectomy, but 50% of candidates for radical treatment presents with abnormal erectile function before surgery when appropriately studied. Patients who will recover erectile function could be identified by NPT test before surgery. Depression associated with the fear for intervention is related with erectile dysfunction measured by IIEF scores before surgery, but depression index scores improve after surgery showing that the role of depression in the maintenance of erectile dysfunction is marginal. Sexual counselling and oral treatment facilitate recovery after surgery in patients with optimal erectile function before treatment.

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PubMed2006

Radical prostatectomy: a comparison of open, laparoscopic and robot-assisted laparoscopic techniques.

INTRODUCTION: Surgical approaches to prostate cancer continue to evolve and patient demand for prostatectomy continues to increase. Technical modifications have expanded beyond open surgical approaches to include laparoscopy and more recently robotics. It is important that the enthusiasm that accompanies the introduction of new technology to surgery be accompanied by tangible benefits in terms of comparable oncological or functional outcomes and treatment morbidity. MATERIALS AND METHODS: A literature review was performed comparing individual experiences in large clinical centers and where available comparisons within the same institute between open retropubic radical prostatectomy (RRP), laparoscopic radical prostatectomy (LRP) and robot-assisted laparoscopic radical prostatectomy (RALP). RESULTS: Mortality was extremely low for each approach, with low post-operative pain-scores and analgesic requirements. Oncological outcomes as assessed by positive surgical margin rate were comparable between RRP (13%-21%), LRP (16%-26%) and RALP (6%-23%). Differences in the manner of data accrual and definition for continence and erectile dysfunction make comparison difficult between patient series, however in single institution series comparable continence rates and time to recovery of continence have been shown. CONCLUSIONS: Early data from LRP and RALP series are comparable to RRP in terms of margin-positivity and functional outcomes. Blood loss and transfusion rates appear to be lower for LRP and RALP compared to RRP, while financial costs remain higher than RRP. Long-term oncological results are keenly awaited. Ideally direct comparison between equally experienced surgeons in similar population groups will be required to demonstrate any inherent advantages or disadvantages of individual surgical approaches.

Adenocarcinoma↗
PubMed2005

Histopathological evaluation of radical prostatectomy in the treatment of localized prostate cancer.

Incidence of prostate cancer has risen dramatically in the past decade. Radical prostatectomy is indicated in patients who have disease localized to the prostate. The aim of the study is to make histopathological evaluation of radical prostatectomy in the treatment local prostate cancer. Authors analyzed 49 cases of radical prostatectomy due to cancer localized to the prostate in period 1996-2000 in Clinic of Urology in Clinical Center of Serbia, Belgrade. The average age of the patients was 65, 6 years (range 44-76, pick 61-70). The most cases 25 (51%, p < 0.001) we found in pT2a N0M0, in pT2b N1M0 9 (18.36%), in pT3bN0M0 10 (20.4%), in pT3bN1M0 3 (6.12%), in pT4aN0M0 2 (4.08%). Nodal status positive was in 12 cases: 9 (18%) in pT2bN1M0- iliac 3 (right 2, left 1), obturatory 6 (right 1, left 5) and 3 cases in pT3bN1M0-iliac left 1 and obturatory 2 (1 right and 1 left). We found Gleason score 8 in 9 cases (18.36%) in pT2bN1M0 versus 7 cases (14.5%) without nodal metastases. Gleason score 9 we found in 3 cases (6.1%) in pT3bN1M0 versus one case without nodal metastases (difference is not significant). Gleason score 3 was in 6.1%, 4 in 12.2%, 5 in 8.1%, 6 in 16, 3%, 7 in 24.5%. Grade 1 of tumors we found in 9 cases (18%), grade 2 in 11 (22%), grade 3 in 29 (60%). HG PIN was in 18 cases (36.7%), LG PIN in 10 (20.4%). In all cases was elevated PSA: 4-10 mmol/L in 24 pts, 11-20 in 15 pts and > 20 in 10 pts. Radical prostatectomy is most adequate method in surgical treatment cancer localized in the prostate. Pelvic lymphadenectomy is necessary for staging purposes in adenocarcinoma of the prostate. Early detection adenocarcinoma of the prostate is important factor in decreasing rate of death.

Adult↗
PubMed2006

Robot-assisted radical prostatectomy in obese patients.

OBJECTIVES: Few centers perform extraperitoneal robot assisted radical prostatectomy. The average patient weight is increasing to the mildly obese. Little is known as to the difficulty-impact, obesity may have on robot-assisted extraperitoneal prostatectomy (RAP). We assess our own experience with obese patients undergoing RAP. MATERIALS AND METHODS: Information on 375 consecutive patients undergoing robot-assisted extraperitoneal prostatectomy by a single surgeon was gathered. Obesity is defined as having a body mass index (BMI) greater than 30 kg/m2. Patients with BMI >/= 30 were compared to those with BMI < 30. Specific comparators between the groups were: age, total operating time, estimated blood loss, total prostate specific antigen (PSA), specimen weight, pathological stage, grade and margin, complications, and functional outcomes. RESULTS: Sixty-seven men were identified as obese. When comparing the two groups, no statistically significant difference (p > .05) was noted in operative time (229 versus 217 min), blood loss (205 versus 175 ml), PSA, clinical and pathologic stages, specimen weight, and complications. 15% of non-obese patients had a positive margin compared to 12% of obese patients (p > .05). The 6-month continence rate in patients with a BMI >/= 30 was 92% versus 97% in patients with a BMI < 30. CONCLUSIONS: The extraperitoneal approach to performing a robot-assisted prostatectomy is not associated with increased morbidity in the obese patient. There were no statistically significant differences noted in oncological or functional outcomes between the two groups.

Adult↗
PubMed2006

[Severe (RTOG grades 3 or 4) long-term complications of adjuvant radiotherapy after total prostatectomy].

OBJECTIVE: Study of the incidence of severe long-term gastrointestinal (GI) and genitourinary (GU) complications of conformal radiotherapy after total prostatectomy for localized prostatic adenocarcinoma. MATERIAL AND METHOD: From 1991 to 2000, 114 patients with a mean age of 62 years (range: 45-82 years) were treated by total prostatectomy followed by adjuvant radiotherapy. The mean dose of radiotherapy was 65 Gy (range: 58-72 Gy). The mean interval between prostatectomy and radiotherapy was 10 months (range: 2-28 months). Patients were reviewed every 6 months. We studied severe complications (RTOG grade 3 or 4) occurring after treatment. The mean follow-up was 74 months (range: 32-132 months). RESULTS: Eight patients (7%) treated by adjuvant radiotherapy with a mean dose of 65.5 Gy (range: 59-70 Gy) developed long-term severe complications. The mean time to onset of complications was 25 months (range: 5-72 months). Three patients developed gastrointestinal complications (2 cases of radiation proctitis and 1 anal stricture). Five patients developed genitourinary complications (4 cases of radiation cystitis and 1 urethral stricture). These eight patients received multiple transfusions and required surgical or endoscopic procedures. Most patients were hospitalized on several occasions for periods ranging between 3 days and 1 month. CONCLUSION: Adjuvant radiotherapy after total prostatectomy is associated with severe long-term complications in 7% of cases. When they occur, these complications generally require repeated major urological and gastrointestinal surgery.

Aged↗
PubMed1990

Prostatectomy in a district hospital.

In order to monitor the safety and efficacy of a new service for transurethral prostatectomy, an audit was performed, prospectively, over a period of 7.25 years. Of 304 prostatectomies performed, 91% were by transurethral prostatectomy. The proportion of patients with retention was 52%, 16% were uraemic and the incidence of carcinoma of the prostate was 21%. The operative mortality rate was 1.0%. An outline of the treatment policy and the data on complications and revision operations are presented. Comparisons are made with the experience of teaching centres and other district hospitals. Transurethral prostatectomy can be performed safely in the district general hospital and is a service which is essential to the smooth running of the surgical department.

Aged↗