How to select the right patient for the right treatment: What role does sexuality play in Pca treatment?
|
|
- Frederick Bailey
- 6 years ago
- Views:
Transcription
1 How to select the right patient for the right treatment: What role does sexuality play in Pca treatment? Andrea Salonia, MD, PhD, FECSM Università Vita-Salute San Raffaele Director, URI-Urological Research Institute Division of Experimental Oncology/Unit of Urology, IRCCS Ospedale San Raffaele
2 Pathway for prevention of SD after PCa treatment Patient baseline evaluation oncological parameters functional parameters Patient s risk of ED stratification Good patient counselling Final treatment choice according to: Oncological risk Baseline functional characteristics Patient s willings and expectations Salonia A et al Eur Urol 2012
3 Patient baseline evaluation oncological risk stratification - Active Surveillance (in selected patients) - Radical Prostatectomy - Radiotherapy - Brachytherapy/Cryotherapy/HIFU - Radical Prostatectomy - Radiotherapy - Multimodal treatment - ADT - Radical Prostatectomy - Radiotherapy - Brachytherapy/Cryotherapy/HIFU EAU Guidelines 2015
4
5 Patient baseline evaluation Functional parameters Salomon G et al J Sex Med 2009
6 Patient baseline evaluation Functional parameters 234 pts who subjectively reported normal EF candidated to BNSRP 38% of the patients with severe ED did not attempt any intercourse during the last 4 weeks prior to surgery. Incorrect timing of questionnaires administration, the potential influence of preoperative patient s psychological distress, may be contributing factors to the high rate of pre-operative ED Salonia A et al Eur Urol 2006
7 THE SUSPICION-DIAGNOSIS-TREATMENT MODEL Salonia A & Montorsi F, ESSM 2012
8 Patient baseline evaluation Functional parameters 333 patients candidated to BNSRP AIM: to test the agreeement between remembered IIEF score (targeted 6 mos before surgery) and real time IIEF score (targeting 4 weeks before surgery) The present findings indicate that remembered IIEF should not be used to assess SF in a real-life clinical setting in candidates for BNSRRP Salonia A et al J Sex Med 2008
9 54 patients completed IIEF-5 questionnaires: before prostate biopsy, 1 day before RLRP, and 1 month after RLRP to assess preoperative baseline EF To accurately assess the pre-diagnostic baseline the psychometric tools should be administered before prostate biopsy since cancer diagnosis-related symptoms and depression can ultimately affect sexual function and index scores Kim DS et al J Sex Med 2012
10 Patient baseline evaluation Functional parameters Baseline EF assessment is still problematic and the most reliable timing of this assessment is even more poorly defined Patients might overestimate their previous EF Proximity to the surgery may reduce the sexual activity/desire of either the patient, his partner or the couple as a whole PCa diagnosis, cancer-related or treatment-associated psychological distress may also significantly impair the real-time assessment of EF immediately prior to RP
11 Patient baseline evaluation Risk of post-operative ED - Pretreatment sexual HRQOL score - Age - PSA - race/ethnicity - BMI were associated with functional erections 2 years after treatment Alemozzaffar M et al JAMA 2011
12 Patient baseline evaluation Risk of post-operative ED the presence, number, and potentially severity of those comorbidities (eg, vascular risk factors such as dyslipidemia, diabetes mellitus, hypertension, coronary artery disease) afflicting the patient well before the RP will likely afflict that man even after surgery, adversely affecting EF recovery, just as usually happens in the general population Salomon G et al J Sex Med 2009
13 THE SUSPICION-DIAGNOSIS-TREATMENT MODEL Salonia A & Montorsi F, ESSM 2012
14 Aim: To test the correlation between patient satisfaction and IIEF-EF domain score cut-offs. 165 patients treated with retropubic BNSRP. All patients had normal preoperative EF and reached an IIEF-EF 17 following surgery. In preop fully potent patients treated with BNSRP a lower satisfaction is expected when an IIEF-EF cut-off of 17 is used. Conversely, no difference was found using a cut-off of 22 or 26. A cut-off of IIEF-EF 22 might represent a reliable score for defining EF recovery after BNSRP Briganti A et al J Sex Med 2011
15 The vast majority of patients will regain Erectile function sufficient to engage in intercourse following LRP Only a fraction, however, will return to their preoperative level of sexual function Levinson AW, et al. World J Urol, 29:29-34, 2011
16 Brajtbord JS, et al. J Urol, 192: , 2014
17 THE SUSPICION-DIAGNOSIS-TREATMENT MODEL Salonia A & Montorsi F, ESSM 2012
18 SCANDINAVIAN PROSPECTIVE STUDY (vs AGE-MATCHED HEALTHY CONTROLS) 50% 34% 23% 26% Johansson et al. Lancet Oncol, 12:91 99, 2011
19 Treatment choice Sexual function outcomes Active Surveillance VasarainenH et al BJU 2011 Venderbos LDF al Curr Op Urol 2015
20 THE SUSPICION-DIAGNOSIS-TREATMENT MODEL Salonia A & Montorsi F, ESSM 2012
21
22 PCa treatment Robotic vs Open surgery The vast majority of data regarding EF recovery comes from RCTs including mainly patients treated with ORP Is robotic surgery changing the landscape in terms of rates and recovery from sexual dysfunction after RP? Do we need to reconceptualized penile rehabilitationin a new patient setting? Capogrosso P & Salonia A, ESSM 2015; AUA2015; SIA2015; SIU2015
23 Functional & topographic anatomy of the prostate: what has changed? Walz J, et al. Eur Urol, 57:179-92, 2010 Salonia A, et al. Eur Urol, 62:261-72, 2012
24 Treatment choice Sexual function outcomes Surgery the right strategy 133 pts submitted to RALP The surgeon intraoperatively graded the NS independently for either side as follows: 1 = no NS; 2 = <50% NS; 3 = 50% NS; 4 = 75% NS; 5 = 95% NS. 52.6% had NSS 5, 30.1% had NSS 4, 2.3 had NSS 3, 13.2% had NSS 2, 1.9 had NSS 1 Schatloff O et al, Eur Urol 2011
25 Treatment choice Sexual function outcomes Surgery the right technique 12-mos potency rate The cumulative analysis showed a nonstatistically significant trend in favor of RARP (OR: 1.89; 95% CI, ; p = 0.21) Ficarra V et al, Eur Urol 2012
26 Treatment choice Sexual function outcomes Surgery the right technique prospective, controlled, nonrandomised trial of patients undergoing prostatectomy in 14 centres using RALP or RRP 12-mos potency rate RALP for prostate cancer was modestly beneficial in preserving erectile function compared with RRP Haglind E et al, Eur Urol 2015
27 Treatment choice Sexual function outcomes Surgery the right strategy 12-mos potency rate Briganti et al developed a preoperative risk stratification tool assessing the probability of EF recovery after BNSRP Low risk: age<65 yr; IIEF-EF 26; CCI 1 Intermediate risk: age yr or IIEF-EF 11-25; CCI 1 High risk: age 70 yr or IIEF-EF 10 or CCI 2 Briganti A et al. J Sex Med 2010
28 Treatment choice Sexual function outcomes Intermediate-risk Low-risk High-risk After stratification according to the erectile dysfunction risk, RARP led to higher erectile function recovery rates in the low- and intermediate-risk erectile dysfunction groups (all P < 0.001) but not for patients at high risk of erectile dysfunction (P = 0.5). Gandaglia G et al J Endourol 2014
29 Patient counselling Neglected side effects A series of additionally side effects have been associated to RP and in some cases to RT treatment of PCa Orgasm-associated incontinence (climacturia) Impaired orgasmic function Painful orgasm Penile shortening
30 Patient counselling Climacturia In light of the complete absence of standardized objective assessment tools the exact rate of climacturia after RP is unknown, varying from 20 93% according to different cohorts The development of climacturia based on time since surgery was reported 22% at 0 6 mo 27% at 6 12 mo 17% at mo and 9% at >24 mo Salonia A et al, Eur Urol 2012 Frey AU et al, J Sex Med 2012
31 Patient counselling Painful orgasm Few available data seem to suggest that dysorgasmia occurred in 12-19% of the patients Pain was reported at the level of: penis (63%) abdomen (9%) rectum (24%) other areas (4%) Salonia A et al, Eur Urol 2012 Frey AU et al, J Sex Med 2012
32 Treatment choice Sexual function outcomes Surgery the right technique Painful orgasm N [%] Total RRP RALP p-value;chi 2 71 (11.5) 43 (14.3) 28 (8.9) 0.02; 4.61 A significant advantage in terms of a lower prevalence of PO and greater and faster recovery from climacturia was observed in men treated with RARP compared with those who underwent OPR Capogrosso P et al Eur Urol 2015
33 TAKE HOME MESSAGE - A correct pre-operative evaluation of EF (SEXUAL FUNCTION) remains of paramount importance - The concept of back to baseline should be comprehensively discussed before treatment - Patient should be given individualized outcome according to: - Pre-operative characteristics (oncological and clinical) - Type of treatment - Prevention and possible management of EF in patients treated for PCa necessarily passes through a careful choice of the right patient at the right time for the right type of treatment - New surgical approaches are changing the landscape Salonia A et al, Eur Urol 2012
State-of-the-art: vision on the future. Urology
State-of-the-art: vision on the future Urology Francesco Montorsi MD FRCS Professor and Chairman Department of Urology San Raffaele Hospital Vita-Salute San Raffaele University Milan, Italy Disclosures
More informationPrevention and management of post prostatectomy erectile dysfunction
Review Article Prevention and management of post prostatectomy erectile dysfunction Andrea Salonia 1,2, Giulia Castagna 1, Paolo Capogrosso 1, Fabio Castiglione 1, Alberto Briganti 1,2, Francesco Montorsi
More informationQuestions & Answers about Sexuality and Intimacy after Bladder Cancer. Part III: Causes and Treatments for Sexual Dysfunction
Questions & Answers about Sexuality and Intimacy after Bladder Cancer A Valentine's chat with Dr. Trinity Bivalacqua Monday, February 13, 2017 Part III: Causes and Treatments for Sexual Dysfunction Presented
More informationPioneering Robotic-Assisted Laparoscopic Prostatectomy in The Pretoria Urology Hospital and the South African urological environment:
Pioneering Robotic-Assisted Laparoscopic Prostatectomy in The Pretoria Urology Hospital and the South African urological environment: Dr. Lance Coetzee Pretoria Urology Hospital SOUTH AFRICA Minimum of
More informationLiterature list to support the LBI HTA on robotic assisted surgery. Radical Prostatectomy
Literature list to support the LBI HTA on robotic assisted surgery Radical Prostatectomy Comprehensive literature search ORP versus RARP versus LRP 2010 to 2015 Study types included: RCTs, prospective
More informationSidney Glina Faculdade de Medicina do ABC Instituto H. Ellis Editor-in-Chief of the International Brazilian Journal of Urology
Sidney Glina Faculdade de Medicina do ABC Instituto H. Ellis Editor-in-Chief of the International Brazilian Journal of Urology (www.intbrazjurol.com.br) glinas@terra.com.br Conflict of Interest: In the
More informationBaseline Potency in Candidates for Bilateral Nerve-Sparing Radical Retropubic Prostatectomy
european urology 50 (2006) 360 365 available at www.sciencedirect.com journal homepage: www.europeanurology.com Sexual Medicine Baseline Potency in Candidates for Bilateral Nerve-Sparing Radical Retropubic
More informationA Proposed Study of Hyperbaric Oxygen Therapy Following Radical Prostatectomy: Effects on Erectile Dysfunction
A Proposed Study of Hyperbaric Oxygen Therapy Following Radical Prostatectomy: Effects on Erectile Dysfunction Anthony J. Bella MD, FRCSC Division of Urology, Department of Surgery and Department of Neuroscience
More informationEUROPEAN UROLOGY 62 (2012)
EUROPEAN UROLOGY 62 (2012) 273 286 available at www.sciencedirect.com journal homepage: www.europeanurology.com Platinum Priority Collaborative Review Sexual Medicine Editorial by Dimitris Hatzichristou
More informationDepartment of Urology, Cochin hospital Paris Descartes University
Technical advances in the treatment of localized prostate cancer Pr Michaël Peyromaure Department of Urology, Cochin hospital Paris Descartes University Introduction Curative treatments of localized prostate
More informationProstate Biopsy Protocol in Active Surveillance for Prostate Cancer Causes ED. Con Man: Andrew McCullough May
Prostate Biopsy Protocol in Active Surveillance for Prostate Cancer Causes ED Con Man: Andrew McCullough May 12 2017 It may be particularly useful as an initial screening instrument in a general practice
More informationAlberto Briganti, M.D., PhD
Alberto Briganti, M.D., PhD Professore Orinario di Urologia IRCCS San Raffaele Divisione di Oncologia / Unità di Urologia Urological Research Institute (URI) Università Vita-Salute San Raffaele, Milano
More informationE U R O P E A N U R O L O G Y O N C O L O G Y X X X ( ) X X X X X X
ava ilable at www.sciencedirect.com journa l homepage: euoncology.europeanurology.com Internal and External Validation of a 90-Day Percentage Erection Fullness Score Model Predicting Potency Recovery Following
More informationda Vinci Prostatectomy
da Vinci Prostatectomy Justin T. Lee MD Director of Robotic Surgery Urology Associates of North Texas (UANT) USMD Prostate Cancer Center (www.usmdpcc.com) Prostate Cancer Facts Prostate cancer Leading
More information10th anniversary of 1st validated CaPspecific
Quality of Life after Treatment of Localised Prostate Cancer Dr Jeremy Grummet Clinical Uro-Oncology Fellow May 28, 2008 1 Why? This is important May be viewed as soft science Until we know which treatment
More informationEffect of penile rehabilitation on erectile function after bilateral nerve-sparing robotic-assisted radical prostatectomy
original article Journal of Andrological Sciences 2010;17:17-22 Effect of penile rehabilitation on erectile function after bilateral nerve-sparing robotic-assisted radical prostatectomy G. Novara, V. Ficarra,
More informationRole of surgery. Theo M. de Reijke MD PhD FEBU Department of Urology Academic Medical Center Amsterdam
Role of surgery Theo M. de Reijke MD PhD FEBU Department of Urology Academic Medical Center Amsterdam Surgery and alternative treatments Radical prostatectomy Open Laparoscopic Robot-assisted Temperature
More informationOpinion: Yes. PDE-5 inhibitors should be used post radical prostatectomy as erection function rehabilitation?
Difference of opinion Vol. 43 (3): 385-389, May - June, 2017 doi: 10.1590/S1677-5538.IBJU.2017.03.03 PDE-5 inhibitors should be used post radical prostatectomy as erection function rehabilitation? Opinion:
More informationPenile Rehabilitation after Radical Prostatectomy
Penile Rehabilitation after Radical Prostatectomy The PRO Position John P. Mulhall MD MSc FECSM FACS Director, Sexual & Reproductive Medicine Program Urology Service Memorial Sloan Kettering Cancer Center
More informationRadical Prostatectomy: Management of the Primary From Localized to Oligometasta:c Disease
Radical Prostatectomy: Management of the Primary From Localized to Oligometasta:c Disease Disclosures I do not have anything to disclose Sexual function causes moderate to severe distress 2 years after
More informationPreserved Postoperative Penile Size Correlates Well with Maintained Erectile Function after Bilateral Nerve-Sparing Radical Retropubic Prostatectomy
european urology 52 (2007) 702 707 available at www.sciencedirect.com journal homepage: www.europeanurology.com Prostate Cancer Preserved Postoperative Penile Size Correlates Well with Maintained Erectile
More informationPentafecta: A New Concept for Reporting Outcomes of Robot-Assisted Laparoscopic Radical Prostatectomy
EUROPEAN UROLOGY 59 (2011) 702 707 available at www.sciencedirect.com journal homepage: www.europeanurology.com Platinum Priority Prostate Cancer Editorial by James A. Eastham and Peter T. Scardino on
More informationAssessment of Erectile and Ejaculatory Function after Penile Prosthesis Implantation
www.kjurology.org DOI:.4/kju.2.5.3.22 Sexual Dysfunction/Infertility Assessment of Erectile and Ejaculatory Function after Penile Prosthesis Implantation Jang Ho Bae, Phil Hyun Song, Hyun Tae Kim, Ki Hak
More informationPotency after unilateral nerve sparing surgery: a report on functional and oncological results of unilateral nerve sparing surgery
Potency after unilateral nerve sparing surgery: a report on functional and oncological results of unilateral nerve sparing surgery F Van der Aa 1, S Joniau 1, D De Ridder 1 & H Van Poppel 1 * 1 Department
More informationPenile rehabilitation after radical prostatectomy: patients attitude and feasibility in China
Original Article Penile rehabilitation after radical prostatectomy: patients attitude and feasibility in China Yi-Jun Shen 1,2, Jian Li 1,2, Ding-Wei Ye 1,2 1 Department of Urology, Fudan University Shanghai
More informationAcceptance of and Discontinuation Rate from Erectile Dysfunction Oral Treatment in Patients following Bilateral Nerve-Sparing Radical Prostatectomy
european urology 53 (2008) 564 570 available at www.sciencedirect.com journal homepage: www.europeanurology.com Prostate Cancer Acceptance of and Discontinuation Rate from Erectile Dysfunction Oral Treatment
More informationLaparoscopic Surgery. The Da Vinci Robot. Limits of Laparoscopy. What Robotics Offers. Robotic Urologic Surgery: A New Era in Patient Care
Laparoscopic Surgery Robotic Urologic Surgery: A New Era in Patient Care Laparoscopic technique was introduced in urologic surgery in the 1990s Benefits: Improved recovery time, decreased morbidity Matthew
More informationLocalized prostate cancer treatment. Open radical prostatectomy. Cabrita Carneiro CHLC Hospital S José Hospital CUF Infante Santo
Localized prostate cancer treatment Cabrita Carneiro CHLC Hospital S José Hospital CUF Infante Santo background - RRP RRP was introduced more than three decades ago RRP has matured over time RRP has been
More informationHigh Risk Localized Prostate Cancer Treatment Should Start with RT
High Risk Localized Prostate Cancer Treatment Should Start with RT Jason A. Efstathiou, M.D., D.Phil. Assistant Professor of Radiation Oncology Massachusetts General Hospital Harvard Medical School 10
More informationdoi: /j x
International Journal of Urology (27) 14, 133 139 doi:.1111/j.1442-242.27.1699.x Impact of unilateral interposition sural nerve graft on the recovery of sexual function after radical prostatectomy in Japanese
More informationRadical Prostatectomy:
Overtreatment and undertreatment Radical Prostatectomy: An Emerging Standard of Care for High Risk Prostate Cancer Matthew R. Cooperberg, MD,MPH UCSF Radiation Oncology Update San Francisco, CA April 2,
More informationIntrafascial versus interfascial nerve sparing in radical prostatectomy for localized prostate cancer: a systematic review and metaanalysis
www.nature.com/scientificreports Received: 26 August 2016 Accepted: 31 August 2017 Published: xx xx xxxx OPEN Intrafascial versus interfascial nerve sparing in radical prostatectomy for localized prostate
More informationPresentation with lymphadenopathy
Presentation with lymphadenopathy Theo M. de Reijke MD PhD FEBU Department of Urology Academic Medical Center Amsterdam Rationale for RRP in N+ disease Prevention local problems Better survival in limited
More informationRAPN. in T1b Renal Masses? A. Mottrie. G. Denaeyer, P. Schatteman, G. Novara
RAPN in T1b Renal Masses? A. Mottrie G. Denaeyer, P. Schatteman, G. Novara Department of Urology O.L.V. Clinic Aalst OLV Vattikuti Robotic Surgery Institute Aalst Belgium Guidelines on Renal Cell Carcinoma
More informationErectile Dysfunction and the Prostate Cancer Patient
BAUN & Prostate cancer UK Erectile Dysfunction Study Day Erectile Dysfunction and the Prostate Cancer Patient Lorraine Montgomery Specialist Nurse Practitioner Urology Queen Elizabeth Hospital Gateshead
More informationCase Discussions: Prostate Cancer
Case Discussions: Prostate Cancer Andrew J. Stephenson, MD FRCSC FACS Chief, Urologic Oncology Glickman Urological and Kidney Institute Cleveland Clinic Elevated PSA 1 54 yo, healthy male, family Hx of
More informationTreatment of localized prostate cancer in elderly patients
Editorial Treatment of localized prostate cancer in elderly patients Mohammed Haseebuddin, Marc C. Smaldone Department of Urologic Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA Correspondence
More informationLAPAROSCOPIC RADICAL PROSTATECTOMY IN THE ERA OF ROBOT-ASSISTED TECHNOLOGY
LAPAROSCOPIC RADICAL PROSTATECTOMY IN THE ERA OF ROBOT-ASSISTED TECHNOLOGY *Iason Kyriazis, 1 Marinos Vasilas, 1 Panagiotis Kallidonis, 2 Vasilis Panagopoulos, 1 Evangelos Liatsikos 3 1. Resident in Urology,
More informationMale Sexuality and Cancer. Anne Katz, PhD, RN CancerCare Manitoba August 29, 2012
Male Sexuality and Cancer Anne Katz, PhD, RN CancerCare Manitoba August 29, 2012 Objectives! Recognize the sexual side effects of treatment for cancer in men! Discuss treatment modalities for these problems!
More informationHealth-related Quality of Life in the First Year after Laparoscopic Radical Prostatectomy Compared with Open Radical Prostatectomy
Jpn J Clin Oncol 2014;44(7)686 691 doi:10.1093/jjco/hyu052 Advance Access Publication 3 May 2014 Health-related Quality of Life in the First Year after Laparoscopic Radical Prostatectomy Compared with
More informationErectile Function Before and After Non-Nerve-Sparing Retropubic Radical Prostatectomy
Archives of Urology ISSN: 2638-5228 Volume 1, Issue 2, 2018, PP: 5-9 Erectile Function Before and After Non-Nerve-Sparing Retropubic Radical Prostatectomy Jørgen Bjerggaard Jensen, MD 1, Jørgen K. Johansen,
More informationERECTILE DYSFUNCTION DIAGNOSIS
ERECTILE DYSFUNCTION DIAGNOSIS Head of Andrology and Sexual Medicine Dep.of Urology and Nefrology Hospital Virgen del Rocío ANDROMEDI. Sexual Medicine SEVILLA. SPAIN General Secretary ESSM Natalio Cruz
More informationOncologic Outcome of Robot-Assisted Laparoscopic Prostatectomy in the High-Risk Setting
END-2010-0305-ver9-Engel_1P.3d 09/17/10 2:42pm Page 1 END-2010-0305-ver9-Engel_1P Type: research-article JOURNAL OF ENDOUROLOGY Volume 24, Number 00, XXXX 2010 ª Mary Ann Liebert, Inc. Pp. &&& &&& DOI:
More information3/22/2014. Goals of this Presentation: in 15 min & 5 min Q & A. Radiotherapy for. Localized Prostate Cancer: What is New in 2014?
3/22/ Goals of this Presentation: in 15 min & 5 min Q & A 1. Potency Preservation. a. Dosimetric considerations Radiotherapy for b. Drugs 2. Update on duration of short term ADT Mack III, MD Professor
More informationDoes RT favor RP in long term Quality of Life? Juanita Crook MD FRCPC Professor of Radiation Oncology University of British Columbia
Does RT favor RP in long term Quality of Life? Juanita Crook MD FRCPC Professor of Radiation Oncology University of British Columbia Disclosures Advisory Board/honoraria: Varian Advisory Board: Breast
More informationInception Cohort. Center for Evidence-Based Medicine, Oxford VIP-- Inception Cohort (2008) Nov Dec
VIP-- Inception Cohort (28) Robotic Prostatectomy: Oncological and Functional Outcomes after 4 cases The Donald Smith Lecture Nov 2- Dec 28---- ----42 patients Patient 1 to patient 38 PSA follow-up -------3481
More informationPenile Implant Should be Offered Early
Penile Implant Should be Offered Early Landon Trost, MD Assistant Professor in Urology Mayo Clinic, Rochester, MN SMSNA AUA May 16 th, 2015 2013 MFMER slide-1 Clear Indications for Penile Implants Men
More informationProstate Cancer Innovations in Surgical Strategies Update 2007!
Prostate Cancer Innovations in Surgical Strategies Update 2007! Curtis A. Pettaway, M.D. Professor Department of Urology The University of Texas M. D. Anderson Cancer Center Radical Prostatectomy Pathologic
More informationClinical Policy Title: Penile implant after prostate cancer surgery
Clinical Policy Title: Penile implant after prostate cancer surgery Clinical Policy Number: 13.03.06 Effective Date: October 1, 2017 Initial Review Date: September 21, 2017 Most Recent Review Date: October
More informationComparison of surgical technique (Open vs. Laparoscopic) on pathological and long term functional outcomes following radical prostatectomy
Magheli et al. BMC Urology 2014, 14:18 RESEARCH ARTICLE Open Access Comparison of surgical technique (Open vs. Laparoscopic) on pathological and long term functional outcomes following radical prostatectomy
More informationElsevier Editorial System(tm) for European Urology Manuscript Draft
Elsevier Editorial System(tm) for European Urology Manuscript Draft Manuscript Number: EURUROL-D-13-00306 Title: Post-Prostatectomy Incontinence and Pelvic Floor Muscle Training: A Defining Problem Article
More informationDepartment of Urology, Washington DC Veterans Affairs Medical Center, Washington, DC, USA 4
Original Article Prostate Int 2013;1(1):31-36 P R O S T A T E INTERNATIONAL Robotic-assisted prostatectomy and open radical retropubic prostatectomy for locally-advanced prostate cancer: multi-institution
More informationOncology Urinary Outcomes Are Significantly Affected by Nerve Sparing Quality During Radical Prostatectomy
Oncology Outcomes Are Significantly Affected by Nerve Sparing Quality During Radical Prostatectomy Deborah R. Kaye, M. Eric Hyndman, Robert L. Segal, Lynda Z. Mettee, Bruce J. Trock, Zhaoyong Feng, Li-Ming
More informationHigh Intensity Focused Ultrasounds for the treatment of Prostate Cancers Clinical update November D. Maruzzi - L. Ruggera
High Intensity Focused Ultrasounds for the treatment of Prostate Cancers Clinical update November 2014 D. Maruzzi - L. Ruggera HIFU development Second prototype 1995-2000 Integrated Imaging 2006-2010 1993
More informationImmediate penile prosthesis insertion after failed T shunt and snake maneuver in patient with prolonged priapism
Immediate penile prosthesis insertion after failed T shunt and snake maneuver in patient with prolonged priapism Evangelos Zacharakis PhD, FRCS, FECSM, FEAA Consultant Urological Surgeon St Peter s Anrology
More informationWhen PSA fails. Urology Grand Rounds Alexandra Perks. Rising PSA after Radical Prostatectomy
When PSA fails Urology Grand Rounds Alexandra Perks Rising PSA after Radical Prostatectomy Issues Natural History Local vs Metastatic Treatment options 1 10 000 men / year in Canada 4000 RRP 15-year PSA
More informationTreating BPH: Comparing Rezum UroLift and HoLEP
Treating BPH: Comparing Rezum UroLift and HoLEP Scott M. Cheney MD Mayo Clinic Arizona 2018 MFMER slide-1 Welcome to AZ 2018 MFMER slide-2 Outline Background on BPH, Rezum, Urolift, HoLEP AUA Guideline
More informationRobotic radical prostatectomy Technique and results of nerve sparing approach EAU 2009 March 19 th 2009
Robotic radical prostatectomy Technique and results of nerve sparing approach EAU 2009 March 19 th 2009 J.H. Witt Department of Urology and Pediatric Urology Prostate Center Northwest St. Antonius-Hospital
More informationSurgical Techniques A Comparison of Outcomes for Interfascial and Intrafascial Nerve-sparing Radical Prostatectomy
Surgical Techniques A Comparison of Outcomes for Interfascial and Intrafascial Nerve-sparing Radical Prostatectomy Jens-Uwe Stolzenburg, Panagiotis Kallidonis, Do Minh, Anja Dietel, Tim Häfner, Robert
More informationRadical Perineal Prostatectomy and Simultaneous Extended Pelvic Lymph Node Dissection via the Same Incision
european urology 52 (2007) 384 388 available at www.sciencedirect.com journal homepage: www.europeanurology.com Surgery in Motion Radical Perineal Prostatectomy and Simultaneous Extended Pelvic Lymph Node
More informationSexual Issues following Prostate Cancer Treatments. Seacourses December 30, 2017 January 6, 2018 Dr. Stacy Elliott
Sexual Issues following Prostate Cancer Treatments Seacourses December 30, 2017 January 6, 2018 Dr. Stacy Elliott Copyright 2017 by Sea Courses Inc. All rights reserved. No part of this document may be
More informationOriginal Paper. Urol Int 2017;98:40 48 DOI: /
Urologia Internationalis Original Paper Urol Int 17;98: 48 DOI: 1.1159/447495 Received: March 29, 16 Accepted after revision: June 6, 16 Published online: August 4, 16 Differences in Patient Characteristics
More informationProstate Cancer: 2010 Guidelines Update
Prostate Cancer: 2010 Guidelines Update James L. Mohler, MD Chair, NCCN Prostate Cancer Panel Associate Director for Translational Research, Professor and Chair, Department of Urology, Roswell Park Cancer
More informationConceptual basis for active surveillance
Conceptual basis for active surveillance 1. Screening results in overdiagnosis 2. Clinically insignificant disease can be identified 3. All treatments have significant side effects and cost. 4. Delayed
More informationLow Energy Shockwaves for the Treatment of Erectile Dysfunction Y. Vardi, B. Appel, I Gruenwald
Low Energy Shockwaves for the Treatment of Erectile Dysfunction Y. Vardi, B. Appel, I Gruenwald Neuro-Urology Unit, Rambam Medical Center & the Technion Faculty of Medicine Haifa, Israel 3 crucial questions
More informationSCIENTIFIC PAPER ABSTRACT INTRODUCTION METHODS
SCIENTIFIC PAPER Patient-Reported Validated Functional Outcome After Extraperitoneal Robotic-Assisted Nerve-Sparing Radical Prostatectomy Ralph Madeb, MD, Dragan Golijanin, MD, Joy Knopf, MD, Ivelisse
More informationQuality of Life After Modern Treatment Options for Prostate Cancer Ronald Chen, MD, MPH
Quality of Life After Modern Treatment Options I will be presenting some recently published data on the quality of life after modern treatment options for prostate cancer. My name is Dr. Ronald Chen. I'm
More informationWho are Candidates for Laparoscopic or Open Radical Nephrectomy. Arieh Shalhav
Who are Candidates for Laparoscopic or Open Radical Nephrectomy Arieh Shalhav Fritz Duda Chair of Urologic Surgery Professor of Surgery and the Comprehensive Cancer Research Center Who are Candidates for
More informationThe Use of IIEF-5 for Reporting Erectile Dysfunction Following Nerve-Sparing Radical Retropubic Prostatectomy
The Open Prostate Cancer Journal, 2009, 2, 1-9 1 The Use of IIEF-5 for Reporting Erectile Dysfunction Following Nerve-Sparing Radical Retropubic Prostatectomy Open Access Maarten Albersen, Steven Joniau
More informationSystematic Review and Meta-analysis of Studies Reporting Potency Rates After Robot-assisted Radical Prostatectomy
EUROPEAN UROLOGY 62 (2012) 418 430 available at www.sciencedirect.com journal homepage: www.europeanurology.com Platinum Priority Review Prostate Cancer Editorial by Peter C. Albertsen on pp. 365 367 of
More informationWhere are we with PSA screening?
Where are we with PSA screening? Faculty/Presenter Disclosure Rela%onships with commercial interests: None Disclosure of Commercial Support This program has received no financial support. This program
More informationMANAGEMENT UPDATE , LLC MedReviews
MANAGEMENT UPDATE 2013 MedReviews, LLC rostate cancer is the most common cancer in men over the age of 50 years. 1 When patients undergo a radical prostatectomy (RP), there is a risk of postoperative erectile
More informationAge-stratified outcomes after robotic-assisted laparoscopic radical prostatectomy
J Robotic Surg (2007) 1:125 132 DOI 10.1007/s11701-007-0009-y ORIGINAL ARTICLE Age-stratified outcomes after robotic-assisted laparoscopic radical prostatectomy Kevin C. Zorn Æ Frederick P. Mendiola Æ
More informationActive surveillance for low-risk Prostate Cancer Compared with Immediate Treatment: A Canadian cost evaluation
Active surveillance for low-risk Prostate Cancer Compared with Immediate Treatment: A Canadian cost evaluation Alice Dragomir, PhD Fabio Cury, MD Armen Aprikian, MD Introduction Clinical and economic burden
More informationSexual dysfunction in male LUTS. M. Gacci Department of Urology, University of Florence
Sexual dysfunction in male LUTS M. Gacci Department of Urology, University of Florence Roma, 25-26 June, 2015 Cross-sectional population-based study of 4800 men (40 79 yr of age) UK, Netherlands, France,
More informationInternational Index of Erectile Function Questionnaire IIEF
International Index of Erectile Function Questionnaire IIEF Instructions: These questions ask about the effects your erections have had on your sex life, over the past 4 weeks. Please answer the following
More informationErectile Dysfunction (ED) after Radiotherapy (RT) for Prostate Cancer. William M. Mendenhall, MD
Erectile Dysfunction (ED) after Radiotherapy (RT) for Prostate Cancer William M. Mendenhall, MD Meta-Analysis of Probability of Maintaining Erectile Function after Treatment of Localized Cancer Treatment
More informationQuality of life issues after treatment for prostate cancer
Quality of life issues after treatment for prostate cancer Christopher Saigal MD, MPH Associate Professor, UCLA Department of Urology Definition of Health not merely the absence of disease or infirmity,
More information/04/ /0 Reprinted from Vol. 172, , August 2004 THE JOURNAL OF UROLOGY
0022-5347/04/1722-0658/0 Reprinted from Vol. 172, 658 663, August 2004 THE JOURNAL OF UROLOGY Printed in U.S.A. Copyright 2004 by AMERICAN UROLOGICAL ASSOCIATION DOI: 10.1097/01.ju.0000132389.97804.d7
More informationFind your ED cure End your frustration. Renew your confidence. Feel complete. Take the next steps. Erectile dysfunction and heart disease
Take the next steps Visit your general practitioner or cardiologist to learn more about your risk for cardiovascular disease. Visit EDCure.org to: Take the online ED quiz and get your customized treatment
More informationBest Papers. F. Fusco
Best Papers UROLOGY F. Fusco Best papers - 2015 RP/RT Oncological outcomes RP/RT IN ct3 Utilization trends RP/RT Complications Evolving role of elnd /Salvage LND This cohort reflects the current clinical
More informationClinical evaluation of Tentex forte and Himcolin cream in the treatment of functional erectile dysfunction
Medicine Update (2004): 11(9), 47-51 Clinical evaluation of Tentex forte and Himcolin cream in the treatment of functional erectile dysfunction Dr. Roumen Bostandjiev, Ph.D. Founder and Director of Sexology
More informationDetection & Risk Stratification for Early Stage Prostate Cancer
Detection & Risk Stratification for Early Stage Prostate Cancer Andrew J. Stephenson, MD, FRCSC, FACS Chief, Urologic Oncology Glickman Urological and Kidney Institute Cleveland Clinic Risk Stratification:
More informationVALUE AND ROLE OF PSA AS A TUMOUR MARKER OF RESPONSE/RELAPSE
Session 3 Advanced prostate cancer VALUE AND ROLE OF PSA AS A TUMOUR MARKER OF RESPONSE/RELAPSE 1 PSA is a serine protease and the physiological role is believed to be liquefying the seminal fluid PSA
More informationThe Royal Marsden. Prostate case study. Presented by Mr Alan Thompson Consultant Urological Surgeon
Prostate case study Presented by Mr Alan Thompson Consultant Urological Surgeon 2 Part one Initial presentation A 62 year old male solicitor attends your GP surgery. He has rarely seen you over the last
More informationProstate MRI: Who needs it?
Prostate MRI: Who needs it? Fergus Coakley MD, Professor of Radiology and Urology, Vice Chair for Clinical Services, Chief of Abdominal Imaging, UCSF Abdominal Imaging Magnetic Resonance Science Center
More informationThe impact of a structured intensive modular training in the learning curve of robot assisted radical prostatectomy
ORIGINAL PAPER DOI: 1.81/aiua.18.1.1 The impact of a structured intensive modular training in the learning curve of robot assisted radical prostatectomy Riccardo Schiavina 1,, Marco Borghesi 1,, Hussam
More informationScreening and Diagnosis Prostate Cancer
Screening and Diagnosis Prostate Cancer Daniel Heng MD MPH FRCPC Chair, Genitourinary Tumor Group Tom Baker Cancer Center University of Calgary, Canada @DrDanielHeng Outline Screening Evidence Recommendations
More informationLONG-TERM POTENCY AFTER IODINE-125 RADIOTHERAPY FOR PROSTATE CANCER AND ROLE OF SILDENAFIL CITRATE
ADULT UROLOGY CME ARTICLE LONG-TERM POTENCY AFTER IODINE-125 RADIOTHERAPY FOR PROSTATE CANCER AND ROLE OF SILDENAFIL CITRATE RUPESH RAINA, ASHOK AGARWAL, KUSH K. GOYAL, CHERYL JACKSON, JAMES ULCHAKER,
More informationClinical Study A Comparison of Radical Perineal, Radical Retropubic, and Robot-Assisted Laparoscopic Prostatectomies in a Single Surgeon Series
Prostate Cancer Volume 2011, Article ID 878323, 6 pages doi:10.1155/2011/878323 Clinical Study A Comparison of Radical Perineal, Radical Retropubic, and Robot-Assisted Laparoscopic Prostatectomies in a
More informationPolicy #: 370 Latest Review Date: April 2017
Name of Policy: Nerve Graft with Radical Prostatectomy Policy #: 370 Latest Review Date: April 2017 Category: Surgery Policy Grade: B Background/Definitions: As a general rule, benefits are payable under
More informationHugh J. Lavery, M.D., Fatima Nabizada-Pace, M.P.H., John R. Carlucci, M.D., Jonathan S. Brajtbord, B.A., David B. Samadi, M.D.*
Urologic Oncology: Seminars and Original Investigations 30 (2012) 26 32 Original article -sparing robotic prostatectomy in preoperatively high-risk patients is safe and efficacious Hugh J. Lavery, M.D.,
More informationErectile Dysfunction: A Primer for Primary Care Providers
Erectile Dysfunction: A Primer for Primary Care Providers Jeanne Martin, DNP, ANP-BC Objectives 1. Understand the definition, incidence and prevalence of Erectile Dysfunction in the U.S. 2. Understand
More informationImpact of Prostate Volume on Oncological and Functional Outcomes After Radical Prostatectomy: Robot-Assisted Laparoscopic Versus Open Retropubic
www.kjurology.org http://dx.doi.org/10.4111/kju.2013.54.1.15 Urological Oncology Impact of Prostate Volume on Oncological and Functional Outcomes After Radical Prostatectomy: Robot-Assisted Laparoscopic
More informationPolicy #: 370 Latest Review Date: December 2013
Name of Policy: Nerve Graft in Association with Radical Prostatectomy Policy #: 370 Latest Review Date: December 2013 Category: Surgery Policy Grade: B Background/Definitions: As a general rule, benefits
More informationOUTCOMES OF ROBOTIC-ASSISTED RADICAL PROSTATECTOMY FOR PATIENTS IN TWO EXTREME AGE-GROUPS (< 50 YEARS VS > 65 YEARS)
Urology DOI: 10.186/cjmed-82 OUTCOMES OF ROBOTIC-ASSISTED RADICAL PROSTATECTOMY FOR PATIENTS IN TWO EXTREME AGE-GROUPS (< 0 YEARS VS > 6 YEARS) RADU-TUDOR COMAN 1, NICOLAE CRISAN 2,, IULIA ANDRAS 2, **,
More informationProstate Cancer Dashboard
Process Risk Assessment Risk assessment: family history assessment of family history of prostate cancer Best Observed: 97 %1 ; Ideal Benchmark:100% measure P8 2 Process Appropriateness of Care Pre-treatment
More informationRobot-Assisted Radical Prostatectomy
John W. Davis Editor Robot-Assisted Radical Prostatectomy Beyond the Learning Curve 123 Apex: The Crossroads of Functional Recovery and Oncologic Control 10 Fatih Atug I nt rod u c ti on Prostate cancer
More informationPresentation with lymphadenopathy
Presentation with lymphadenopathy Theo M. de Reijke MD PhD FEBU Department of Urology Academic Medical Center Amsterdam Rationale for RRP in N+ disease Prevention local problems Better survival in limited
More informationU.S. Preventive Services Task Force: Draft Prostate Cancer Screening Recommendation (April 2017)
1 U.S. Preventive Services Task Force: Draft Prostate Cancer Screening Recommendation (April 2017) Alex Krist MD MPH Professor and Director of Research Department of Family Medicine and Population Health
More information