IntroductionNowadays, the expectations for functional prostatectomy outcomes are quite high. Robot-assisted laparoscopic radical prostatectomy (RALRP) has become an increasingly common treatment option for men with localized prostate cancer. In this study, we aimed to present the results of our bilateral nerve-sparing RALRP procedure and to evaluate the effects of the learning curve (LC) on perioperative data, early oncologic, and functional outcomes.MethodsThe records of 132 RALRP cases performed between January 2016 and March 2019 by a single surgeon experienced in open and laparoscopic radical prostatectomy were evaluated retrospectively. Results of 91 cases with the bilateral nerve-sparing technique were analyzed. The learning curve was determined using the moving average method. LC analysis using the moving average method showed that the LC stabilized between cases 40 and 50. So, patients were divided into two groups: group 1 consisted of the first 45 cases, while group 2 consisted of 46-91st cases. The groups were compared in terms of surgical, functional, and oncologic outcomes.ResultsThe mean duration of surgery was significantly reduced in the second group (250 vs 235 min, p <0.002). However, there was no statistically significant difference between the groups in terms of hemoglobin decrease, hospitalization and catheterization time, and intraoperative and postoperative complication rates. The rates of pT2 cancers’ positive surgical margins (PSMs) were 32.4% and 19.4%, respectively. The recovery rate of continence in all the patients was 90.1% at 12 months. The potency ratios were calculated as 33.8% at 12 months. There was no statistically significant difference between the groups in terms of potency and continence rates at 3 months and 12 months, postoperatively.ConclusionFor surgeons experienced in retropubic radical prostatectomy (RRP) and laparoscopic radical prostatectomy (LRP) surgeries, RALRP is a safe and feasible surgical procedure for both oncological and functional outcomes even during the learning curve.

Batmaz et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

No abstract

Varikosel, pampiniform pleksus ve internal spermatik venlerin anormal bir dilatasyonu olup, seminifer tübüllerdeki sıcaklığın artmasına, toksik adrenal ve renal metabolitlerin renal ven yoluyla geri akışına, sperm kalitesinin düşmesine ve testis büyümesinin durmasına neden olur. [1] Erkek infertilitesinin en sık düzeltilebilir nedenidir. Adölesan varikosel insidansı erişkinlere benzer şekilde %15-16'dır. [2] Tedavi endikasyonları arasında varikoselin semptomatik ABSTRACT OBJECTIVES: In the treatment of adolescent varicocele, there isn't any consensus and the ideal technique is not yet defined. Open surgery (microscopy-assisted or not) or laparoscopic techniques are surgical methods used in treatment. We planned to compare the results of microscopic, laparoscopic and open varicocelectomy techniques. MATERIAL and METHODS: Patients who underwent varicocele therapy between 2003-2018 were evaluated retrospectively in 3 groups. Patients who underwent laparoscopic varicocele ligation were included in Group 1, patients who underwent microscopic varicocelectomy were included in Group 2 and patients who underwent subinguinal varicocelectomy were included in Group 3. Three groups were compared in terms for operation and postoperative follow-up data. RESULTS: The study included 113 patients, 30 patients in Group 1, 43 patients in Group 2, 40 patients in Group 3. The mean age was 13.2 years. There was no significant difference between groups in terms of side and varicocele degree. The median operation times for group1.2 and 3 were 55 (35-70), 50 (40-80) and 55 min. (40-70) (p>0.05). The hydrocele development after surgery was detected in 3, 1 and 2 patients, respectively (p>0.05). Varicocele recurrence was not seen in the LVL group, but it was seen in 3 patients in the MV group and in 7 patients in the SV group (p>0.05). Postoperative testicular volume loss was detected in 3 patients in Group 1, 1 patient in Group 2 and in Group 3 no patient was detected. There was no statistical significant different between groups although there were clinical differences between the groups in terms of results or complications. CONCLUSION: In the treatment of adolescent varicoceles, it was found that all 3 techniques can be used successfully but in microscopic or under magnification (via loop) techniques, complication rates seem to be much less and clinical successful rates seem to be much higher.

No abstract