The purpose of this study was to investigate urinary continence four weeks following Retzius-sparing robotassisted radical prostatectomy. Patients and methods: Forty patients with T2-T3 prostate cancer underwent Retzius-sparing-robot-assisted radical prostatectomy and their results were compared with those from the 40 patients having robot-assisted radical prostatectomy done by the same surgeon immediately prior to the adoption of Retzius-sparing-robot-assisted radical prostatectomy. Results: Patients in the two groups had similar age, body mass index, prostate specific antigen, biopsy Gleason sum, clinical stage, d'Amico risk profile, blood loss, prostate weight and post-operative hospital stay. Median operating time (200 (interquartile range=155-266) vs 223 (interquartile range=100-238) min; p=0.05) and catheterisation (8 (interquartile range=8-8) vs 14 (interquartile range=14-14) days; p<0.0001) were shorter in the Retzius-sparing group, many of whom had suprapubic catheters inserted. The overall complication rate was lower in Retzius-sparing patients (2.5% vs 8.0%; p=0.36). Positive surgical margin rates were similar for Retzius-sparing and non-Retzius-sparing patients and decreased with greater experience with the Retzius-sparing technique: 16.7% vs 7.7% for pT2 (p=0.65) and 31.8% vs 14.3% for pT3 (p=0.44). Initial prostate specific antigen was <0.1 ng/ml in 97.5% and 100%, respectively (p=1.00). At four weeks post-operation 0, 1 and 2 pads/day were needed in the Retzius-sparing group in 90.0%, 7.5% and 2.5% of patients, compared to 37.5% (p<0.0001), 32.5% (p=0.01) and 30% (p=0.002) of men having conventional surgery. Conclusion: Retzius-sparing-robot-assisted radical prostatectomy is faster than the anterior approach to the prostate, allows a shorter catheterisation time and produces dramatically better continence results at four weeks with 90% of patients being pad-free and 97.5% of patients needing 0-1 pads/day.

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This study evaluates personality changes, after successful completion of long-term group-analytic psychotherapy, in an outpatient day treatment unit (Athens Open Psychotherapy Centre). 1 Testretest method was applied in thirty-nine patients, who were assessed by the MMPI test and the Rorschach projective technique.The results indicate that group-analytic treatment appears to have an impact on functional and certain structural dimensions of the patient personality. More specifically, a significant decrease of clinical symptomatology, improved social adaptation, more controlled and better-adjusted emotional expressions, maturity of internalized representations and ability to establish and maintain personal relationships are observed.

What's known on the subject? and What does the study add?• Erectile dysfunction after nerve-sparing radical retropubic prostatectomy constitutes a challenge to the urologist.The mainstay of medical treatment after radical prostatectomy to restore spontaneous erectile function remains phosphodiesterase (PDE5) inhibitors, despite the fact that data from animal studies suggesting that PDE5 inhibitors can prevent smooth muscle apoptosis and fibrosis have not yet been extrapolated to humans because of a lack of standardized protocols. If the above treatment fails, second-line therapies such as intraurethral prostaglandins, penile injection therapy and vacuum devices are offered. When less invasive therapies are ineffective, interventions that preserve sexual function such as penile prosthesis implantation become the treatment of choice.• Our study reveals the alternative of penile prosthesis implantation as first-line treatment in erectile dysfunction after nerve-sparing radical prostatectomy. It also highlights its superiority to the oral PDE5 inhibitor treatment, regarding the erection, frequency, firmness, maintenance and penetration ability. This suggests that a concept of an early penile intervention in the future would be promising for those patients who wish to remain sexually active without depending on oral formulations with doubtful and delayed results.