PurposeTo develop a safe and precise method for intraprostatic injection, and to establish correlation between the volume of ethanol injectate and the volume of subsequent infiltrated prostate tissue.Materials and methodsWe performed intraprostatic injection of 96% ethanol using a needle which has a segment of its wall made of capillary membrane with hundreds of pores in an acute and chronic canine experiment, in heart-beating cadaveric organ donors, and in a xenograft model of human prostate cancer. Whole mount tissue sections were used for three-dimensional reconstruction of the necrotic lesions and calculation of their volumes.ResultsThe ethanol injection resulted in oval shaped lesions of well-delineated coagulative necrosis. In both healthy human and canine prostates, the prostatic pseudocapsule and neurovascular bundle remained intact without evidence of disruption. There was a linear correlation between administered volume of ethanol and the volume of necrotic lesion. Regression analysis showed strong correlation in the acute canine experiments and in experiments performed on xenografts of human prostate cancer. A formula was calculated for each experiment to estimate the relationship between the injected volume and the volume of infiltrated prostate tissue area.ConclusionsIntraprostatic injection using a porous needle allows for effective and predictable tissue distribution of the injectate in the prostate. Through varying the volume of the agent injected and use of needles with a different length of the porous segment, the volume of infiltrated tissue could be adjusted allowing for targeted focal treatment.

Background: We describe the creation and impact of a novel Surgical Subspecialty Experience (OR vs clinic shadowing and surgical skills sessions) Program (SSEP) for pre-clinical medical curricula. Methods: The program was offered to first year medical students (Fall 2018). Students completed the following surveys: Pre-SSEP, Post-Experience, and Post-SSEP. Paired samples t-test were utilized to determine changes in interest as well as factors that impact this interest. Results: After one year of participation, there was no significant change in interest in the included surgical subspecialties. Sub-analyses demonstrated an increasingly negative impact of specialty specific characteristics on student interest in the diversity of procedures, work hours, patient outcomes, and call nights. Conclusions: We successfully designed and implemented the SSEP to supplement our medical school curriculum. Our hope is that other institutions can utilize our model via our online Handbook to provide students firsthand insight into surgical subspecialties prior to the clinical years: https://github.com/SSEPUVM/SSEP-supplemental-materials.git.