Aim: The aims of this study were to evaluate the health-related quality of life (HRQOL) and make the treatment decision less difficult. Methods: Between 2007 and 2009 radical retropubic prostatectomy (RRP) was performed in 96 patients and permanent prostate brachytherapy (PPB) in 88 patients at our hospital. The general and disease-specific HRQOL was measured using two instruments, the Medical Outcome Study 8-Item Short-Form Health Survey (SF-8) and the expanded prostate index composite (EPIC). Results: Comparing RRP and PPB, there were significant differences in all scores except for general health in the 1st month after treatment which had the same score in both groups. The baseline quality of life scores in physical function (p < 0.05), physical role (p < 0.01), social functioning (p < 0.01), emotional role (p < 0.01) and mental health (p < 0.01) showed significant differences between the group and were better in the PPB group than in the RRP group. The physical component summary score in the PPB group was better than in the RRP group in the 1st month (p < 0.01) but recovered up to 3 months in the RRP group. The urinary bother and irritative/obstructive scores in the 1st month were worse from baseline in both groups (p < 0.05) and remained significantly worse up to 6 months in the PPB group than in the RRP group where these scores recovered within3 months. The urinary incontinence score in the RRP group was still worse than in the PPB group up to 12 months (p < 0.01). Bowel function and bother were significantly better in the RRP group at 3 (p < 0.05) and 6 months (p < 0.01) than in the PPB group where bowel function at 12 months was worse than at baseline and in the RRP group. Sexual function (p < 0.01) and sexual bother were better in the PPB group and did not change until 12 months. Conclusion: The difference in disease-specific quality of life has become clearer using EPIC. As with other published studies, our results provide important information that will therefore be useful for selecting the optimal treatments for localized prostate cancer.
Laparoscopic nephrectomy is indicated in the treatment of many benign conditions of the kidneys. Hydronephrosis caused by obstruction of the ureter, either internal, or external, is one of the main indications for laparoscopic reconstruction. If an obstruction is prolonged, consequently, it leads to chronic inflammatory process accompanied by persistent and recurrent pain with fever, which eventually become resistant to therapy. If not operated sufficiently fast to resolve the causes, as a consequence it leads to hypofunction and ultimately afunction of affected kidney. In such a situation, the only therapeutic option is surgical treatment. By analyzing the case, we will try to illustrate the diagnostic algorithm and therapeutic treatment modality.
The success of treatment mainly depends on tumor stage and grade and not on type of surgical method in conservative treatment, but renal failure and its complications are an important risk factor in these patients.
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