Funktionelle Ergebnisse unterschiedlicher Operationstechniken der radikalen Prostatektomie

Michl, Uwe; Graefen, Markus; Noldus, Joachim; Eggert, Thomas; Huland, Hartwig

doi:10.1007/s00120-003-0431-3

Cited by 27 publications

(7 citation statements)

References 44 publications

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“…Reported continence rates at 18 months after RP are 90–93%, with or without nerve‐sparing [22,23]; RPP has identical continence rates of 87–94%[8,18]. The early continence rate after 1–3 months was reported to be higher using RPP than RRP [6,7].…”

Section: Discussionmentioning

confidence: 99%

Seminal vesicle‐sparing perineal radical prostatectomy improves early functional results in patients with low‐risk prostate cancer

et al. 2007

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antigen (PSA) level of ≤ 10 ng/mL, a Gleason sum of ≤ 7 and a prostate volume of ≤ 50 mL. This group was randomly divided in those having SV-RPP (147 men) and a classical RPP (171); men in the third group with adverse factors were offered a classical RRP (190). The main endpoint of the trial was the early continence rate at 4 weeks after surgery. RESULTSThe oncological outcome of patients treated with SV-RPP was no different from that of RPP or RRP. Continence rates (0-1 pad/day) at 4 weeks and 12 months after SV-RPP were 61.7% and 96.3%, respectively, and significantly higher than with RPP ( P < 0.023) and RRP ( P < 0.005). The transfusion rates (3.4%), anastomotic leaks (6.6%) and mean operative duration (90 min) were significantly lower. CONCLUSIONSSV-RPP is a better technique in reducing complications during and after surgery for selected patients. Leaving the SV in place did not increase the short-term PSA relapse rates. As the operation was significantly faster and with better early recovery, SV-RPP might be justified if the long-term oncological data confirm the efficacy of the approach. KEYWORDSprostate cancer, radical prostatectomy, perineal, nerve-sparing, seminal vesiclesparing Study Type -Therapy (RCT) Level of Evidence 1b OBJECTIVETo report a new and improved seminal vesicle-sparing (SV) technique of radical perineal prostatectomy (RPP) as an option for patients with localized prostate cancer, which is currently competing with the retropubic RP (RRP), endoscopic and robotic approaches.

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Section: Discussionmentioning

confidence: 99%

Seminal vesicle‐sparing perineal radical prostatectomy improves early functional results in patients with low‐risk prostate cancer

et al. 2007

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“…Numerous studies have been published demonstrating excellent tumor control, good functional results, and low morbidity associated with the procedure (1-4). …”

Section: Introductionmentioning

confidence: 99%

Neuroanatomical Study of Periprostatic Nerve Distributions Using Human Cadaver Prostate

et al. 2010

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We investigated the distribution and navigation of periprostatic nerve fibers and constructed a 3-dimensional model of nerve distribution. A total of 5 cadaver specimens were serially sectioned in a transverse direction with 0.5 cm intervals. Hematoxylineosin staining and immunohistochemical staining were then performed on whole-mount sections. Three representative slides from the base, mid-part, and apex of each prostate were subsequently divided into 4 sectors: two lateral, one ventral, and one dorsal (rectal) part. The number of nerve fibers, the distance from nerve fiber to prostate capsule, and the nerve fiber diameters were analyzed on each sector from the representative slides by microscopy. Periprostatic nerve fibers revealed a relatively even distribution in both lateral and dorsal parts of the prostate. There was no difference in the distances from the prostate capsule to nerve fibers. Nerve fibers in the ventral area were also thinner as compared to other areas. In conclusion, periprostatic nerve fibers were observed to be distributed evenly in the periprostatic area, with the exception of the ventral area. As the number of nerve fibers on the ventral part is fewer in comparison, an excessive high up incision is insignificant during the nerve-sparing radical prostatectomy.

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“…In der Prädisposition sind die Ursachen in einer infravesikalen Obstruktion (LUTS), dem Alterungsprozess der Blase und des Sphinkters sowie deren neurogenen Steuerung zu finden [4,5,7]. In der Operationstechnik der radikalen Prostatovesikulektomie gilt bezüglich der Minimierung der postoperativen Belastungsinkontinenz die Aufmerksamkeit der Erhaltung der Rhabdosphinkterfunktion, der urethralen Aufhängung und der Erhaltung des Gefäß-Nerven-Bündels [1,3].Betrachtet man die Vielzahl der im Alter zunehmenden prädisponierenden Erkrankungen einer Blasenentleerungsoder Speicherstörung parallel zu den Folgen nach radikaler Prostatovesikulektomie, so stellt sich die Frage, ob aufgrund der genannten Gründe ein altersabhän-gig ansteigendes Risiko einer Harninkontinenz nach radikaler Prostataoperation nachzuweisen ist. Diese Frage wollte unsere Arbeitsgruppe in einer prospektiven Studie und erstmals an einem großen Patientenklientel mit Hilfe objektiver Parameter beantworten.…”

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Harninkontinenz nach radikaler Prostatovesikulektomie?

Borrusch

Müller

Otto

2011

Urologe

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The investigation was intended to research the correlation between age and urinary incontinence after radical prostatectomy (RP). We considered the effects of RP as well as bladder function impairment and urge symptomatology of the elderly. A total of 3,912 patients after RP were included subsequent to aftercare. They were divided into age groups, and data on micturition and urinary loss were documented. We found that urinary loss was proportional to age. We concluded that older patients need more intense diagnostic workup and treatment during rehabilitation with respect to urinary incontinence. Presurgical advice should consider these facts.

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Funktionelle Ergebnisse unterschiedlicher Operationstechniken der radikalen Prostatektomie

Cited by 27 publications

References 44 publications

Seminal vesicle‐sparing perineal radical prostatectomy improves early functional results in patients with low‐risk prostate cancer

Seminal vesicle‐sparing perineal radical prostatectomy improves early functional results in patients with low‐risk prostate cancer

Neuroanatomical Study of Periprostatic Nerve Distributions Using Human Cadaver Prostate

Harninkontinenz nach radikaler Prostatovesikulektomie?

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