Temporal National Trends of Minimally Invasive and Retropubic Radical Prostatectomy Outcomes from 2003 to 2007: Results from the 100% Medicare Sample

Kowalczyk, Keith; Levy, Jesse M.; Caplan, Craig; Lipsitz, Stuart R.; Yu, Hua-yin; Gu, Xiangmei; Hu, Jim C.

doi:10.1016/j.eururo.2011.12.020

Cited by 89 publications

(63 citation statements)

References 31 publications

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“…Recent population studies have indicated that for men with clinically localized prostate cancer, approximately half will elect to proceed with prostatectomy as their primary treatment modality [ 54 ]. While recent surgical trends have favored the use of the robotic assisted radical prostatectomy, as recently as 2007, the majority of prostatectomies in the United States were performed using a radical retropubic technique [ 55 ].…”

Section: Radical Retropubic Prostatectomy (Rrp)mentioning

confidence: 99%

Male Stress Urinary Incontinence Following Surgical Intervention: Procedures, Technical Modifications, and Patient Considerations

Dobbs

Kocjancic

Crivellaro

2015

Male Stress Urinary Incontinence

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IntroductionStress urinary incontinence has long been associated with urologic surgery. In Millin's initial description of the technique of the radical retropubic prostatectomy (RRP) he notes that one of his reasons for pursuing an improved technique was the "dread sequelae even in hands of the foremost exponents -e.g. incontinence (9 % Hinman, 5-8 % Goldstein), urethrorectal fi stulae, persistent perineal fi stulae" [ 1 ] associated with the perineal prostatectomy as fi rst described by Hugh Hampton Young in 1905 [ 2 ]. This interest in postsurgical urinary incontinence has produced a wealth of information from a number of investigators and studies. Between different studies, with varying patient populations, the defi nitions used to defi ne continence, utilization of different questionnaires, and duration of follow-up, signifi cant variation may exist in reported complication rates. For example, previous studies have reported rates of incontinence following RRP from 2.5 to 87 %, demonstrating the tremendous variability in recording this critical postoperative outcome [ 3 ].Going forward, standardization of defi nitions for urinary incontinence and the use of validated metrics in evaluating postoperative functional outcomes are of critical importance for designing future research studies to scientifi cally approach and assess postoperative continence following urologic surgery.

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Section: Radical Retropubic Prostatectomy (Rrp)mentioning

confidence: 99%

Male Stress Urinary Incontinence Following Surgical Intervention: Procedures, Technical Modifications, and Patient Considerations

Dobbs

Kocjancic

Crivellaro

2015

Male Stress Urinary Incontinence

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“…The use of robot-assisted laparoscopic radical prostatectomy has been rapidly adopted over the past decade [11]. In addition to lower BNC rates, reported advantages of RALP, compared to RRP, include decreased blood loss, transfusions, and length of hospital stay [1].…”

Section: Discussionmentioning

confidence: 99%

Novel Use of the Capio Urethral Anastomotic Suturing Device: A 50-Case Assessment

et al. 2014

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Objective: Robotic laparoscopic assisted prostatectomy (RALP) has become the predominant technique for prostatectomy despite significant expense and no robust evidence supporting better cancer control, erectile function, or continence. Several studies have demonstrated lower bladder neck contracture (BNC) rates with RALP, believed to be related to improved visualization and control of the urethrovesical anastomosis. We evaluated the Capio™ radical prostatectomy (RP) suture capturing device for improving anastomotic precision during urethrovesical anastomosis in open radical prostatectomy. Materials and Methods: We performed a retrospective review on a single-surgeon series of 50 consecutive patients undergoing radical retropubic prostatectomy (RRP) with utilization of the Capio™ RP device at an academic hospital (February 2010 to May 2012). Patient demographics, pathology, and outcomes data including rates of anastomotic leak, BNC, erectile function, and continence were collected. Results: Mean age of patients at the time of procedure was 60.4 ± 6.43 years. Patients were stratifed by D'Amico criteria into low (14.3%), intermediate (67.4%), and high (18.4%) risk groups. Mean follow-up for all patients was 13.1 ± 7.29 months. No patients were diagnosed with BNC within 90 days after surgery. Two patients (4%) were subsequently diagnosed and treated for BNC, one of whom was asymptomatic prior to diagnosis. Conclusion: Utilizing the Capio™ RP device during RRP, we were able to achieve a BNC rate equivalent to rates reported for RALP. Use of the Capio™ RP device appears to be a cost-effective method for improving RRP urethrovesical anastomotic results.

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“…In other urologic conditions, the diffusion of minimally invasive techniques, such as robotic prostatectomy, is associated with both clinical (e.g., age, comorbidity) and nonclinical (e.g., insurance status, region of residence) characteristics. 9,10 The degree to which these factors are associated with the use of ureteropelvic junction obstruction treatments is unclear.…”

Section: Introductionmentioning

confidence: 99%

Variation in the Use of Open Pyeloplasty, Minimally Invasive Pyeloplasty, and Endopyelotomy for the Treatment of Ureteropelvic Junction Obstruction in Adults

Jacobs

Seelam

Hanley

et al. 2017

Journal of Endourology

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Background and Purpose: Ureteropelvic junction obstruction is a common condition that can be treated with open pyeloplasty, minimally invasive pyeloplasty, and endopyelotomy. While all these treatments are effective, the extent to which they are used is unclear. We sought to examine the dissemination of these treatments. Patients and Methods: Using the MarketScan Ò database, we identified adults 18 to 64 years old who underwent treatment for ureteropelvic junction obstruction between 2002 and 2010. Our primary outcome was ureteropelvic junction obstruction treatment (i.e., open pyeloplasty, minimally invasive pyeloplasty, endopyelotomy). We fit a multilevel multinomial logistic regression model accounting for patients nested within providers to examine several factors associated with treatment. Results: Rates of minimally invasive pyeloplasty increased 10-fold, while rates of open pyeloplasty decreased by over 40%, and rates of endopyelotomy were relatively stable. Factors associated with receiving an open vs a minimally invasive pyeloplasty were largely similar. Compared with endopyelotomy, patients receiving minimally invasive pyeloplasty were less likely to be older (odds ratio [OR] 0.96; 95% confidence interval [CI], 0.95, 0.97) and live in the south (OR 0.52; 95% CI, 0.33, 0.81) and west regions (OR 0.57; 95% CI 0.33, 0.98) compared with the northeast and were more likely to live in metropolitan statistical areas (OR 1.52; 95% CI 1.08, 2.13). Conclusions: Over this 9-year period, the landscape of ureteropelvic junction obstruction treatment has changed dramatically. Further research is needed to understand why geographic factors were associated with receiving a minimally invasive pyeloplasty or an endopyelotomy.

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Temporal National Trends of Minimally Invasive and Retropubic Radical Prostatectomy Outcomes from 2003 to 2007: Results from the 100% Medicare Sample

Cited by 89 publications

References 31 publications

Male Stress Urinary Incontinence Following Surgical Intervention: Procedures, Technical Modifications, and Patient Considerations

Male Stress Urinary Incontinence Following Surgical Intervention: Procedures, Technical Modifications, and Patient Considerations

Novel Use of the Capio Urethral Anastomotic Suturing Device: A 50-Case Assessment

Variation in the Use of Open Pyeloplasty, Minimally Invasive Pyeloplasty, and Endopyelotomy for the Treatment of Ureteropelvic Junction Obstruction in Adults

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