Erratum: Intra-Operative Damage to the Pelvic Diaphragm Musculature and Difficulty in Exposure of the Urethra Are Risk Factors of Postoperative Urinary Incontinence after Laparoscopic Radical Prostatectomy: Review of Surgical Video

<i>Purpose: </i>The aim of this study was to clarify risk factors related to postoperative urinary incontinence after laparoscopic radical prostatectomy (LRP). <i>Patients and Methods: </i>Outcomes of 214 consecutive patients who underwent LRP at our institute between April 2001 and January 2009 were reviewed. Patients were divided into 2 groups, continent patients (group A: n = 172), who used one or fewer urinary pads per day 6 months after LRP, and incontinent patients (group B: n = 42), who used two or more pads per day 6 months after LRP. Patient age, prostate specific antigen before LRP, blood loss, duration of indwelling urethral catheter, and the positive margin rate between the 2 groups were compared. In addition, surgical videos were reviewed with attention paid to surgical procedures. We examined the correlation between the occurrence of urinary incontinence and the rate of patients with intra-operative damage to the pelvic diaphragm musculature and difficulty in exposure of the urethra during LRP. <i>Results: </i>There were no significant differences in patient age, prostate specific antigen before LRP, blood loss, duration of indwelling urethral catheter, positive margin rate between groups A and B. However, significant differences were found in the rate of patients with damage to the pelvic diaphragm musculature (16.3 and 73.8%, respectively) and difficulty in exposure of the urethra (20.9 and 83.3%, respectively) during LRP. <i>Conclusions: </i>Intra-operative damage to the pelvic diaphragm musculature and difficulty in exposure of the urethra during LRP are risk factors of urinary incontinence after LRP

Supplementary Material for: Pure Lymphoepithelioma-Like Carcinoma Originating from the Urinary Bladder

Lymphoepithelioma-like carcinoma of the urinary bladder (LELCB) is a rare variant of infiltrating urothelial carcinoma. We report a case of LELCB in a 43-year-old man. Ultrasonography and cystoscopy revealed two bladder tumors, one on the left side of the trigone and the other on the right side of the trigone. Transurethral resection of the bladder tumors was performed and pathological analysis revealed undifferentiated carcinoma. We therefore performed radical cystectomy and urinary diversion. Immunohistochemically the tumor cells were positive for cytokeratin, but negative for Epstein-Barr virus-encoded small RNA in situ hybridization as found for previous cases of LELCB. The final pathological diagnosis was a lymphoepithelioma-like variant of urothelial carcinoma with perivesical soft tissue invasion. For adjuvant systemic chemotherapy, three courses of cisplatin were administered. The patient subsequently became free of cancer 72 months postoperatively. Based on the literature, pure or predominant LELCB types show favorable prognoses due to their sensitivity to chemotherapy or radiotherapy. An analysis of the apparent diffusion coefficient (ADC) values of bladder tumors examined in our institution revealed that the ADC value measured for this LELCB was relatively low compared to conventional urothelial carcinomas. This suggests that measuring the ADC value of a lymphoepithelioma-like carcinoma prior to operation may be helpful in predicting LELCB