GreenLight laser prostatectomy:a safe and effective treatment for bladder outlet obstruction by prostate cancer

Level of Evidence 4 What's known on the subject? and What does the study add? Although looked on as standard of care there is little published data on the use of "channel TURP" . Those case series that have been published show significant morbidity (in particular stress incontinence) and relatively long hospitalization compared to standard TURP. The use of vaprorising lasers in this patient group has not been addressed. GreenLight laser is a safe and efficacious treatment for bladder outflow obstruction in men with prostate cancer. Hospitalization is minimal (most were day cases) which we feel is important in men who are often in their last few months. We had no serious complications apart from a few patients with stress incontinence. The stress incontinence rate was dramatically lower than that reported in previous reported series of channel TURP - we are not however able to offer any obvious explanation for that finding. OBJECTIVE To present our experience on photoselective vaporization of the prostate (PVP) in a cohort of men with bladder outlet obstruction (BOO) by prostate cancer. PATIENTS AND METHODS From 2003 to 2008 we identified 43 patients with prostate cancer treated with PVP. The patients' hospital records were comprehensively reviewed to obtain preoperative, intra-operative and postoperative data. Inclusion criteria were patients with BOO or urinary retention with a diagnosis of prostate cancer. RESULTS Mean operating time was 42 min, mean post-operative hospital stay was 9.6 h. 32 out of 43 patients were discharged home within 24 h. Twelve patients (28%) did not need post-operative catheter. Mean and median catheter times were 22 and 21.5 h respectively. Complications were mild: 1 patient needed bladder irrigation, 3 failed initial TWOC, 1 had early stress incontinence. Three had clot retention. At 3 months post-operatively, 41 of 42 evaluable patients were voiding without a catheter. The mean peak flow rate had increased by 80% and a mean residual volume decreased of 49%. Four patients underwent a second laser treatment. Three had developed further retention between 7 and 23 months post-operatively and did not want further surgery. The local failure rate at a mean follow up of 22 months was 7 of 39 patients (18%). CONCLUSION The present study is the first on PVP applied to patients with prostate cancer. It is shown that, for patients with CaP bothered by LUTS or retention, GreenLight laser prostatectomy is very safe and gives excellent relief from symptoms, with a good improvement in peak flow rate

Greenlight laser prostatectomy: a safe and effective treatment for bladder outlet obstruction by prostate cancer

Level of Evidence 4 What\u27s known on the subject? and What does the study add? Although looked on as standard of care there is little published data on the use of "channel TURP" . Those case series that have been published show significant morbidity (in particular stress incontinence) and relatively long hospitalization compared to standard TURP. The use of vaprorising lasers in this patient group has not been addressed. GreenLight laser is a safe and efficacious treatment for bladder outflow obstruction in men with prostate cancer. Hospitalization is minimal (most were day cases) which we feel is important in men who are often in their last few months. We had no serious complications apart from a few patients with stress incontinence. The stress incontinence rate was dramatically lower than that reported in previous reported series of channel TURP - we are not however able to offer any obvious explanation for that finding. OBJECTIVE To present our experience on photoselective vaporization of the prostate (PVP) in a cohort of men with bladder outlet obstruction (BOO) by prostate cancer. PATIENTS AND METHODS From 2003 to 2008 we identified 43 patients with prostate cancer treated with PVP. The patients\u27 hospital records were comprehensively reviewed to obtain preoperative, intra-operative and postoperative data. Inclusion criteria were patients with BOO or urinary retention with a diagnosis of prostate cancer. RESULTS Mean operating time was 42 min, mean post-operative hospital stay was 9.6 h. 32 out of 43 patients were discharged home within 24 h. Twelve patients (28%) did not need post-operative catheter. Mean and median catheter times were 22 and 21.5 h respectively. Complications were mild: 1 patient needed bladder irrigation, 3 failed initial TWOC, 1 had early stress incontinence. Three had clot retention. At 3 months post-operatively, 41 of 42 evaluable patients were voiding without a catheter. The mean peak flow rate had increased by 80% and a mean residual volume decreased of 49%. Four patients underwent a second laser treatment. Three had developed further retention between 7 and 23 months post-operatively and did not want further surgery. The local failure rate at a mean follow up of 22 months was 7 of 39 patients (18%). CONCLUSION The present study is the first on PVP applied to patients with prostate cancer. It is shown that, for patients with CaP bothered by LUTS or retention, GreenLight laser prostatectomy is very safe and gives excellent relief from symptoms, with a good improvement in peak flow rate

Disease-specific and general health-related quality of life in newly diagnosed prostate cancer patients: The Pros-IT CNR study

BACKGROUND: The National Research Council (CNR) prostate cancer monitoring project in Italy (Pros-IT CNR) is an observational, prospective, ongoing, multicentre study aiming to monitor a sample of Italian males diagnosed as new cases of prostate cancer. The present study aims to present data on the quality of life at time prostate cancer is diagnosed. METHODS: One thousand seven hundred five patients were enrolled. Quality of life is evaluated at the time cancer was diagnosed and at subsequent assessments via the Italian version of the University of California Los Angeles-Prostate Cancer Index (UCLA-PCI) and the Short Form Health Survey (SF-12). RESULTS: At diagnosis, lower scores on the physical component of the SF-12 were associated to older ages, obesity and the presence of 3+ moderate/severe comorbidities. Lower scores on the mental component were associated to younger ages, the presence of 3+ moderate/severe comorbidities and a T-score higher than one. Urinary and bowel functions according to UCLA-PCI were generally good. Almost 5% of the sample reported using at least one safety pad daily to control urinary loss; less than 3% reported moderate/severe problems attributable to bowel functions, and sexual function was a moderate/severe problem for 26.7%. Diabetes, 3+ moderate/severe comorbidities, T2 or T3-T4 categories and a Gleason score of eight or more were significantly associated with lower sexual function scores at diagnosis. CONCLUSIONS: Data collected by the Pros-IT CNR study have clarified the baseline status of newly diagnosed prostate cancer patients. A comprehensive assessment of quality of life will allow to objectively evaluate outcomes of different profile of care

Disease-specific and general health-related quality of life in newly diagnosed prostate cancer patients: the Pros-IT CNR study

Background: The National Research Council (CNR) prostate cancer monitoring project in Italy (Pros-IT CNR) is an observational, prospective, ongoing, multicentre study aiming to monitor a sample of Italian males diagnosed as new cases of prostate cancer. The present study aims to present data on the quality of life at time prostate cancer is diagnosed. Methods: One thousand seven hundred five patients were enrolled. Quality of life is evaluated at the time cancer was diagnosed and at subsequent assessments via the Italian version of the University of California Los Angeles-Prostate Cancer Index (UCLA-PCI) and the Short Form Health Survey (SF-12). Results: At diagnosis, lower scores on the physical component of the SF-12 were associated to older ages, obesity and the presence of 3+ moderate/severe comorbidities. Lower scores on the mental component were associated to younger ages, the presence of 3+ moderate/severe comorbidities and a T-score higher than one. Urinary and bowel functions according to UCLA-PCI were generally good. Almost 5% of the sample reported using at least one safety pad daily to control urinary loss; less than 3% reported moderate/severe problems attributable to bowel functions, and sexual function was a moderate/severe problem for 26.7%. Diabetes, 3+ moderate/severe comorbidities, T2 or T3-T4 categories and a Gleason score of eight or more were significantly associated with lower sexual function scores at diagnosis. Conclusions: Data collected by the Pros-IT CNR study have clarified the baseline status of newly diagnosed prostate cancer patients. A comprehensive assessment of quality of life will allow to objectively evaluate outcomes of different profile of care

Pros-IT CNR: an Italian prostate cancer monitoring project

Aims: The Pros-IT CNR project aims to monitor a sample of Italian males \ue2\u89\ua518\uc2 years of age who have been diagnosed in the participating centers with incident prostate cancer, by analyzing their clinical features, treatment protocols and outcome results in relation to quality of life. Methods: Pros-IT CNR is an observational, prospective, multicenter study. The National Research Council (CNR), Neuroscience Institute, Aging Branch (Padua) is the promoting center. Ninety-seven Italian centers located throughout Italy were involved. The field study began in September 1, 2014. Subjects eligible were diagnosed with biopsy-verified prostate cancer, na\uc3\uafve. A sample size of 1500 patients was contemplated. A baseline assessment including anamnestic data, clinical history, risk factors, the initial diagnosis, cancer staging information and quality of life (Italian UCLA Prostate Cancer Index; SF-12 Scale) was completed. Six months after the initial diagnosis, a second assessment evaluating the patient\ue2\u80\u99s health status, the treatment carried out, and the quality of life will be made. A third assessment, evaluating the treatment follow-up and the quality of life, will be made 12\uc2 months after the initial diagnosis. The 4th, 5th, 6th and 7th assessments, similar to the third, will be completed 24, 36, 48 and 60\uc2 months after the initial diagnosis, respectively, and will include also a Food Frequency Questionnaire and the Physical Activity Scale for the Elderly. Discussion: The study will provide information on patients\ue2\u80\u99 quality of life and its variations over time in relation to the treatments received for the prostate cancer