erectile function after radical prostatectomy

In this study our aim is to increase the understanding of the prostate and related organs anatomy for better continence and erectile function results after urological surgery. Prostate and related organs were dissected from seven cadavers. After dissection, 165 serial sections with 300 mu m thickness were derived at a 100 mu m interval. The histological images were examined and imported to the computer. Three-dimensional (3D) remodeling had been performed. The findings were evaluated into three categories: macroscopic, microscopic and 3D reconstruction. Striated muscle fibers had been detected at the anterior fibromuscular stroma in histological sections. In 3D remodeling, urethra seemed to be a complete functional unit, beginning from the trigone up to the membranous urethra. The neurovascular bundles run under the pelvic fascia on both sides and go through to the bladder neck at 5 and 7 o'clock. Computer remodeling demonstrated that neurovascular structures had a close association with the bladder neck and the seminal vesicle. Computer program made it possible to rotate all 3D-reconstructed figures by 3601 and examine them from all possible angles. All reconstructed structures can be examined together at the same time or one by one. Surgeons must pay special attention to the continence area described as a single unit, beginning from trigone to the membranous urethra, during the surgery. Meticulous dissection of the neurovascular bundles, especially close to the seminal vesicles and bladder neck, during the radical prostatectomy is necessary. These reconstructions can be used for the educational purpose of medical students as well as the urology surgeons

<シンポジウム>科学研究の移り変わりと米国外交 : 1920年代から1950年代まで

WOS: 000274393100041PubMed ID: 19589584OBJECTIVES To examine, in a multicenter validation study designed under the guidance of the Uro-Oncology Society, the predictive accuracies of the 1998 and 2006 Kattan preoperative nomograms in Turkish patients. These 2 preoperative Kattan nomograms use preoperative parameters to estimate disease recurrence after radical prostatectomy. METHODS A total of 1261 men with clinically localized prostate cancer undergoing radical prostatectomy were included. The preoperative prostate-specific antigen level, biopsy Gleason score, clinical stage, number of positive and negative prostate biopsy cores, and postoperative recurrence status of all patients were studied. The predicted values using the Kattan nomograms and the observed values were compared. RESULTS The patient characteristics in the cohort were comparable with those of the cohorts used to create the Kattan nomograms. The 5-year probability of freedom from recurrence was 73% using Kaplan-Meier analysis and was similar to that of the 1998 Kattan nomogram cohort. However, the 10-year probability of freedom from recurrence was 67%, slightly lower than the same estimate from the 2006 nomogram cohort. The predicted values of recurrence using Kattan nomogram and the observed rates in our cohort were similar. The estimated concordance index value was 0.698 and 0.705 for 1998 and 2006 nomograms, respectively. CONCLUSIONS The Kattan preoperative nomograms can be used with adequate success in Turkey, because the predicted and observed rates in our cohort were similar. Our results have demonstrated satisfactory concordance index values, suggesting that both the 1998 and the 2006 Kattan preoperative nomograms can safely be used in Turkish patients with similar accuracy. Although the 2006 nomogram had slightly better discrimination, the 1998 nomogram was a little more calibrated. UROLOGY 74: 1289-1295, 2009. (C) 2009 Published by Elsevier Inc

A cadaveric histological investigation of the prostate with three-dimensional reconstruction for better results in continence and erectile function after radical prostatectomy.

In this study our aim is to increase the understanding of the prostate and related organs anatomy for better continence and erectile function results after urological surgery. Prostate and related organs were dissected from seven cadavers. After dissection, 165 serial sections with 300 microm thickness were derived at a 100 microm interval. The histological images were examined and imported to the computer. Three-dimensional (3D) remodeling had been performed. The findings were evaluated into three categories: macroscopic, microscopic and 3D reconstruction. Striated muscle fibers had been detected at the anterior fibromuscular stroma in histological sections. In 3D remodeling, urethra seemed to be a complete functional unit, beginning from the trigone up to the membranous urethra. The neurovascular bundles run under the pelvic fascia on both sides and go through to the bladder neck at 5 and 7 o'clock. Computer remodeling demonstrated that neurovascular structures had a close association with the bladder neck and the seminal vesicle. Computer program made it possible to rotate all 3D-reconstructed figures by 360 degrees and examine them from all possible angles. All reconstructed structures can be examined together at the same time or one by one. Surgeons must pay special attention to the continence area described as a single unit, beginning from trigone to the membranous urethra, during the surgery. Meticulous dissection of the neurovascular bundles, especially close to the seminal vesicles and bladder neck, during the radical prostatectomy is necessary. These reconstructions can be used for the educational purpose of medical students as well as the urology surgeons

Symptom Score (IPSS) as a new IPSS ratio

Background/aim: To evaluate the effects of the storage/total International Prostate Symptom Score (s/T) ratio on the selection and success of medical therapy in men with lower urinary tract symptoms (LUTS).Materials and methods: A total of 54 men (>45 years of age) with moderate or severe LUTS were divided into 2 groups according to the s/T ratio: Group 1 at 0.43. Tamsulosin (0.4 mg to Group 1) and tolterodine ER (4 mg to Group 2) were administered. Patients were evaluated during the 1st and 3rd months of follow-up treatment.Results: Thirty-seven (68.5%) and 17 (31.5%) patients were in Groups 1 and 2, respectively. The mean s/T ratios in Groups 1 and 2 increased to 0.38 +/- 0.19 from 0.33 +/- 0.08 (P = 0.03) and decreased to 0.54 +/- 0.18 from 0.59 +/- 0.1 (P = 0.17) during the 3rd month of follow-up, respectively. The treatment success rates of Groups 1 and 2 were 88.4% and 75.7%, respectively. Nine unsuccessful cases were treated with combination therapy and the treatment success was 86.6% at follow-up.Conclusion: The s/T ratio is effective to determine symptom dominance in men with LUTS and can guide medical treatment selection through better identification of symptoms

Multicenter Study of the Uro-oncology Society

OBJECTIVES To examine, in a multicenter validation study designed under the guidance of the Uro-Oncology Society, the predictive accuracies of the 1998 and 2006 Kattan preoperative nomograms in Turkish patients. These 2 preoperative Kattan nomograms use preoperative parameters to estimate disease recurrence after radical prostatectomy