Are there limits of robotic partial nephrectomy? TRIFECTA outcomes of open and robotic partial nephrectomy for completely endophytic renal tumors.

Background: To compare the outcomes of robot-assisted (RAPN) and open partial nephrectomy (OPN) for completely endophytic renal tumors.

Methods: Consecutive patients undergoing OPN or RAPN for entirely endophytic tumors in four high-volume centers between 2008 and 2016 were identified. Endophytic masses were identified based on sectional imaging.

Adreno-muscarinic synergy in the male human urinary outflow tract.

Aim: To examine putative interaction between adrenergic and muscarinic contractile activation in the human urinary outflow tract.

Methods: Tissue from the trigone and prostatic urethra was obtained from 12 cystectomy and 16 prostatectomy specimen. Contractions were elicited by exposure to exogenous agonists before and after inhibition of Rho kinase and protein kinase c (PKC).

Tumor complexity and the impact on MIC and trifecta in robot-assisted partial nephrectomy: a multi-center study of over 500 cases.

Purpose: To demonstrate the surgical feasibility of robot-assisted partial nephrectomy for complex renal masses with comparison of low/intermediate risk versus high-risk tumors according to the PADUA score.

Methods: Since 2008, 538 robot-assisted partial nephrectomies were performed at three German robotic centers. Both the MIC (margin, ischemia, complications) criteria and trifecta were applied.

Outcome of Robotic Radical Prostatectomy in Men Over 74.

Introduction: We set out to evaluate outcomes in patients over 74 after robotic radical prostatectomy.

Materials And Methods: Six hundred forty-seven patients over 74 (≥75) were analyzed for preoperative factors (body mass index [BMI], American Society of Anestesiologists classification [ASA], prostate-specific antigen [PSA], International prostate symptome score [IPSS], International index of erectile function [IIEF]), operative and perioperative characteristics (technique, erythrocyte conc., complications), and histopathological results.

Minimally Invasive Repair of a Prostatorectal Fistula with an Over-the-Scope Rectal Clip.

Fistulae between the prostatic urethra and the rectum are rare. They may result from prostatic or rectal surgery. Predisposing factors are previous radiation or immunosuppression.

"Finding the needle in a haystack": oncologic evaluation of patients treated for LUTS with holmium laser enucleation of the prostate (HoLEP) versus transurethral resection of the prostate (TURP).

Purpose: To evaluate oncologic parameters of men with bothersome LUTS undergoing surgical treatment with HoLEP or TURP.

Methods: Five hundred and eighteen patients undergoing HoLEP (n = 289) or TURP (n = 229) were retrospectively analyzed for total PSA, prostate volume, PSA density, history of prostate biopsy, resected prostate weight, and histopathological features. Univariate and multivariate logistic regression models were used to identify independent predictors of incidental PCa (iPCa).

Is One Early Renographic Follow-Up Adequate to Measure the Success of Robotic Pyeloplasty?

Purpose: Diuretic renography (DRG) is commonly used to diagnose ureteropelvic junction obstruction (UPJO) and to evaluate the success of surgical repair (pyeloplasty). Duration, frequency, and interpretation of renographic follow-ups are still under dispute.

Methods: We retrospectively reviewed 94 consecutive patients diagnosed with UPJO who underwent a minimally invasive, robotically assisted laparoscopic pyeloplasty at our institution between January 2009 and September 2015.

Poor standard mp-MRI and routine biopsy fail to precisely predict intraprostatic tumor localization.

Purpose: To evaluate the localization accuracy of routinely performed preoperative multiparametric MRI (mp-MRI), not being assessed according to PI-RADS criteria.

Methods: One hundred and six patients underwent radical retropubic prostatectomy (January 2011-June 2012) with preoperative MRI. Intraprostatic tumor localization suggested by mp-MRI was correlated to both biopsy and histopathology results.

[PSA screening].

Screening for prostate cancer should help to detect malignancy at an early and potentially treatable stage. Serum psa has been used as a test for prostate cancer for over 20 years, but its practise is still very controversial worldwide. Studies can demostrate good aspects for screening with psa: the overall mortality and especially the metastases at stage of primary diagnosis can be reduced.

A comparative assessment of prostate positioning guided by three-dimensional ultrasound and cone beam CT.

Background: The accuracy of the Elekta Clarity™ three-dimensional ultrasound system (3DUS) was assessed for prostate positioning and compared to seed- and bone-based positioning in kilo-voltage cone-beam computed tomography (CBCT) during a definitive radiotherapy.

Methods: The prostate positioning of 6 patients, with fiducial markers implanted into the prostate, was controlled by 3DUS and CBCT. In total, 78 ultrasound scans were performed trans-abdominally and compared to bone-matches and seed-matches in CBCT scans.

Preoperative mp-MRI of the prostate provides little information about staging of prostate carcinoma in daily clinical practice.

Purpose: To evaluate the staging accuracy of preoperative multiparametric MRI (mp-MRI), its influence on the technique of radical retropubic prostatectomy (RRP), and its value for daily clinical practice.

Methods: A total of 106 patients underwent RRP (January 2011-June 2012) and had preoperative MRI staging data available for review. Staging results acquired by mp-MRI were correlated to both biopsy and histopathology results.

Single fraction radiosurgery for the treatment of renal tumors.

Purpose: High dose local stereotactic radiosurgery was performed in select patients to improve local tumor control and overall survival. We report on patients with renal tumors treated with single fraction robotic stereotactic radiosurgery.

Materials And Methods: A total of 40 patients with a median age of 64 years who had an indication for nephrectomy and subsequent hemodialysis were entered in a prospective case-control study of single fraction stereotactic radiosurgery.

Urethral stricture: etiology, investigation and treatments.

Background: Urethral stricture is a narrowing of the urethra due to scar tissue, which leads to obstructive voiding dysfunction with potentially serious consequences for the entire urinary tract. Its prevalence among men in industrial countries is estimated at 0.9%.

Impact of the 'repositioning test' on postoperative outcome of retroluminar transobturator male sling implantation.

Objective: To evaluate prospectively the value of the 'repositioning test' (RT) in preoperative patient selection for the efficacy of male stress urinary incontinence (SUI) treatment using a retroluminar transobturator male sling (AdVance sling).

Patients And Methods: 65 consecutive patients with SUI after radical prostatectomy were included in this single-center prospective study. Preoperatively, patients were classified into those with 'positive' and 'negative' RT.

Contraction of the anterior prostate is required for the initiation of micturition.

Unlabelled: WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: In a recent rtMRI study, we were able to show that, during initiation of voiding, there was both funnelling of the bladder neck and simultaneous contraction of the ventral prostate. We presumed that the vertical contraction of the ventral prostate contributes to the initiation of successful micturition. The question remained as to whether this shortening of the ventral prostate is predominantly caused by contractile elements in the organ itself, or by surrounding contractile elements of the pelvic floor.

Microbial colonization and ureteral stent-associated storage lower urinary tract symptoms: the forgotten piece of the puzzle?

Purpose: Ureteral stents are frequently associated with side effects. Most patients suffer from storage lower urinary tract symptoms (LUTS). Storage LUTS are commonly attributed to the irritation of the trigone, smooth muscle spasm or a combination of factors.

Activation of protein kinase B/Akt by alpha1-adrenoceptors in the human prostate.

Aims: Besides their role in contraction, α1-adrenoceptors may be involved in prostate hyperplasia. This would require receptor signaling by growth-promoting pathways. Akt (syn.

Expression and alpha1-adrenoceptor regulation of caldesmon in human prostate smooth muscle.

Objective: To investigate expression and α1-adrenergic regulation of caldesmon in the human prostate. Caldesmon is an important mediator and regulator of contraction in different smooth muscle types. However, this has not been investigated in the prostate to date.

Monitoring the coupling of the lithotripter therapy head with skin during routine shock wave lithotripsy with a surveillance camera.

Purpose: With lithotripters today the shock waves are typically transmitted into the body via water filled bellows using coupling gel to make contact with the skin. Usually the coupling zone is not visible to the operator. We investigated coupling quality during routine clinical shock wave lithotripsy and the associated effect on shock wave disintegration efficiency.

Single-stage dorsal inlay for reconstruction of recurrent peno-glandular stenosis.

Objective: To evaluate the validity of a single-stage dorsal inlay for recurrent peno-glandular stenosis following previous endourological or open urethroplastic surgery. Urethral glanular reconstruction included a deep dorsal incision followed by complete scar excision to create a deep groove presenting well-vascularized recipient bed ensuring appropriate graft healing.

Materials And Methods: Between April 2002 and January 2008, a total of 34 patients (mean age 51.

Alpha1-adrenoceptor signaling in the human prostate involves regulation of p38 mitogen-activated protein kinase.

Objective: To investigate whether 1-adrenoceptor signaling in the human prostate involves regulation of the mitogen-activated protein kinase (MAPK) p38. Although α1-adrenoceptors are an important target for therapy of lower urinary tract symptoms in patients with prostate hyperplasia, intracellular signaling by prostate α1-adrenoceptors is not sufficiently understood.

Methods: Prostate tissue was obtained from patients undergoing radical prostatectomy.