Oncological and functional outcomes following open radical prostatectomy: how patients may achieve the "Trifecta"?

Purpose: The desirable outcomes after open radical prostatectomy (RP) for localized prostate cancer (PC) are to: a) achieve disease recurrence free, b) urinary continence (UC), and c) maintain sexual potency (SP). These 3 combined desirable outcomes we called it the "Trifecta". Our aim is to assess the likelihood of achieving the Trifecta, and to analyze the influencing the Trifecta.

Factors that influence patient enrollment in active surveillance for low-risk prostate cancer.

Objectives: To learn from patients their rationale for enrollment in active surveillance (AS) for low-risk prostate cancer as an alternative to primary treatment.

Methods: A rank-order survey was designed to assess the relative influence of factors that contributed to the decision to elect AS. The survey was mailed to 185 patients enrolled in AS at our university-based urologic oncology practice.

Prospective randomized comparison of the safety, efficacy, and cosmetic outcome associated with mini-transverse and mini-longitudinal radical prostatectomy incisions.

Aims: Open radical retropubic prostatectomy (ORP) has traditionally been performed through a lower midline incision. Prior efforts to reduce pain and expedite recovery include a variety of alterations in length and the orientation of the incision. The aim of our study is to compare the safety, efficacy, and cosmetic outcomes associated with transverse and longitudinal mini-radical prostatectomy incisions.

Careful selection and close monitoring of low-risk prostate cancer patients on active surveillance minimizes the need for treatment.

Background: With the advent of prostate-specific antigen (PSA) screening and the increase in the number of transrectal ultrasound-guided biopsy cores, there has been a dramatic rise in the incidence of low-risk prostate cancer (LRPC). Because > 97% of men with LRPC are likely to die of something other than prostate cancer, it is critical that patients give thought to whether early curative treatment is the only option at diagnosis.

Objective: To identify a group of men with LRPC who may not require initial treatment and monitor them on our active surveillance (AS) protocol, to determine the percentage treated and the outcome and to analyze the quality-of-life data.

"Complete transurethral resection of bladder tumor": are the guidelines being followed?

Objectives: To determine how often complete eradication of all visible tumors during transurethral resection of bladder tumor (TURBT) is accomplished in a referral setting. The American Urological Association guidelines recommend complete eradication whenever possible.

Methods: We retrospectively reviewed the records of patients who underwent a second TURBT within 4 weeks of being referred to us.

Trends in Gleason score: concordance between biopsy and prostatectomy over 15 years.

Objectives: To assess the changes in the concordance rate of prostate biopsy and radical prostatectomy (RP) Gleason score (GS) over 15 years.

Methods: We reviewed 1670 consecutive patients who underwent RP between 1992 and 2006. We excluded patients who underwent neoadjuvant hormone therapy or salvage RP, or who had incomplete data.

Active surveillance; a reasonable management alternative for patients with prostate cancer: the Miami experience.

Objective: To examine the outcome of patients diagnosed with 'low-risk' prostate cancer managed by active surveillance (AS).

Patients And Methods: In all, 157 men with localized prostate cancer were followed on AS. The inclusion criteria for AS included: Gleason score of < or = 6, a serum prostate-specific antigen (PSA) level of < or = 15 ng/mL, stage < or = T2, low-volume disease and > 12 months of follow-up.

Efficacy and patient satisfaction associated with penile prosthesis revision surgery.

Introduction: Complications that arise after placement of a penile prosthesis may result in the need for revision surgery. Few contemporary penile prosthesis series have focused solely on describing the efficacy and patient satisfaction associated with penile prosthesis revision surgery.

Aim: To determine the overall success of penile prosthesis revision surgery in providing the patient with a functional implant.

Sexual, psychological and dyadic qualities of the prostate cancer 'couple'.

Objectives: To examine the levels of sexual, psychological and dyadic functioning of the prostate cancer 'couple' (as studies have shown that spouses/partners play an integral role in the patient's adjustment to prostate cancer treatment), to encourage the creation of innovative psychosexual interventions to be used in the outpatient setting, and to offer insights into a novel area of prostate cancer research.

Patients And Methods: In all, 103 men newly diagnosed with prostate cancer, and their partners, were assessed in an academic outpatient setting using instruments measuring sexual function, depressed mood, psychological distress and dyadic adjustment.

Results: The partners' mean scores on sexual function questions were 55.