Objective: To correlate the utility of the Fundamentals of Laparoscopic Surgery (FLS) manual skills program with the Objective Structured Assessment of Technical Skills (OSATS) global rating scale in evaluating operative performance.
Methods: The Asian Urological Surgery Training and Educational Group (AUSTEG) Laparoscopic Upper Tract Surgery Course implemented and validated the FLS program for its usage in laparoscopic surgical training. Delegates' basic laparoscopic skills were assessed using three different training models (peg transfer, precision cutting, and intra-corporeal suturing).
Introduction: Previously, in a randomised trial we demonstrated bipolar transurethral resection of bladder tumor (TURBT) could achieve a higher detrusor sampling rate than monopolar TURBT. We hereby report the long-term oncological outcomes following study intervention.
Methods: This is a post-hoc analysis of a randomized phase III trial comparing monopolar and bipolar TURBT.
Eur Urol
August 2024
Background And Objective: Conventionally, standard resection (SR) is performed by resecting the bladder tumour in a piecemeal manner. En bloc resection of the bladder tumour (ERBT) has been proposed as an alternative technique in treating non-muscle-invasive bladder cancer (NMIBC). The objective of this study is to investigate whether ERBT could improve the 1-yr recurrence rate of NMIBC, as compared with SR.
View Article and Find Full Text PDFObjectives: To report the perioperative outcomes of robot-assisted radical cystectomy and elucidate their risk factors.
Methods: A review of the Asian Robot-Assisted Radical Cystectomy Consortium database from 2007 to 2020 was performed. The perioperative outcomes studied included complication rates, time to solid food intake, estimated blood loss, length of hospital stay, and 30-day readmission rates.
Purpose: This study was designed to investigate and compare the perioperative outcomes of intracorporeal urinary diversion (ICUD) versus extracorporeal urinary diversion (ECUD) following robotic-assisted radical cystectomy (RARC) in patients with localized bladder cancer from the Asian Robot-Assisted Radical Cystectomy (RARC) Consortium.
Methods: The Asian RARC registry was a multicenter registry involving nine centers in Asia. Consecutive patients who underwent RARC were included.
Background: To establish a set of consensus statements for the management of metastatic renal cell carcinoma, a total of 12 urologists and clinical oncologists from two professional associations in Hong Kong formed an expert consensus panel.
Methods: Through a series of meetings and using the modified Delphi method, the panelists presented recent evidence, discussed clinical experiences, and drafted consensus statements on several areas of focus regarding the management of metastatic renal cell carcinoma. Each statement was eventually voted upon by every panelist based on the practicability of recommendation.
Robotic-assisted radical cystectomy (RARC) has been gaining momentum as an alternative to its conventional open radical cystectomy (ORC) for the management of invasive bladder cancer. Although RARC, in general, demonstrated less blood loss and shorter hospital stay than ORC, whether there is any significant difference in the overall complication rate still requires further investigation. Thus, both RARC and ORC share a similar oncology outcome, with comparable positive surgical margin rates, disease-free survival, and overall survival.
View Article and Find Full Text PDFAnatomical endoscopic enucleation of the prostate has been proposed as a potentially superior benign prostatic hyperplasia surgery than conventional transurethral resection of prostate. However, the learning curve of the procedure is steep, hence limiting its generalisability worldwide. In order to overcome the learning curve, a proper surgical training is extremely important.
View Article and Find Full Text PDFAim: The 2017 Advanced Prostate Cancer Consensus Conference (APCCC) convened an international multidisciplinary panel to vote on controversial issues in the management of advanced prostate cancer (APC). We aimed to compare their conclusions with the opinions of local specialists and explore the practicability of international recommendations in the healthcare setting in Hong Kong.
Methods: Urologists and clinical oncologists practicing in Hong Kong were invited to complete a survey based on the original APCCC 2017 questionnaire and recently published trials in APC.
Objective: To investigate the safety and feasibility of robot-assisted single-port radical prostatectomy using the da Vinci single-port surgical system.
Methods: This was a prospective phase 1 clinical study of prostate cancer patients undergoing robot-assisted single-port radical prostatectomy using the da Vinci single-port surgical system. Primary outcome measures included the conversion rate and 30-day complications after surgery.
It is largely unknown whether lower urinary tract symptoms (LUTS) or acute retention of urine (AROU) is linked to shorter life expectancy in men. We conducted a multicenter, retrospective database analysis of patients undergoing transurethral resection of prostate (TURP) to study their relationships. Multivariate Cox regression analysis and Kaplan-Meier analysis with stratification to age and indication of TURP were performed.
View Article and Find Full Text PDFPurpose: The Asian Urological Surgery Training & Education Group (AUSTEG) has been established to provide training and education to young urologists in Asia. We developed and validated a porcine bladder training model for transurethral resection of bladder tumour (TURBT).
Methods: Urology residents and specialists were invited to test the training model.
Introduction: We evaluated the factors associated with secondary hemorrhage after bipolar transurethral resection of prostate (TURP) and vaporization of prostate.
Materials And Methods: The perioperative data of patients undergoing endoscopic surgery for benign prostatic hyperplasia (BPH) were prospectively collected. Procedures involved included bipolar TURP, bipolar vaporization of prostate, and hybrid bipolar TURP/vaporization of prostate.
Purpose: Our aim was to investigate the detrusor muscle sampling rate after monopolar versus bipolar transurethral resection of bladder tumor (TURBT).
Methods: This was a single-center, prospective, randomized, phase III trial on monopolar versus bipolar TURBT. Baseline patient characteristics, disease characteristics and perioperative outcomes were compared, with the primary outcome being the detrusor muscle sampling rate in the TURBT specimen.
Purpose: We investigated the extended use of Prostate Health Index (PHI) and percentage of [-2]pro-prostate-specific antigen (%p2PSA) in Chinese men with prostate-specific antigen (PSA) 10-20 ng/mL and normal digital rectal examination (DRE).
Materials And Methods: All consecutive Chinese men with PSA 10-20 ng/mL and normal DRE who agreed for transrectal ultrasound (TRUS)-guided 10-core prostate biopsy were recruited. Blood samples were taken immediately before TRUS-guided prostate biopsy.
Purpose: To investigate the performance of prostate health index (PHI) and percentage prostate-specific antigen (PSA) isoform [-2]proPSA (%p2PSA) in predicting pathologic outcomes at radical prostatectomy (RP) in a Chinese population.
Methods: We performed a prospective study of 135 prostate cancer patients with RP. The accuracy of preoperative %p2PSA (= p2PSA/free PSA) and PHI [= (p2PSA/free PSA) × √PSA] in predicting pathologic outcomes of RP including pT3 disease, pathologic Gleason score (pGS) ≥7, Gleason score (GS) upgrade at RP, tumor volume >0.
J Laparoendosc Adv Surg Tech A
March 2015
Purpose: Robot-assisted radical cystectomy (RARC) was first introduced in 2003. Although there have been modifications to the surgical techniques over the years, in every published RARC series the surgical robot is invariably docked between the patient's legs. We evaluated the use of a side-docking approach in RARC.
View Article and Find Full Text PDFObjective: To investigate the feasibility of side-docking techniques in robot-assisted urologic pelvic surgery.
Materials And Methods: Six consecutive patients undergoing robot-assisted pelvic surgery participated in the study: 3 undergoing radical cystectomy for muscle-invasive bladder cancer, 1 patient undergoing ureteroneocystostomy for ureteric stricture, 1 patient undergoing partial cystectomy for urothelial cancer in a bladder diverticulum, and 1 undergoing transvesical simple prostatectomy. Each patient was placed in the lithotomy-Trendelenburg position, with the robot docked over the patient's right side.
Background: A prior study showed significant antibiotic resistance to quinolone in our population. In this study we aimed to evaluate and compare the efficacy of a single versus a combined prophylactic antibiotic regimen before transrectal ultrasound-guided prostate biopsy (TRUGPB).
Methods: A prospective randomized study was conducted at a university hospital.
Objective: To evaluate the effects of sunitinib on localized bladder cancer in a mouse orthotopic bladder tumor model.
Methods: We used an established orthotopic mouse bladder cancer model in syngeneic C3H/He mice. Treatment doses of 40 mg/kg of sunitinib or placebo sterile saline were administrated daily by oral gavage.
Unlabelled: We quantified the urine sediment and supernatant levels of microRNA (miRNA) targets related to epithelial-mesenchymal transition in 51 patients with bladder cancer and in 24 controls. We found that patients with bladder cancer had depressed levels of the miR-200 family, miR-192, and miR-155 in urinary sediment. The urinary level of these miRNAs may be developed as noninvasive markers for bladder cancer.
View Article and Find Full Text PDFPurpose: We investigated the effect of the combination of the doxazosin gastrointestinal therapeutic system and 10 mg vardenafil on the hemodynamic status of patients with benign prostatic hyperplasia and erectile dysfunction.
Materials And Methods: This was a double-blinded, randomized, placebo controlled crossover trial. Patients with benign prostatic hyperplasia and erectile dysfunction treated with the doxazosin gastrointestinal therapeutic system on a regular basis, with no other antihypertensive events, were recruited.
Background And Purpose: The prone position has been widely adopted in conventional percutaneous nephrolithotomy (PCNL). Following its introduction in 1998, we changed our routine practice of PCNL from the prone to the supine position, which had numerous benefits and was safe and effective. Tract formation and stone fragmentation and retrieval were accomplished with the patient supine.
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