Genitourinary Prosthetic Use among Prostate Cancer Survivors Treated with Radical Prostatectomy.

Introduction: Erectile dysfunction and urinary incontinence are well-known side effects of radical prostatectomy that, when refractory to medical therapy, can be addressed by major genitourinary prosthetic surgery (urethral slings, artificial urinary sphincters, penile prostheses). Although these procedures have been evaluated in single institution studies, population based analyses regarding their use have been sporadic. Thus, we characterized post-prostatectomy genitourinary prosthetic surgery in a contemporary, population based cohort of men with private insurance.

Peyronie's Disease: Intralesional Therapy and Surgical Intervention.

Peyronie's disease is a collagen wound healing disorder of the penis that negatively affects the quality of life of afflicted men. According to the 2015 AUA Consensus Guidelines on Peyronie's Disease, minimally invasive intralesional therapies and surgical intervention form the basis of contemporary therapy for this disorder. These therapeutic options, along with selected portions of the guidelines, are explored in this review.

Efficacy of pioglitazone on erectile function recovery in a rat model of cavernous nerve injury.

Objective: To examine the effect of pioglitazone on erectile function in a rat model of postprostatectomy erectile dysfunction.

Methods: Twenty adult rats were divided into 4 groups: (a) sham, (b) control--bilateral cavernosal nerve crush injury (BCNI), (c) BCNI + low-dose pioglitazone (PioL), and (d) BCNI + high-dose pioglitazone (PioH). Sham and control rats were administered phosphate-buffered saline, whereas PioL and PioH rats received 0.

Pioglitazone prevents cavernosal nerve injury after radical prostatectomy.

Erectile dysfunction (ED) is a common consequence of radical prostatectomy (RP) and can affect a man's long-term quality of life. Intraoperative manipulation of the neurovascular bundle causes neuropraxia with resultant fibrosis and trabecular smooth-muscle damage. Pioglitazone is an anti-diabetic agent with recognized antifibrotic and vasculoprotective properties, which can protect smooth muscle function.

A positive-margin resection model recreates the postsurgical tumor microenvironment and is a reliable model for adjuvant therapy evaluation.

Up to 30% of cancer patients undergoing curative surgery develop local recurrences due to positive margins. Patients typically receive adjuvant chemotherapy, immunotherapy and/or radiation to prevent such relapses. Interestingly, evidence supporting these therapies is traditionally derived in animal models of primary tumors, thus failing to consider surgically induced tumor microenvironment changes that may influence adjuvant therapy efficacy.

Characterization of surgical models of postoperative tumor recurrence for preclinical adjuvant therapy assessment.

Purpose: Nearly 30% of cancer patients undergoing curative surgery succumb to distant recurrent disease. Despite large implications and known differences between primary and recurrent tumors, preclinical adjuvant therapy evaluation frequently occurs only in primary tumors and not recurrent tumors. We hypothesized that well characterized and reproducible models of postoperative systemic recurrences should be used for preclinical evaluation of adjuvant approaches.

Vascular endothelial-targeted therapy combined with cytotoxic chemotherapy induces inflammatory intratumoral infiltrates and inhibits tumor relapses after surgery.

Surgery is the most effective therapy for cancer in the United States, but disease still recurs in more than 40% of patients within 5 years after resection. Chemotherapy is given postoperatively to prevent relapses; however, this approach has had marginal success. After surgery, recurrent tumors depend on rapid neovascular proliferation to deliver nutrients and oxygen.

Sleeve lobectomy: current indications and future directions.

Sleeve lobectomy was initially conceived as an alternative to pneumonectomy for patients with low-grade, centrally located lesions and limited cardiopulmonary reserve. Over the last several decades, advances in patient selection criteria and surgical techniques have allowed sleeve lobectomy to evolve from a compromise to pneumonectomy to first line intervention for centrally located lesions of all grades. Although more challenging than pneumonectomy, long-term outcomes and cost-effective measures favor sleeve lobectomy.