An uncommonly encountered perirenal mass: Robotic resection of renal vein leiomyosarcoma.

Primary leiomyosarcoma (LMS) of the renal vein is a rare tumour and poorly described in the literature. Surgical resection, using open and laparoscopic approaches, is the mainstay of treatment. In this report, we describe a patient with left renal vein LMS, report the first robotic laparoscopic resection for this tumor, and review the typical presentation, imaging, pathology and treatment for this rare clinical entity.

Risk factors for delayed hematuria following photoselective vaporization of the prostate.

Purpose: Photoselective vaporization of the prostate has become an increasingly popular option for the treatment of benign prostatic hyperplasia. However, delayed bleeding has been raised as a potential issue as more cases are performed. We characterize delayed bleeding after photoselective vaporization of the prostate and identify associated risk factors.

Understanding early functional recovery after robotic prostatectomy.

Objectives: The time to regain urinary control and sexual function after robotic-assisted prostatectomy varies widely. The authors performed a study to prospectively assess relationships between intraoperative processes and early functional recovery after surgery.

Methods: Prostate cancer patients undergoing robotic prostatectomy prospectively completed questionnaires (Expanded Prostate Cancer Index Composite-Short Form, Sexual Health Inventory for Men) preoperatively and at 3 months postoperatively.

Variation in use of lymph node dissection during radical cystectomy for bladder cancer.

Objectives: To better inform avenues for improving the quality of bladder cancer care, we evaluated whether the variation in pelvic lymph node dissection during radical cystectomy was primarily due to the patient or the surgeon. In the clinical guidelines, pelvic lymph node dissection has been recommended as an adjunct to radical cystectomy. However, its use and extent have varied across providers and regions.

The impact of anterior urethropexy during robotic prostatectomy on urinary and sexual outcomes.

Objectives: We determined the effect of an anterior urethropexy (AU) stitch on postoperative urinary continence, irritative urinary symptoms, and sexual function after robotic radical prostatectomy (RP).

Methods: Consecutive patients undergoing robotic RP for prostate cancer were prospectively evaluated. The Expanded Prostate Cancer Index Composite (EPIC) questionnaire was administered pre- and postoperatively to all patients.

Does robotic technology mitigate the challenges of large prostate size?

Objectives: For radical prostatectomy, the advantages of robotic surgery may facilitate precise dissection and improve functional outcomes. However, patients with larger prostates may still pose increased challenges because of impaired visualization and mobility in the pelvis. For this reason, we undertook a study to better understand the relationships between large prostate size and robotic prostatectomy outcomes with respect to intraoperative and pathologic factors.

Body image and bladder cancer specific quality of life in patients with ileal conduit and neobladder urinary diversions.

Purpose: Patients undergoing radical cystectomy with neobladder for bladder cancer are hypothesized to tolerate worse urinary function than ileal conduit patients because of improved body image. The purpose of this study was to compare body image and quality of life between the 2 diversion types after surgery.

Materials And Methods: Patients who underwent radical cystectomy at the University of Michigan from November 1999 onwards and completed follow-up between July 2007 and August 2008 were eligible for the study.

Clinical interpretation of the Expanded Prostate Cancer Index Composite-Short Form sexual summary score.

Purpose: The Expanded Prostate Cancer Index Composite is a validated health related quality of life instrument that is commonly administered after prostate cancer treatment. We classified Expanded Prostate Cancer Index Composite-Short Form sexual summary scores into clinically meaningful groups.

Materials And Methods: A development cohort of 561 patients undergoing radical prostatectomy was used to define sexual summary groups by correlation with their responses on the Sexual Health Inventory for Men.

Patient-reported recovery after abdominal and pelvic surgery using the Convalescence and Recovery Evaluation (CARE): implications for measuring the impact of surgical processes of care and innovation.

Background: Recovery is an integral part of the surgical process and measuring it provides insight into the impact of surgical innovation. This study used a recently validated instrument, the Convalescence and Recovery Evaluation (CARE), to measure return to baseline health after surgery and explore clinical factors associated with recovery.

Study Design: Patient health was measured among 96 patients before and after abdominal and pelvic surgery.

Rapid development of metastatic Xp11 translocation renal cell carcinoma in a girl treated for neuroblastoma.

We report the case of a 5-year-old girl with metastatic renal cell carcinoma (RCC) diagnosed 19 months after treatment for neuroblastoma. Immunostaining of the secondary tumor was consistent with Xp11 translocation morphology. This is the second report of this translocation RCC presenting after neuroblastoma and the most rapid onset of RCC reported thus far.

Expanded Prostate Cancer Index Composite versus Incontinence Symptom Index and Sexual Health Inventory for Men to measure functional outcomes after prostatectomy.

Purpose: Evaluating quality of life outcomes following prostate cancer treatment is important because different treatments provide similar survival outcomes. A wide variety of quality of life surveys are used with an unknown correlation between domain specific and broad domain instruments. We compared the urinary and sexual outcome measures of the Expanded Prostate Cancer Index Composite, a broad domain instrument, to those of the Incontinence Symptom Index and the Sexual Health Inventory for Men, which are domain specific instruments.