Purpose: The aim of this study was to evaluate the contribution of an injection of hyaluronic acid (HA) between the rectum and the prostate for reducing the dose to the rectal wall in a hypofractionated irradiation for prostate cancer.
Methods And Materials: In a phase 2 study, 10 cc of HA was injected between the rectum and prostate. For 16 patients, the same intensity modulated radiation therapy plan (62 Gy in 20 fractions) was optimized on 2 computed tomography scans: CT1 (before injection) and CT2 (after injection). Rectal parameters were compared: dose to 2.5 cc (D2.5), 5 cc (D5), 10 cc (D10), 15 cc (D15), and 20 cc (D20) of rectal wall and volume of rectum covered by the 90% isodose line (V90), 80% (V80), 70% (V70), 60% (V60), and 50% (V50).
Results: The mean V90, V80, V70, V60, and V50 values were reduced by 73.8% (P<.0001), 55.7% (P=.0003), 43.0% (P=.007), 34% (P=.002), and 25% (P=.036), respectively. The average values of D2.5, D5, D10, D15, and D20 were reduced by 8.5 Gy (P<.0001), 12.3 Gy (P<.0001), 8.4 Gy (P=.005), 3.7 Gy (P=.026), and 1.2 Gy (P=.25), respectively.
Conclusions: The injection of HA significantly limited radiation doses to the rectal wall.
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http://dx.doi.org/10.1016/j.ijrobp.2012.11.027 | DOI Listing |
Cureus
December 2024
Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, JPN.
Rectal gastrointestinal stromal tumors (GISTs) are often asymptomatic and may be detected as giant tumors. This may require highly invasive surgery for radical resection. Here, we describe a 74-year-old man with a locally advanced non-metastatic GIST in the right anterolateral wall of the lower rectum.
View Article and Find Full Text PDFAsian J Endosc Surg
January 2025
Department of Urology, Kanagawa Cancer Center, Yokohama, Japan.
Introduction: The Retzius-sparing technique for prostate cancer has shown favorable continence recovery outcomes. Magnetic resonance imaging after Retzius-sparing showed that the bladder anterior wall is widely connected to the abdominal wall, which contributes to urinary continence. We aimed to evaluate whether the Peritoneal Fixation technique, which involves suturing the anterior bladder wall onto the abdominal wall above the pubic bone, contributes to the recovery of urinary continence.
View Article and Find Full Text PDFInt J Urol
January 2025
Department of Urology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan.
Objectives: This study aimed to investigate the association between the type of prostate biopsy and the occurrence of rectal wall infiltration (RWI) with hydrogel spacer placement in patients undergoing radiotherapy for prostate cancer.
Methods: A retrospective study was conducted involving 175 patients who received hydrogel spacer placement before radiotherapy at the National Cancer Center East Hospital, between October 2021 and December 2023. The patients were categorized based on the type of prostate biopsy: transperineal and transrectal.
Urogynecology (Phila)
January 2025
From the Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, IA.
Importance: The Pelvic Organ Prolapse Quantification (POP-Q) stages do not correlate with symptoms or characterize important prolapse subtypes.
Objectives: We hypothesize that clinically meaningful prolapse "phenotypes" utilizing POP-Q measurements can be defined. The primary aim was to define the phenotypes and their frequency.
Neurourol Urodyn
January 2025
Department of Surgery, Division of Urology, Virginia Commonwealth University Health System, Richmond, Virginia, USA.
Introduction And Objective: Observable autonomous rhythmic changes in intravesical pressure, termed bladder wall micromotion, is a phenomenon that has been linked to urinary urgency, the key symptom in overactive bladder (OAB). However, the mechanism through which micromotion drives urinary urgency is poorly understood. In addition, micromotion is inherently difficult to study in human urodynamics due to challenges distinguishing it from normal cyclic physiologic processes such as pulse rate, breathing, rectal contractions, and ureteral jetting.
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