Prostate International最新文献

{"title":"Holmium laser enucleation of the prostate as a treatment option for patients with concurrent outlet obstruction and bladder diverticulum","authors":"Michael Frumer,&nbsp;Iyad Khamaisi,&nbsp;Guy Levenberg,&nbsp;Gherman Creiderman,&nbsp;Ron Gilad,&nbsp;Sagi A. Shpitzer,&nbsp;Tzach Aviv,&nbsp;Muhammad Krenawi,&nbsp;Shayel Bercovich,&nbsp;Nadav Dekel,&nbsp;Hadar Tamir,&nbsp;Tomer Hasdai,&nbsp;Yossi Ventura,&nbsp;Niv Segal,&nbsp;Hen Hendel,&nbsp;Liran Zieber,&nbsp;Jack Baniel,&nbsp;David Lifshitz,&nbsp;Abd E. Darawsha,&nbsp;Yaron Ehrlich","doi":"10.1016/j.prnil.2025.07.003","DOIUrl":"10.1016/j.prnil.2025.07.003","url":null,"abstract":"<div><h3>Background</h3><div>A bladder diverticulum is a source of infections, urinary stones, and malignancy. Until recent years, patients suffering from large obstructive prostate and diverticulum were treated with open surgery, which also allowed diverticulectomy. The transition to a closed approach has led to diverticulum preservation. The clinical implications of this preservation strategy have not been sufficiently studied.</div></div><div><h3>Materials and methods</h3><div>A retrospective comparison was made between holmium laser enucleation of the prostate (HoLEP) patients with a diverticulum (≥2 cm) and HoLEP patients without any diverticulum. For each patient with a diverticulum, two patients without a diverticulum who were operated on around the same time were matched (1:2). Patients operated on until March 2022 were included to allow for a relatively long follow-up period.</div></div><div><h3>Results</h3><div>Out of 602 HoLEP patients, 32 (5%) had a diverticulum <strong>≥</strong>2 cm, and they were matched with 64 patients without a diverticulum. The median diverticulum size was 37 mm (interquartile range: 25, 51). A comparison of preoperative data between the two groups revealed no significant differences. Two patients with a diverticulum required a temporary urinary catheter at discharge, but there were no significant differences in surgical, perioperative, or postoperative measures between the two groups, except for a clinically insignificant difference in residual urine volume. With a median follow-up of 3.3 years (interquartile range: 2.5, 4.5), no patient required or was referred for diverticulectomy.</div></div><div><h3>Conclusions</h3><div>HoLEP is an effective treatment method for patients with bladder outlet obstruction and concomitant bladder diverticulum. By effectively relieving the bladder outlet obstruction, HoLEP can avoid the need for more invasive surgical interventions.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"13 4","pages":"Pages 253-257"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodality focal therapy for prostate cancer: outcome of the à la carte approach in clinical practice","authors":"Chi-Hang Yee ,&nbsp;Peter K-F. Chiu ,&nbsp;Alex Q. Liu ,&nbsp;H.F. Wong ,&nbsp;Wilson H.C. Chan ,&nbsp;K.L. Lo ,&nbsp;C.K. Chan ,&nbsp;R. Chan ,&nbsp;Carmen CM. Cho ,&nbsp;H.Y. Hung ,&nbsp;Jeremy Y.C. Teoh ,&nbsp;C.F. Ng","doi":"10.1016/j.prnil.2025.03.006","DOIUrl":"10.1016/j.prnil.2025.03.006","url":null,"abstract":"<div><h3>Background</h3><div>Our study reported the outcome of a multimodality focal therapy (FT) cohort for localized primary prostate cancer.</div></div><div><h3>Methods</h3><div>In a prospective registry all patients underwent magnetic resonance imaging and biopsy (fusion targeted or template biopsy) before FT. Modalities included focal high-intensity focused ultrasound (HIFU), focal cryotherapy, or targeted microwave ablation (TMA). Postoperatively, prostate-specific antigen and functional outcome assessment with validated questionnaires were checked 3 monthly. Magnetic resonance imaging was performed at 1 week, 6 months, and 12 months. Elective prostate biopsy was performed between 6 and 12 months.</div></div><div><h3>Results</h3><div>A total of 102 patients underwent FT between 2019 and 2024. The cohort consisted of 44 (43.1%) patients for focal HIFU, 18 (17.6%) patients for focal cryotherapy, and 40 (39.2%) patients for TMA. D'Amico low-, intermediate-, and high-risk patients accounted for 31 (30.4%), 66 (64.7%), and 5 (4.9%) patients, respectively. Referring to tumor location, focal HIFU had 38 (86.4%) posterior tumors, focal cryotherapy had 12 (72.2%) anterior tumors, and TMA had 31 (77.5%) anterior tumors. Biopsy data were available for 63 patients (61.8%). Clinically significant recurrence (International Society of Urological Pathology grade group: ≥2) were found in 7 patients (11.1%). Subsequent salvage treatment included the following cases: robotic radical prostatectomy: 2, radiotherapy: 4, and second focal cryotherapy: 1. No deterioration in Expanded Prostate Cancer Index Composite score was observed across all domains before and after the treatment. Improvement in the Urinary Irritative/Obstructive domain was observed in focal cryotherapy (78.3 vs. 91.5, <em>P</em> = 0.011) and TMA (75.7 vs. 84.9, <em>P</em> = 0.019) at 12 months.</div></div><div><h3>Conclusions</h3><div>Multimodality FT with <em>à la carte</em> approach provides versatility in ablative strategies and offers a reasonable functional and oncological outcome for low- to intermediate-risk prostate cancer.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"13 4","pages":"Pages 201-206"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of 7-tesla ex vivo and conventional 3-tesla magnetic resonance imaging for prostate cancer staging","authors":"Taek Min Kim ,&nbsp;Sang Hun Song ,&nbsp;Sung Il Hwang ,&nbsp;Sung Kyu Hong ,&nbsp;Seok-Soo Byun ,&nbsp;Gheeyoung Choe ,&nbsp;Hye Mi Jee ,&nbsp;Sung Woo Park ,&nbsp;Hyungwoo Ahn","doi":"10.1016/j.prnil.2025.06.002","DOIUrl":"10.1016/j.prnil.2025.06.002","url":null,"abstract":"<div><h3>Background</h3><div>Conventional 3T magnetic resonance imaging (MRI) shows limited sensitivity for predicting extraprostatic extension (EPE) and frequently underestimates prostate tumor size versus pathology. Ultrahigh-field (7T) <em>ex vivo</em> MRI—performed on prostatectomy specimens after surgery—may overcome these limitations through superior spatial resolution and tissue contrast.</div></div><div><h3>Materials and methods</h3><div>In this prospective study, 20 patients with biopsy-proven prostate cancer underwent preoperative 3T <em>in vivo</em> MRI followed by 7T <em>ex vivo</em> MRI of radical prostatectomy specimens. Two experienced uroradiologists independently assigned EPE scores (a 5-point scale modified from International Society of Urological Pathology (ISUP) guidelines) and measured tumor dimensions on both modalities; histopathology served as the reference standard. A clarity score quantified the deviation of each EPE score from an equivocal midpoint. Statistical analyses included logistic regression for EPE prediction, receiver operating characteristic curve analysis for diagnostic performance, Wilcoxon signed-rank testing for paired comparisons of clarity scores and size discrepancies, weighted kappa for inter-reader agreement, and intraclass correlation coefficients (ICCs) for MRI–pathology size concordance.</div></div><div><h3>Results</h3><div>The 7T MRI EPE score was the only significant predictor of pathologic EPE (odds ratio: 4.40, <em>P</em> = 0.02) and achieved an area under the receiver operating characteristic curve of 0.86 versus 0.61 for 3T (<em>P</em> = 0.06). Clarity scores improved on 7T (<em>P</em> &lt; 0.01), with inter-reader agreement rising from κ = 0.32 (3T) to κ = 0.53 (7T). Both modalities underestimated tumor size, but the median discrepancy was significantly lower with 7T (2.0 mm vs. 6.0 mm; <em>P</em> &lt; 0.01), and size concordance improved from ICC = 0.48 (3T) to ICC = 0.70 (7T).</div></div><div><h3>Conclusions</h3><div>The 7T <em>ex vivo</em> MRI enhances the diagnostic accuracy, clarity, and reproducibility of EPE assessment and reduces tumor size underestimation compared to 3T MRI, supporting its potential role in optimizing preoperative prostate cancer staging.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"13 4","pages":"Pages 227-233"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transurethral water vapor therapy (Rezūm) for acute urinary retention with obstructive uropathy: a prospective cohort study with one-year follow-up","authors":"Brian W.H. Siu ,&nbsp;Jeremy M.H. Ho ,&nbsp;Steffi K.K. Yuen ,&nbsp;David K.W. Leung ,&nbsp;Alex Q. Liu ,&nbsp;Chris H.M. Wong ,&nbsp;Yvonne Y.Y. Chan ,&nbsp;Ivan C.H. Ko ,&nbsp;Chi Hang Yee ,&nbsp;Jeremy Y.C. Teoh ,&nbsp;Chi Fai Ng ,&nbsp;Peter K.F. Chiu ,&nbsp;Ka Lun Lo","doi":"10.1016/j.prnil.2025.08.001","DOIUrl":"10.1016/j.prnil.2025.08.001","url":null,"abstract":"<div><h3>Introduction</h3><div>This prospective cohort study evaluates the safety and efficacy of transurethral water vapor therapy (Rezūm) in men with acute urinary retention (AUR) complicated by obstructive uropathy (acute renal impairment).</div></div><div><h3>Patients and methods</h3><div>Obstructive uropathy was defined per 2012 Kidney Disease Improving Global Outcomes (KDIGO) Acute Kidney Injury (AKI) criteria. Rezūm was performed as an ambulatory procedure under local anesthesia. The primary outcome was the proportion of catheter-free patients at 3 and 12 months with stable renal function (i.e. serum creatinine not exceeding +0.3 mg/dL or 1.5 times baseline).</div></div><div><h3>Results</h3><div>Twenty-three consecutive patients were recruited (August 2023–February 2024). Median age was 71 years (interquartile range [IQR]: 67–80) and mean ± standard deviation of prostate size was 57.9 ± 13.8 mL. At 3- and 12-month follow-up, 96% (22/23) were catheter-free with stable renal function. Median time to successful trial without catheter (TWOC) was 36.5 days (IQR: 27.5–42.8 days). Prostate size decreased by 36.8% (P &lt; 0.001) at 3 months. Thirty-day readmissions occurred in 13% (3/23), all Clavien–Dindo grade 1–2.</div></div><div><h3>Conclusion</h3><div>Rezūm shows promise as a safe and effective procedure in AUR with obstructive uropathy, providing durable catheter independence in high-risk patients. It expands minimally invasive surgical therapies (MISTs) indications, particularly as an ambulatory option under local anesthesia.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"13 4","pages":"Pages 258-263"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of the prostate health index density for detecting clinically significant prostate cancer in patients with negative magnetic resonance imaging findings","authors":"Kazuhiko Oshinomi,&nbsp;Shota Kikuchi,&nbsp;Hirotaka Kishi,&nbsp;Anju Hayashi,&nbsp;Sho Okada,&nbsp;Masahiro Kurokawa,&nbsp;Toshiki Mugita,&nbsp;Yoshiki Tsunokawa,&nbsp;Tatsuki Inoue,&nbsp;Motoki Yamagishi,&nbsp;Yoshihiro Nakagami,&nbsp;Masakazu Nagata,&nbsp;Takashi Fukagai","doi":"10.1016/j.prnil.2025.08.004","DOIUrl":"10.1016/j.prnil.2025.08.004","url":null,"abstract":"<div><h3>Background</h3><div>Multiparametric magnetic resonance imaging (MRI) is widely used in prostate cancer diagnosis; however, a significant proportion of clinically important cancers can be missed in patients with negative MRI findings. Although attempts have been made to analyze prostate-specific antigen (PSA)-related parameters to improve the specificity of PSA testing, no evidence-based cutoff values have been established. This study aimed to evaluate the diagnostic performance of the prostate health index (PHI) and PHI density (PHID) in detecting clinically significant prostate cancer (csPCa) in the MRI-negative population.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 339 MRI-negative patients with PSA levels of 3–15 ng/mL who underwent PHI testing and MRI between September 2022 and July 2024. MRI-negative patients were defined as those with Prostate Imaging Reporting and Data System (PI-RADS) category 1 or 2 lesions. Biopsies were performed in 181 patients. The diagnostic accuracies of PSA, % free PSA, PHI, PSA density, and PHID were assessed using the receiver operating characteristic curves.</div></div><div><h3>Results</h3><div>Among the 47 patients with PI-RADS 1 or 2 who underwent biopsy, 24 (51.1%) had prostate cancer, of whom 16 (66.7%) had csPCa. The PHID showed the highest diagnostic performance (area under the curve [AUC] = 0.8832 for any cancer; AUC = 0.7843 for csPCa). Two patients with a PHI &lt;27.2 were diagnosed with low-risk cancer (Gleason 6).</div></div><div><h3>Conclusions</h3><div>The PHI and PHID may serve as valuable adjuncts to MRI for the detection of csPCa and may help avoid unnecessary biopsies in patients with negative MRI findings.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"13 4","pages":"Pages 271-275"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden of prostate cancer in China during 1990–2021 and the projections through 2050","authors":"Lei Hua ,&nbsp;Qiulin Huang ,&nbsp;Jinlei Zhang ,&nbsp;Ruijiao Lei ,&nbsp;Xukai Chen ,&nbsp;Xiaohua Tan ,&nbsp;Tianhua Chen ,&nbsp;Tianhui Chen","doi":"10.1016/j.prnil.2025.06.001","DOIUrl":"10.1016/j.prnil.2025.06.001","url":null,"abstract":"<div><h3>Background</h3><div>To provide the most up-to-date data on the burden of prostate cancer (PC) in China and the projections through 2050.</div></div><div><h3>Methods</h3><div>Using the Global Burden of Disease (GBD) database 2021, we investigated the characteristics of PC burden in China, including temporal trends in incidence, prevalence, mortality, and disability-adjusted life years (DALYs). Age-period-cohort models, frontier analysis, decomposition analysis and prediction models were used for data analyze.</div></div><div><h3>Results</h3><div>In 2021, the age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR) reached 9.34, 59.86, 4.89, and 76.97 (per 100 000), respectively. The ASIR and ASPR in 2021 increased by 87.17 % and 209.03 %, respectively, compared with 1990, while the ASMR and ASDR remained stable. The relative risk (RR) of PC increases with age, with the highest risk of incidence at 85–89 years. By 2050, the projected age-standardized rate for incidence and mortality are expected to reach 20.85 and 5.11 per 100,000, respectively. Decomposition analysis indicated that population aging and epidemiological shifts primarily drove the increasing PC burden in China.</div></div><div><h3>Conclusions</h3><div>We found that the burden of PC in China is rapidly rising, with an increasing proportion of young patients, posing a serious threat to men’s health in China currently and also in 2050. Our findings suggest strengthening early screening programs and prevention strategies for high-risk groups of PC in China.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"13 4","pages":"Pages 219-226"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal trends of prostate cancer diagnostics in Australia: Has the introduction of a magnetic resonance imaging prostate subsidy fulfilled its cost-saving promises?","authors":"Matthew Qiu ,&nbsp;Adib Rahman ,&nbsp;Lu Yu Kuo ,&nbsp;Kreyen Ponen ,&nbsp;Michael Chen","doi":"10.1016/j.prnil.2025.05.003","DOIUrl":"10.1016/j.prnil.2025.05.003","url":null,"abstract":"<div><h3>Background</h3><div>This study aims to assess whether magnetic resonance imaging of the prostate (MRIp) had a statistically significant effect on prostate biopsies in Australia and decreased biopsies performed in Australia. Temporal trends and cost-effectiveness of this policy were also analysed.</div></div><div><h3>Methods</h3><div>National and state-level data were obtained from the Australian Medicare Benefits Schedule from 1 January 2006 to 1 January 2024 on MRIp and prostate biopsies. A regression model was used to calculate the impact of MRIp use on the number of biopsies. Paired t-test was used to determine statistical significance between population-adjusted pre- and post-subsidy rates. Cost-effectiveness of the subsidy was calculated.</div></div><div><h3>Results</h3><div>MRIp had a statistically significant impact on biopsies, with an OR of 1.42 MRIps to biopsies (95% CI: 1.358, 1.473; <em>P</em> &lt; 0.0002) at a national level. State-level data suggested it impacted most, but not all, states. Population-adjusted prostate biopsy rates decreased from 215 per 100,000 men per year to 182 per 100,000 men following the introduction of MRIp subsidy (<em>P</em> = 0.02). Cost analysis suggests that MRIp subsidy has led to approximately $10 million in cost savings since 2018, although projected savings during policy proposal were vastly overestimated.</div></div><div><h3>Conclusion</h3><div>Government subsidised MRIp in Australia has a statistically significant effect on prostate biopsies. There has been a reduction in prostate biopsies, but this is likely more reflective of the rapid development and increasing complexity within prostate cancer diagnostics. Subsidy of MRI is questionable in its cost effectiveness.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"13 4","pages":"Pages 214-218"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oncologic outcomes of salvage radiotherapy and lymphadenectomy for positron emission tomography–positive lymph nodes in biochemical recurrence: A systematic review to inform treatment decisions","authors":"Yun-Jung Yang ,&nbsp;Kyungchan Min ,&nbsp;Jong Hyun Tae ,&nbsp;Chung Un Lee ,&nbsp;Joongwon Choi ,&nbsp;Jung Hoon Kim ,&nbsp;Eun-Jung Yang ,&nbsp;Tuan Thanh Nguyen ,&nbsp;Se Young Choi","doi":"10.1016/j.prnil.2025.05.002","DOIUrl":"10.1016/j.prnil.2025.05.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Positron emission tomography (PET) scans are widely used for detecting biochemical recurrence (BCR) in prostate cancer, yet evidence for salvage treatments of PET-positive lymph nodes remains limited. This study aimed to analyze the oncologic outcomes of salvage treatments, specifically lymph node dissection (LND) and radiotherapy (RT), in patients with BCR and PET-positive lymph node recurrence.</div></div><div><h3>Methods</h3><div>Systematic reviews and meta-analyses were performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search of PubMed, Cochrane, and Web of Science databases up to June 2023 was conducted. Inclusion criteria encompassed patients with BCR and PET-positive lymph node recurrence following definitive prostate cancer treatment, who underwent salvage LND or RT.</div></div><div><h3>Results</h3><div>A total of 38 publications involving 3,559 patients (1391 LND, 2168 RT) were included. Pooled incidence rates after LND and RT were as follows: prostate-specific antigen (PSA) response (56.4% vs. 78.9%), PSA progression (61.3% vs. 36.0%), image progression (44.9% vs. 34.9%), systemic progression (41.3% vs. 35.0%), overall mortality (3.0% vs. 4.8%), and cancer-specific mortality (8.4% vs. 4.1%). Subgroup analyses by prostate-specific membrane antigen (PSMA) PET scan, PSA level ≤2 ng/ml at PET scan, and androgen deprivation therapy usage with salvage therapy revealed varied outcomes.</div></div><div><h3>Conclusions</h3><div>Despite salvage LND or RT, about half of BCR patients with PET-positive nodal recurrence showed disease progression, suggesting limited effectiveness of focal therapies alone. RT appeared to provide better short-term disease control than LND, highlighting the importance of treatment selection. The study underscores the necessity for further investigation into optimal salvage management strategies for BCR using PET in prospective clinical studies.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"13 4","pages":"Pages 191-200"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical implication of peri-seminal vesicle soft-tissue invasion in patients with pT3b prostate cancer","authors":"Sungun Bang ,&nbsp;Su-Jin Shin ,&nbsp;Do Kyung Kim ,&nbsp;Jong Kyou Kwon ,&nbsp;Jinhyung Jeon ,&nbsp;Kang Su Cho","doi":"10.1016/j.prnil.2025.06.005","DOIUrl":"10.1016/j.prnil.2025.06.005","url":null,"abstract":"<div><h3>Background</h3><div>Prognosis of patients with prostate cancer seminal vesicle invasion (SVI) varies considerably, suggesting that SVI may be a heterogeneous pathological entity. This study aimed to perform a detailed histopathological analysis of seminal vesicle (SV) specimens in prostate cancer to better characterize SVI and evaluate its clinical significance.</div></div><div><h3>Materials and methods</h3><div>We retrospectively reviewed a database of robotic prostatectomies performed between July 2020 and December 2024. Since July 2020, a refined histopathological protocol has been employed in which the prostate and SVs are axially sectioned and separated, and the SVs and vas deferens are sectioned along their natural anatomical axis. This approach allowed a detailed assessment of SV stromal invasion, peri-SV soft-tissue involvement, and surgical margin status.</div></div><div><h3>Results</h3><div>We identified 73 patients with pT3b prostate cancer. Unilateral SVI was present in 40 patients (54.8%) and bilateral SVI in 33 patients (45.2%). Notably, peri-SV soft-tissue invasion was observed in 54 patients (74.0%), with it being unilateral in 28 (38.4%) and bilateral in 26 (35.6%). Positive surgical margins in the peri-SV soft-tissue were found in five patients (9.3%). Among 58 patients who underwent pelvic lymph node dissection without preoperative androgen deprivation therapy, 25 (43.1%) had lymph node metastases. On multivariate analysis, lymph node metastasis was significantly associated with lymphovascular invasion only, but not with peri-SV soft-tissue invasion.</div></div><div><h3>Conclusion</h3><div>In pT3b patients, peri-SV soft-tissue invasion and lymph node metastasis are common. These findings suggest that a more radical surgical approach is warranted in patients with suspected SVI.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"13 4","pages":"Pages 246-252"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative tadalafil for recovery of continence and voiding function after radical prostatectomy for prostate cancer: a single-center experience","authors":"Sang Hun Song ,&nbsp;Hae Sung Lee ,&nbsp;Younsoo Chung ,&nbsp;Hyung Joon Kim ,&nbsp;Hakmin Lee ,&nbsp;Jong Jin Oh ,&nbsp;Sangchul Lee ,&nbsp;Seok-Soo Byun ,&nbsp;Sung Kyu Hong","doi":"10.1016/j.prnil.2025.06.004","DOIUrl":"10.1016/j.prnil.2025.06.004","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the impact of postoperative tadalafil on the recovery of erectile function, voiding function, and urinary continence in patients undergoing radical prostatectomy (RP) for prostate cancer.</div></div><div><h3>Materials and methods</h3><div>A retrospective analysis was conducted on 4,173 patients who underwent RP. Patients were categorized based on postoperative use of tadalafil. Functional outcomes were assessed using the International Index of Erectile Function (IIEF-5) and the International Prostate Symptom Score (IPSS), along with continence status and oncologic parameters. Statistical analyses included chi-square and t-tests.</div></div><div><h3>Results</h3><div>In the final cohort, 916 patients received postoperative tadalafil and were compared to 3,257 patients without any phosphodiesterase type 5 (PDE5) inhibitor therapy. While early postoperative erectile function was lower in the tadalafil cohort at 1 month, recovery was superior by 12 months (IIEF-5: 5.9 ± 5.5 vs. 4.8 ± 5.6, p = 0.002). Voiding function also declined less markedly postoperatively (IPSS increase: 1.4 vs. 2.4 points), with significant improvement maintained through 12 months. Social continence rates were higher in the tadalafil group (95.1% vs. 92.6 %, p = 0.009), and biochemical recurrence was lower (11.7% vs. 25.7%, p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Postoperative tadalafil is associated with improved recovery of erectile and voiding function, as well as higher continence rates, without compromising oncologic outcomes. These findings support its consideration as part of routine postoperative management in selected RP patients.</div></div>","PeriodicalId":20845,"journal":{"name":"Prostate International","volume":"13 4","pages":"Pages 234-238"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145712407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}