Seminars in urologic oncology最新文献_第9页

Erectile function after radical prostatectomy. 根治性前列腺切除术后的勃起功能。

Seminars in urologic oncology Pub Date : 2000-02-01

J J Mulcahy

{"title":"Erectile function after radical prostatectomy.","authors":"J J Mulcahy","doi":"","DOIUrl":"","url":null,"abstract":"The early detection of prostate cancer through the use of prostate-specific antigen screening has resulted in the performance of many more radical prostatectomy procedures as a curative treatment for this disease. Many patients who are candidates for this procedure already suffer from erectile dysfunction, and the incidence of inadequate erections following radical prostatectomy is certainly high. Nerve-sparing procedures during performance of this operation are encouraged as the incidence of erectile dysfunction is lower if one or both nerves are spared. If the patient is already impotent before the procedure, medical treatments with oral agents, intraurethral compounds, or intracorporally injected medications may be more effective with the nerves intact. Early institution of medical therapy, specifically intracorporal injections, after 2 months postoperatively has resulted in a higher incidence of spontaneous return of erections at 1 year. Vacuum erection devices may be successful in restoring erections but extensive practice in their use is necessary, and they may be unappealing to many patients. A penile prosthesis will restore erections if the patient is so motivated for implantation of such a device. These are expensive and require invasive surgery, but satisfaction rates among patients and partners who have used them have been in the range of 85%, the highest satisfaction rate among all of the treatments of erectile dysfunction.","PeriodicalId":79436,"journal":{"name":"Seminars in urologic oncology","volume":"18 1","pages":"71-5"},"PeriodicalIF":0.0,"publicationDate":"2000-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21571551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparison of patients' and physicians' rating of urinary incontinence following radical prostatectomy. 根治性前列腺切除术后患者与医生对尿失禁的评价比较。

Seminars in urologic oncology Pub Date : 2000-02-01

J T Wei, J E Montie

{"title":"Comparison of patients' and physicians' rating of urinary incontinence following radical prostatectomy.","authors":"J T Wei, J E Montie","doi":"","DOIUrl":"","url":null,"abstract":"One of the most important endpoints following a radical prostatectomy focuses on the recovery of urinary continence; however, the reported incontinence rates have been quite variable. In men with prostate cancer, it has been found that the physician's assessment of a patient's symptom does not correlate with the patient's own assessment. To further explore the differences in the reported outcomes between physicians and patients, we evaluated the assessment of urinary incontinence in a cohort of men undergoing radical prostatectomy. A total of 145 individuals completed a brief urinary continence questionnaire postoperatively at the 1-year anniversary of their operation and also had the physicians' assessment of incontinence documented in the medical record. Patient-reported incontinence rates varied from 13% to 65% depending on the definition of incontinence applied and the greatest agreement was seen when the physicians' assessment of incontinence was compared with the patient's report of pad use and urinary bother. These comparisons resulted in only moderate to good levels of agreement, which suggests that a more reliable and accurate means to evaluate urinary incontinence following radical prostatectomy needs to be developed.","PeriodicalId":79436,"journal":{"name":"Seminars in urologic oncology","volume":"18 1","pages":"76-80"},"PeriodicalIF":0.0,"publicationDate":"2000-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21571552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Management of the dorsal vein complex during radical retropubic prostatectomy. 根治性耻骨后前列腺切除术中背静脉复群的处理。

Seminars in urologic oncology Pub Date : 2000-02-01

M O Koch

引用次数: 0

Bladder-neck preservation during radical retropubic prostatectomy. 根治性耻骨后前列腺切除术中膀胱颈的保存。

Seminars in urologic oncology Pub Date : 2000-02-01

M S Soloway, E Neulander

引用次数: 0

Radical prostatectomy and collaborative care pathways. 根治性前列腺切除术和协同护理途径。

Seminars in urologic oncology Pub Date : 2000-02-01

J M Holzbeierlein, J A Smith

引用次数: 0

Anatomy and innervation of the rhabdosphincter of the male urethra. 男性尿道横纹肌的解剖与神经支配。

Seminars in urologic oncology Pub Date : 2000-02-01

H Strasser, G Bartsch

{"title":"Anatomy and innervation of the rhabdosphincter of the male urethra.","authors":"H Strasser, G Bartsch","doi":"","DOIUrl":"","url":null,"abstract":"The rhabdosphincter of the male urethra and its innervation are still a subject of controversy. Essentially, two concepts of its anatomy can be found in the literature. Some authors describe the rhabdosphincter as part of the urogenital diaphragm caudal to the prostate, others as a striated muscle that extends from the base of the bladder to the \"urogenital diaphragm.\" In anatomic histological studies, the rhabdosphincter and its innervation were examined by means of anatomical dissections and serial anatomical as well as histological sections of 19 male pelves, including 8 fetal specimens. The rhabdosphincter presents as a vertical structure extending from the bulb of the penis to the region of the bladder neck along the prostate and the membranous urethra. Inserting dorsally in the perineal body via a broad tendinous raphe, the striated muscle fibers form an omega-shaped loop around the anterior and lateral aspects of the membranous urethra. The existence of a \"urogenital diaphragm\" and a strong, circular, striated \"external sphincter urethrae\" completely encircling the urethra caudal to the apex of the prostate cannot be confirmed by anatomical and histological investigations. The rhabdosphincter is supplied by branches of the pudendal nerve after leaving the pudendal canal.","PeriodicalId":79436,"journal":{"name":"Seminars in urologic oncology","volume":"18 1","pages":"2-8"},"PeriodicalIF":0.0,"publicationDate":"2000-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21572353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predictive factors in prostate cancer: current concepts from the 1999 College of American Pathologists Conference on Solid Tumor Prognostic Factors and the 1999 World Health Organization Second International Consultation on Prostate Cancer. 前列腺癌的预测因素:1999年美国病理学会实体瘤预后因素会议和1999年世界卫生组织第二届前列腺癌国际磋商会的最新概念。

Seminars in urologic oncology Pub Date : 1999-11-01

D G Bostwick, C S Foster

{"title":"Predictive factors in prostate cancer: current concepts from the 1999 College of American Pathologists Conference on Solid Tumor Prognostic Factors and the 1999 World Health Organization Second International Consultation on Prostate Cancer.","authors":"D G Bostwick, C S Foster","doi":"","DOIUrl":"","url":null,"abstract":"Many clinically important predictive factors in prostate cancer are derived from light microscopic examination of tissue specimens by the pathologist. Two separate international consensus conferences held in 1999 addressed the contemporary status of such prognostic factors, sponsored by the College of American Pathologists (CAP) and the World Health Organization (WHO). Both conferences concluded that the following factors are recommended for routine use based on evidence from multiple published trials: TNM stage, histological grade using the Gleason system, surgical margin status, and serum prostate-specific antigen concentration. The WHO conference additionally recommended use of WHO nuclear grade, location of cancer within the prostate, and pathological effects of treatment. Other factors were categorized as promising or of unproven utility, including a wide variety of histopathologic and genetic markers. Standards are needed for analysis and quantitation of methods of tissue analysis, particularly for immunohistochemical studies and genotypic studies. This report describes the recommendations and conclusions of these two conferences.","PeriodicalId":79436,"journal":{"name":"Seminars in urologic oncology","volume":"17 4","pages":"222-72"},"PeriodicalIF":0.0,"publicationDate":"1999-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21490089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Overdiagnosis of prostatic adenocarcinoma. 前列腺癌的过度诊断。

Seminars in urologic oncology Pub Date : 1999-11-01

D G Bostwick, L Chang

{"title":"Overdiagnosis of prostatic adenocarcinoma.","authors":"D G Bostwick, L Chang","doi":"","DOIUrl":"","url":null,"abstract":"A wide variety of histopathologic mimics of prostatic adenocarcinoma have been recently described, which may cause overdiagnosis of malignancy. To our knowledge, the frequency and causes of overdiagnosis of prostate cancer have not been previously examined. Two pathologists evaluated the Mayo Clinic experience with small foci of stage T1a cancer diagnosed between 1960 and 1970 in an effort to identify cases that were overdiagnosed as cancer. Only cases with available diagnostic slides and blocks were re-evaluated, and immunohistochemical studies were obtained in select cases to confirm the amended diagnoses. Follow-up was obtained in all cases from patient medical records. We identified a total of 31 patients who were overdiagnosed with prostatic carcinoma from among a series of 150 cases initially diagnosed as well-differentiated stage T1a cancer (21% incidence). Patients ranged in age from 42 to 85 years, and the weight of the transurethral resections varied from 6 to 90 g. Findings misinterpreted as cancer included atypical adenomatous hyperplasia (8 cases), basal cell hyperplasia (8), atrophy (5), sclerosing adenosis (3), high-grade prostatic intraepithelial neoplasia (3), xanthogranulomatous prostatitis (2), florid cribriform hyperplasia (1), and post-atrophic hyperplasia (1). None of the patients received additional treatment for prostatic disease. Mean follow-up was 10.8 years; 14 patients were alive with no evidence of disease, 14 died of intercurrent disease without recurrent prostatic disease, and the status of 3 was unknown. We conclude that misinterpretation of prostate cancer in transurethral resection specimens results from overdiagnosis of small microscopic foci of hyperplasia, atrophy, prostatic intraepithelial neoplasia, and granulomatous inflammation. The incidence of overdiagnosis three decades ago was 21% of small foci in transurethral resections, usually resulting from the presence of undescribed pathological entities. Long-term follow-up revealed no evidence of recurrent prostatic disease.","PeriodicalId":79436,"journal":{"name":"Seminars in urologic oncology","volume":"17 4","pages":"199-205"},"PeriodicalIF":0.0,"publicationDate":"1999-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21490087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prostate-specific antigen and other serum markers: current concepts from the World Health Organization Second International Consultation on Prostate Cancer. 前列腺特异性抗原和其他血清标志物:来自世界卫生组织第二届前列腺癌国际磋商会的当前概念。

Seminars in urologic oncology Pub Date : 1999-11-01

M K Brawer, M C Benson, D G Bostwick, B Djavan, H Lilja, A Semjonow, S Su, Z Zhou

引用次数: 0

Prostate biopsy 1999: strategies and significance of pathological findings. 前列腺活检1999:病理结果的策略和意义。

Seminars in urologic oncology Pub Date : 1999-11-01

K A Iczkowski, D G Bostwick

引用次数: 0