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Query: UMLS:C0376358 (prostate cancer)
 59,338 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Erectile dysfunction was evaluated in 459 men with prostate cancer before and after radical prostatectomy. Potency was defined as the ability to achieve unassisted intercourse with vaginal penetration. Of the patients 51 were potent postoperatively, including 2 of 187 (1.1%) undergoing surgery without nerve sparing, and 27 of 203 (13.3%) undergoing unilateral and 22 of 69 (31.9%) undergoing bilateral nerve sparing prostatectomy. Less than half of the patients who were sexually active postoperatively were satisfied with the erections or achieved intercourse at least once a month. Postoperative potency was statistically related to the number of neurovascular bundles spared, frequency of intercourse preoperatively, absence of seminal vesicle or lymph node involvement with cancer, absence of postoperative incontinence or strictures, patient age and cancer volume.
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PMID:Nerve sparing radical prostatectomy: a different view. 777 12

The authors performed radical prostatectomy on 35 prostate cancer patients between 1986 and 1991. At the end of 1993 the authors were informed about 25 patients. The mean follow-up was 4.4. years. Two patients have died in tumour related diseases, one in intercurrent diseases. In six patients progression was observed. Five patients had to operated because of anastomosis stricture. One patient was operated because of total incontinence another one uses penis clamp.
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PMID:[Follow up of patients with prostatic cancer after radical prostatectomy: results, late complication, survival rate]. 788 88

The authors studied the morbidity of retropubic radical prostatectomy in 150 patients operated between December 1983 and March 1993. The perioperative mortality was zero. A rectal injury occurred in 3 cases (2%) and was repaired immediately without colostomy. The median operative blood loss was 1,500 ml. 36.6% of cases developed perioperative complications. 8% of early postoperative complications (< 1 month) required reoperation. Major complications (thromboembolic and septic) were observed in 3.2% of cases. The late postoperative complications included fibrous stenosis of the urethrovesical anastomosis in 12% of cases with a median time to onset of 4 months: 3.6% of patients developed an anastomotic stenosis due to local recurrence. 12.6% of cases developed persistent urinary incontinence (6.6% of minor incontinence, 5.3% of moderate incontinence and 0.7% of severe incontinence). Incontinence was more frequent (p < 0.05) among the first 75 patients of the series. Erectile function was preserved in 19.8% of patients. The incidence of post-operative impotence was significantly lower (p < 0.01) in patients under the age of 60 years (65% vs 94.8%). Radical prostatectomy, considered to be the most appropriate treatment for localised prostatic cancer, can now be performed with acceptable morbidity.
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PMID:[The morbidity of radical prostatectomy using a retropubic approach: a series of 150 cases]. 792 Jul 28

The young and the elderly patients with surgically resectable prostate cancer require considerations unique to their age group. From 1966 to 1988, 191 patients who were < or = 55 years old and 51 elderly patients who were > or = 75 years old underwent radical retropubic prostatectomy. Compared with younger patients, elderly patients had a higher pathologic stage (71 versus 45% stage pT3 or greater, p < 0.001) and higher-grade lesions (49 versus 21%, p < 0.001). Survival was significantly worse compared with age-matched controls for younger patients with high-stage or high-grade lesions (p < 0.001). No elderly patients died within the first 5 years after hospital dismissal. Two thirds of elderly as well as younger patients had no perioperative complications. Significant urinary incontinence occurred in 16% of the elderly compared with 3% of the younger patients (p = 0.001) at 1 year. These data reflect our philosophy of using surgical treatment for patients with unfavorable, large-volume disease even when patients are elderly; if well-selected, these patients can have excellent survival. The observed higher incontinence rate in the elderly should be part of the discussion with the patient before operation.
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PMID:Radical retropubic prostatectomy for prostate cancer in the elderly and the young: complications and prognosis. 805 22

Today's older generation of men were raised to believe that men and boys do not cry or talk about their feelings. Fear, anger, confusion and depression are common reactions to all cancers. Prostate cancer carries the additional concerns of impotence, incontinence, and loss of self-esteem. Through support and self-help groups such as Us Too, survivors of prostate cancer, their families, and the medical community are coming together to share their feelings and concerns and learn from each other. By keeping up-to-date with accurate information relative to the disease, survivors of prostate cancer are better able to work through the dilemmas of their disease and move forward with their lives. An informed survivor is an informed patient. Working with the American Foundation for Urologic Disease, Us Too has grown into a nationwide network of family-centered prostate support groups. The motto "learning to cope though knowledge and hope" succinctly describes how these support groups have transformed the lives of survivors of prostate cancer and their families from coast to coast.
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PMID:The role of the support group, "Us Too". 808 89

Total prostatectomy in the properly selected patient will provide disease-free survival rates comparable to the expected survival in similarly aged men for up to 30 years of observation (Figure 4). Patients who undergo total prostatectomy accept a very small risk of long-term permanent complications or mortality, and effective treatment is available for most complications. The morbidity and costs associated with hormone refractory metastatic prostate cancer are significant, with bone pain and anemia from bone marrow invasion, bladder dysfunction (retention, incontinence, and hematuria), urinary tract infection, anorexia, and uremia from obstructed ureters being common sequelae in the months before death. In the properly selected patient, minimal risk is incurred from total prostatectomy, the potential complications are well defined and manageable, and long-term disease-free survival is seen in most patients.
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PMID:Localized prostate carcinoma. Surgical management. 822 51

To estimate the probabilities of complications and follow-up treatment, a sample of Medicare patients who underwent radical prostatectomy (1988 through 1990) was surveyed by mail, telephone, and personal interview. Respondents reported their current status with respect to continence and sexual function as well as post-surgical treatments they had had to treat residual or recurrent cancer or surgical complications. Over 30 percent reported currently wearing pads or clamps to deal with wetness; over 40 percent said they drip urine when they cough or when their bladders are full; 23 percent reported daily wetting of more than a few drops. About 60 percent of patients reported having no full or partial erections since their surgery, and only 11 percent had any erections sufficient for intercourse during the month prior to the survey. Six percent had surgery after the radical prostatectomy to treat incontinence; 15 percent had treatments or used devices to help with sexual function; 20 percent report having had post-surgical treatment for urethral strictures. In addition 16 percent, 22 percent, and 28 percent reported follow-up treatment for cancer (radiation or androgen deprivation therapy) at two, three, and four years after radical prostatectomy. These estimates of complication and follow-up treatment rates are generally higher, and almost certainly more representative for older men, than estimates previously published. Patients and physicians may want to weight heavily the complications and need for follow-up treatments when considering radical prostatectomy for prostate cancer.
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PMID:Patient-reported complications and follow-up treatment after radical prostatectomy. The National Medicare Experience: 1988-1990 (updated June 1993). 825 94

Prostate cancer is the most common cancer in men and the second leading cause of cancer deaths. New advances in screening and imaging allow earlier diagnosis, and improved surgical techniques have reduced sexual dysfunction and incontinence that often resulted from radical prostatectomy. However, many questions remain. How can prostate cancer best be detected in an early curable form? What is the role of tumor markers? Who should be screened and how? What prognostic tools can help with decisions about appropriate therapy?
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PMID:Cancer of the prostate. 829 Aug 19

To examine the role of radical retropubic prostatectomy in clinically localised prostatic cancer we reviewed a series of 201 patients all of whom had undergone bilateral pelvic lymphadenectomy. Frozen section showed metastatic pelvic lymph nodes in 13 cases and 6 cases were too locally advanced for operation; prostatectomy was done for the remaining 182. The pathological staging was based on examination of sections of the whole organ. In 109 (60%) the carcinoma was confined to the prostate gland or to the specimen, in 46 (25%) there was carcinomatous growth in the surgical margin, and in 27 (15%) there was invasion of the seminal vesicles. The Gleason score was significantly higher in cases with involvement of the surgical margin or seminal vesicles. There was one operative death (of pulmonary embolism), and the postoperative cardiovascular morbidity was 7%. The incidence of wound infection was 6%, and there were two rectal injuries and three symptomatic lymphoceles. A total of 135/170 evaluable patients (79%) were completely continent postoperatively, and only two developed severe incontinence. Erectile potency was preserved in 24 of 126 (19%). We conclude that radical retropubic prostatectomy is safe and that the complication rate is acceptable. The completeness of the tumour excision seems to be associated with the pathological grade of the tumour.
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PMID:Radical retropubic prostatectomy for localised prostatic carcinoma: a clinical and pathological study of 201 cases. 835 76

The value of early detection, via screening and/or treatment of localised prostate cancer has not been established in well-designed clinical trials. However, radical prostatectomy in localised disease can be justified for a number of reasons. Cure of localised prostate cancer is necessary: 3% of men over 50 years of age will die of prostate cancer. Cure is possible: prostate tumours take 10-15 years to grow from 0.5 cm3 to, for example, 8 cm3--the window where cure is possible by radical prostatectomy. Large series of studies show that the probability of remaining progression free, as determined by prostate specific antigen, can be up to 90% for pT2 tumours and 60-75% for pT3a/b tumours. A radical, anatomic technique is necessary with a low positive margin rate (zero in pT2 tumours) to achieve such results. Radical prostatectomy has a low morbidity: perioperative mortality is far below 1%, complete continence rate is 80-90%, complete incontinence rate 4%, stricture rate 6%, and relaparotomy rate <5%. To conclude, in suitable patients (for example, younger than 70 years of age) with tumours at suitable stages, cure is necessary, possible, and safe using the right technique of radical prostatectomy.
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PMID:The risks outweigh the benefits of radical prostatectomy in localised prostate cancer: the argument against. 871 59


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