ABSTRACT
【Objective】 To investigate the risk factors and clinical significance of incidental prostate cancer (IPCa) in patients undergoing radical cystoprostatectomy (PCR). 【Methods】 The clinicopathological data of 260 patients undergoing RCP in our hospital during Jan. 2010 and Jan. 2022 were retrospectively analyzed, including 39 cases of IPCa detected with postoperative pathology, and 221 non-IPCa cases. 【Results】 The detection rate of IPCa was 15%. Univariate logistic regression analysis showed age (P<0.001), smoking (P<0.05), T stage (P<0.05), number of tumors (P<0.05), involvement of trigone (P<0.05), prostate volume (P<0.05), and preoperative total prostate-specific antigen (tPSA) (P<0.05) were influencing factors of prostate cancer. Multivariate logistic regression analysis showed that age (OR=1.061, 95%CI: 1.021-1.107, P=0.004), smoking (OR=2.852, 95%CI: 1.296-6.677, P=0.012), involvement of trigone(OR=2.967, 95%CI: 2.365-3.657, P=0.019) and preoperative tPSA (OR=1.109, 95%CI: 1.011-1.223, P=0.030) were independent risk factors of IPCa. 【Conclusion】 Advanced age, smoking, bladder tumor in trigone and preoperative PSA abnormality are risk factors for incidental prostate cancer in bladder cancer patients.
ABSTRACT
Objective To assess the incidence,clinic feature,pathological characteristics and prognosis of incidental prostate cancer from specimens via radical cystoprostatectomy (RCP) for muscleinvasive bladder cancer.The postoperative erectile function in patients with NVB operation are also to be evaluated.Methods Between Jan 2002 and Jan 2015,150 male patients with bladder cancer who underwent radical cystoprostatectomy in our center were included in this study.133 patients underwent open surgery and 17 cases underwent laparoscopic operation (13 patients underwent NVB operation).The average age of 150 patients was 63 years (ranging 41 to 83 years).The average tPSA was 3 ng/ml(ranging 0.2 to 7.8 ng/ml).The digital rectal examination was negative,CT results didnt exhibit the evident of abnormality in prostate.Results Overall,incidental prostate cancer was diagnosed in 11 male patients (7.3％).The pathological diagnosis are all prostatic adenocarcinoma.In those patients,the mean age was 65.5 years (ranging 42 to 82 years).The mean tPSA at the time of surgery was 2.6 ng/ml (0.3-4.0 ng/ml).There was no statistical significance of tPSA values in the incidental prostate cancer group and non risk group (2.6vs.3.2ng/ml)(P ＞ 0.05).The preoperative enhanced CT imaging showed normal prostate in 7 cases,prostate hyperplasia in 2 cases,prostate calcification in 1 cases and bladder cancer invasion into the prostate in 1 cases.9 cases of incidental prostate cancer are low risk grade (Gleason score ≤ 6,the clinical stage ≤T2).Among 11 cases,bladder cancer histologic type in 10 cases was transitional cell carcinoma and small cell carcinoma in 1 case.According to the TNM classification,4 cases were less than pT2 stage and 7 cases were more than pT3 stage.11 patients were followed up between 6 to 24 months (mean 10 months).All patient survived at the end of study without the treatment of castration.Among 13 cases accepted NVB operation,8 cases achieve the preoperative level of erectile function to achieve.Conclusions The rate of incidental prostate cancer from RCP specimens is low,Most patients have low risk level,and there was no statistical significance of tPSA values between the incidental prostate cancer group and non risk group.
ABSTRACT
Se presenta caso de varón, fumador crónico, con tumor vesical operado con la técnica de Paduana, con excelente postoperatorio.
A case report of male chronic smoker with bladder tumor operated with the Paduana technique, with excellent postoperative.
ABSTRACT
Objective To study a new method of opening prostatectomy.Methods 71 cases of benign prostatic hyperplasia (BPH) patients were divided into three group at random;treating group:prostatectomy by transfixing inferior vesical artery and reserving posterior urethra(n=21),control group Ⅰ:Millin operation(n=18) and control group Ⅱ:cystoprostatectomy through superior pectineus(n=32),the clinical effect was studied and observated.Results All 71 cases of patients were BPH according to pathology reports.Treating group had lower incidence than that of control group in injury of urethra,bleeding after operation,the times of irrigation of urinary bladder,urinary incontinence in the near future,secondary bleeding,urinary tract infection,bladder spasm,urethral stricture,and so on.Conclusions Prostatectomy by transfixing inferior vesical artery and reserving posterior urethra has many virtues such as simple,soon to discharge,cheapness of medical cost,and easy to spread.