ABSTRACT
The aim of the study was to evaluate the effect of the acupuncture treatment on sperm parameters and pregnancy rates in patients with primary infertility. Between January 2008 and May 2010, 30 men with the primary infertility (one year of unprotected intercourse, healthy wife) and varicocele with normal hormone levels and abnormal semen analysis were randomised into two groups. Group 1 underwent subinguinal microscopic varicocelectomy, and Group 2 underwent acupuncture treatment twice a week for 2 months. Both groups were evaluated with semen analysis at 6 months after the treatment. Patients in both groups evaluated with telephone calls and e-mail in terms of pregnancy. The mean age of the patients was 27.2, and groups were comparable regarding the age (P = 0.542). The pre-treatment sperm concentration, motility and morphological characteristics were similar in both groups. Sperm concentration and motility improved significantly in both groups after the treatment. Increase in sperm concentration was higher in the acupuncture group compared to the varicocelectomy group (P = 0.039). The average follow-up was 42 months, and pregnancy rates were emphasised 33% in both groups. Acupuncture treatment in primary infertile varicocele patients with semen abnormalities seems to be effective and has comparable results with the varicocelectomy treatment.
Subject(s)
Infertility, Male/therapy , Microsurgery/methods , Sperm Motility/physiology , Spermatozoa/cytology , Urogenital Surgical Procedures/methods , Varicocele/therapy , Acupuncture Therapy , Adult , Humans , Infertility, Male/physiopathology , Infertility, Male/surgery , Male , Semen Analysis , Sperm Count , Treatment Outcome , Varicocele/physiopathology , Varicocele/surgery , Young AdultABSTRACT
BACKGROUND: Robot-assisted radical prostatectomy (RARP) is a rising minimally invasive treatment of localized prostate cancer (PC). We present our multicenter experience of 1,499 consecutive cases with an analysis of complication rates, oncologic, and functional outcomes. PATIENTS AND METHODS: From March 2005 through December 2012, details of 1,499 patients were retrospectively analyzed. Transperitoneal approach using a da-Vinci robotic system was used to perform RARP. Perioperative characteristics and postoperative oncologic and functional outcomes are reported. RESULTS: The mean age was 61.3 years (37-77). Mean PSA level was 8.3 ng/ml. According to D'Amico classification, the percentage of patients with low-, intermediate-, and high-risk disease cases were 65.0, 30.1, and 4.8 %, respectively. Mean operative time was 181.9 min. Mean estimated blood loss was 225.4 cc (30-1,250). Positive surgical margin (PSM) was detected in 212 (14.1 %) patients. PSM rates in pT2, pT3, and pT4 stages were 6.1, 37.1, and 100 %, respectively. The overall complication rate due to modified Clavien classification was 6.1 %. Mean follow-up time was 26.7 months. Continence, potency, and biochemical recurrence rates were 88.7, 58.2, and 2.9 %, respectively. CONCLUSIONS: Our analyses including high-volume centers, which is the first largest series in Turkey, show that RARP is a safe procedure, has low PSM rates, high continence, and potency rates for the treatment of localized PC at experienced centers.
Subject(s)
Neoplasm Recurrence, Local/epidemiology , Postoperative Complications/epidemiology , Prostatectomy , Prostatic Neoplasms/surgery , Robotic Surgical Procedures , Sexual Dysfunction, Physiological/epidemiology , Urinary Incontinence/epidemiology , Adult , Aged , Humans , Kallikreins/blood , Male , Middle Aged , Neoplasm Recurrence, Local/blood , Neoplasm Staging , Prostate-Specific Antigen/blood , Prostatic Neoplasms/blood , Prostatic Neoplasms/pathology , Retrospective Studies , Treatment Outcome , TurkeyABSTRACT
INTRODUCTION AND OBJECTIVES: We aim to compare the first year oncological and functional outcomes of Retzius-sparing robot-assisted radical prostatectomy (Rs-RARP) and standard robot-assisted radical prostatectomy (RARP). MATERIALS AND METHODS: Eighty-eight patients who underwent robotic radical prostatectomy between 2018-2019 were included. We compared the minimum one-year follow-up results of patients who underwent Rs-RARP or RARP in terms of oncological and functional outcomes. Potency was assessed with the Sexual Health Inventory for Men (SHIM) score and was defined as an erection sufficient for penetration. Continence was defined as the absence of urinary incontinence with no safety pad. Patients were evaluated in the first month of follow-up and subsequently, every three months. RESULTS: Forty-six patients in Rs-RARP and 42 patients in the RARP group were enrolled. Catheter removal time was shorter in the Rs-RARP group (12 vs. 14 days, pâ¯=â¯0.001). At the 1st month visit, 41 patients (%89) were continent (no pads) in the Rs-RARP group while 25 patients (%59) were continent in the RARP group (pâ¯=â¯0.001). Patients who underwent Rs-RARP achieved faster recovery of urinary continence (Log-rank, pâ¯=â¯0.001). After one year of follow-up, 43 patients (93%) in Rs-RARP group and 38 patients (90%) in RARP group were continent (pâ¯=â¯0.6). Potency rates were 38.7% in Rs-RARP and 34.4% in RARP group (pâ¯=â¯0.28). There were no cases of biochemical recurrence in any group. CONCLUSIONS: Rs-RARP is a feasible technique, providing early return of continence. However, overall continence rates were similar at the end of the one-year follow-up.
Subject(s)
Prostatic Neoplasms , Robotic Surgical Procedures , Robotics , Humans , Male , Prostatectomy/methods , Prostatic Neoplasms/surgery , Robotic Surgical Procedures/methods , Treatment OutcomeABSTRACT
Introducción y objetivos Nuestro objetivo fue comparar los resultados oncológicos y funcionales del primer año tras la prostatectomía radical asistida por robot con preservación del espacio de Retzius (PRAR-PR) y la prostatectomía radical estándar asistida por robot (PRAR). Materiales y métodos Se incluyeron 88 pacientes sometidos a prostatectomía radical robótica entre 2018-2019. Se compararon los resultados oncológicos y funcionales de los pacientes que recibieron PRAR-PR o PRAR durante un periodo mínimo de seguimiento de un año. La potencia se evaluó con la puntuación del cuestionario de salud sexual del varón (Sexual Health Inventory for Men) y se definió como una erección con rigidez suficiente para la penetración. La continencia se definió como la ausencia de incontinencia urinaria sin compresa de seguridad. Los pacientes fueron evaluados en el primer mes y trimestralmente durante el resto del seguimiento. Resultados Se incluyeron 46 pacientes en el grupo PRAR-PR y 42 en el grupo PRAR. El tiempo de retirada del catéter fue menor en el grupo PRAR-PR (12 vs. 14 días, p=0,001). En la consulta del primer mes 41 pacientes (89%) eran continentes (no utilizaban compresas) en el grupo PRAR-PR, mientras que 25 pacientes (59%) eran continentes en el grupo PRAR (p=0,001). Los pacientes sometidos a PRAR-PR lograron una recuperación más rápida de la continencia urinaria (Log-rank, p=0,001). Tras un año de seguimiento 43 pacientes (93%) del grupo PRAR-PR y 38 (90%) del grupo PRAR eran continentes (p=0,6). Las tasas de potencia fueron del 38,7% en el grupo PRAR-PR y del 34,4% en el grupo PRAR (p=0,28). No se observaron recurrencias bioquímicas en ningún grupo. Conclusiones La PRAR-PR es una técnica factible, que proporciona un retorno temprano de la continencia. Sin embargo, las tasas globales de continencia fueron similares al final del periodo de un año de seguimiento (AU)
Introduction and objectives We aim to compare the first year oncological and functional outcomes of Retzius-sparing robot-assisted radical prostatectomy (Rs-RARP) and standard robot-assisted radical prostatectomy (RARP). Materials and methods Eighty-eight patients who underwent robotic radical prostatectomy between 2018-2019 were included. We compared the minimum one-year follow-up results of patients who underwent Rs-RARP or RARP in terms of oncological and functional outcomes. Potency was assessed with the Sexual Health Inventory for Men (SHIM) score and was defined as an erection sufficient for penetration. Continence was defined as the absence of urinary incontinence with no safety pad. Patients were evaluated in the first month of follow-up and subsequently, every three months. Results Forty-six patients in Rs-RARP and 42 patients in the RARP group were enrolled. Catheter removal time was shorter in the Rs-RARP group (12 vs. 14 days, P=.001). At the 1st month visit, 41 patients (%89) were continent (no pads) in the Rs-RARP group while 25 patients (%59) were continent in the RARP group (P=.001). Patients who underwent Rs-RARP achieved faster recovery of urinary continence (Log-rank, P=.001). After one year of follow-up, 43 patients (93%) in Rs-RARP group and 38 patients (90%) in RARP group were continent (P=.6). Potency rates were 38.7% in Rs-RARP and 34.4% in RARP group (P=.28). There were no cases of biochemical recurrence in any group. Conclusions Rs-RARP is a feasible technique, providing early return of continence. However, overall continence rates were similar at the end of the one-year follow-up (AU)