Clinical and histopathological features of bladder cancer following radiotherapy for prostate cancer: A comparative study.

INTRODUCTION: Low certainty exists on how bladder cancer (BCa) after pelvic radiotherapy (RT) differs from BCa in radiation-naive patients from a histopathological and clinical perspective. This study aims to compare histopathological features of bladder tumors between patients with previous RT for prostate cancer (PCa) and radiation-naive patients using single-institutional data and to estimate relapse-free survival (eRFS) and cystectomy-free survival (eCFS) in both groups. MATERIALS AND METHODS: Comparative study in adult men diagnosed with BCa in Hospital Italiano de Buenos Aires, Argentina, between January 2015 and December 2020. Included patients were categorized as previously irradiated for PCa or radiation-naive. PRIMARY OUTCOME: differences in prevalence of aggressiveness features of bladder tumors (variant histology; high-grade tumors; muscle-invasive disease; criteria compliance for high or very-high risk of progression) between irradiated and radiation-naive patients at diagnosis of BCa. SECONDARY OUTCOMES: differences in eRFS and eCFS between groups. RESULTS: In total, 34 and 291 patients were included in the Irradiated and Radiation-naive groups, respectively. Mean age at the time of diagnosis of BCa was 72.7 years (CI 95% 71.6-73.8). Median follow-up of the overall cohort was 25 months (IQR 11-45.5). Concerning primary outcomes, no statistical differences were found except for a higher prevalence of low-grade tumors between irradiated patients and high-grade tumors between radiation-naive patients (P 0.018). Regarding secondary outcomes, prior RT did not increase neither eRFS nor eCFS in both univariate and multivariate analysis. CONCLUSIONS: BCa after RT for PCa has similar histological features and cystectomy free-survival compared to BCa in a radiation-naive population. For patients with non-muscle invasive BCa arising after prostate RT, the risk of recurrences appears to be similar to non-irradiated patients.

[Randomized study on urinary continence after radical prostatectomy with previous kinesic perineal physiotherapy]. / Estudio randomizado sobre continencia urinaria postprostatectomía radical con rehabilitación perineal kiesica previa.

OBJECTIVES: Urinary incontinence is one of the main complications after radical prostatectomy (RP). Preoperative kinetic physiotherapy could be useful as a preventive treatment of these complication. The objective of this work is to demonstrate the usefulness of preoperative perineal kinetic physiotherapy for early recovery of urinary continence after radical prostatectomy. METHODS: Randomized controlled clinical trial. 38 patients were divided into groups of 19 before radical prostatectomy. The first group (K) received preoperative kinesic treatment whereas the second group (NK) did not (control group). Urinary continence was evaluated at 14, 30 and 60 days after catheter retrieval. RESULTS: There were not epidemiological or tumor biology differences between groups. The percentages of continent patients in group K at 14, 30 and 60 days were 47.36%, 47.36% and 78.9% respectively, whereas in the NK group where 47.36%, 47.36%, and 89.4% respectively (p > 0.05). CONCLUSIONS: Kinesic perineal exercises before radical prostatectomy did not diminish the times of urinary continence recovery or its appearance.

Estudio randomizado sobre continencia urinaria postprostatectomía radical con rehabilitación perineal kiesica previa / Randomized study on urinary continence after radical prostatectomy with previous kinesic perineal physiotherapy

Objetivo: La incontinencia urinaria es una de las principales complicaciones luego de la realización de prostatectomía radical (PR). La rehabilitación kinésica preoperatoria, podría ser de utilidad como tratamiento preventivo de esta complicación. Demostrar la utilidad de la kinesiología perineal preoperatoria en la recuperación precoz de la continencia urinaria post prostatectomía radical. Métodos: Ensayo Clínico Controlado Randomizado Aleatorizado. 38 pacientes fueron divididos en dos grupos de 19 previo a la realización de la PR. El primer grupo (K) recibió tratamiento kinésico preoperatorio, mientras que el segundo grupo (NK) no (grupo control). Se evaluó la continencia de orina a los 14, 30 y 60 días post extracción de sonda. Resultados: No hubo diferencias epidemiológicas y de biología tumoral entre grupos. El porcentaje de pacientes continentes en el grupo K al los 14, 30 y 60 días, respectivamente fue de 47,36%, 47,36% y 78,9%, respectivamente, mientras que en el grupo NK fueron de 47,36%, 47,36% y 89,4%, respectivamente (p>0,05). Conclusión: Los ejercicios kinésicos perineales previos a la prostatectomía radical, no disminuyeron los tiempos de recuperación de la continencia urinaria ni la ocurrencia de la misma (AU)

Objectives: Urinary incontinence is one of the main complications after radical prostatectomy (RP). Preoperative kinetic physiotherapy could be useful as a preventive treatment of these complication. The objective of this work is to demonstrate the usefulness of preoperative perineal kinetic physiotherapy for early recovery of urinary continence after radical prostatectomy. Methods: Randomized controlled clinical trial. 38 patients were divided into groups of 19 before radical prostatectomy. The first group (K) received preoperative kinesic treatment whereas the second group (NK) did not (control group). Urinary continence was evaluated at 14, 30 and 60 days after catheter retrieval. Results: There were not epidemiological or tumor biology differences between groups. The percentages of continent patients in group K at 14,30 and 60 days were 47.36%, 47.36% and 78.9% respectively, whereas in the NK group where 47.36%, 47.36%, and 89.4% respectively (p > 0.05). Conclusions: Kinesic perineal exercises before radical prostatectomy did not diminish the times of urinary continence recovery or its appearance (AU)

Neuromodulación: una alternativa terapéutica para las disfunciones miccionales / Neuromodulation: a therapeutic alternative for mictional dysfunctions

La neuromodulación mediante estimulación eléctrica de las raíces sacras (EERS) es una alternativa terapéutica no destructiva y reversible, indicada en pacientes con disfunción miccional crónica cuando los tratamientos conservadores han resultado ineficaces o mal tolerados. Esta estimulación logra influir sobre el comportamiento de la vejiga, del esfínter uretral externo y de los músculos del suelo pélvico. La estimulación es de tipo eléctrico y se ejerce mediante salvas de pulsos de corriente aplicada a la tercera raíz sacra (S3). El objetivo primordial de esta técnica es restablecer el patrón de micción normal

Neuromodulación: una alternativa terapéutica para las disfunciones miccionales / Neuromodulation: a therapeutic alternative for mictional dysfunctions

La neuromodulación mediante estimulación eléctrica de las raíces sacras (EERS) es una alternativa terapéutica no destructiva y reversible, indicada en pacientes con disfunción miccional crónica cuando los tratamientos conservadores han resultado ineficaces o mal tolerados. Esta estimulación logra influir sobre el comportamiento de la vejiga, del esfínter uretral externo y de los músculos del suelo pélvico. La estimulación es de tipo eléctrico y se ejerce mediante salvas de pulsos de corriente aplicada a la tercera raíz sacra (S3). El objetivo primordial de esta técnica es restablecer el patrón de micción normal