Impact of cosmetic result on selection of surgical treatment in patients with localized prostate cancer.

OBJECTIVES: To analyze the effect of cosmetic outcome as an isolated variable in patients undergoing surgical treatment based on the incision used in the 3 variants of radical prostatectomy: open (infraumbilical incision and Pfannestiel incision) and laparoscopic, or robotic (6 ports) surgery. PATIENTS AND METHODS: 612 male patients 40 to 70 years of age with a negative history of prostate disease were invited to participate. Each patient was evaluated by questionnaire accompanied by a set of 6 photographs showing the cosmetic appearance of the 3 approaches, with and without undergarments. Participants ranked the approaches according to preference, on the basis of cosmesis. We also recorded demographic variables: age, body mass index, marital status, education level, and physical activity. RESULTS: Of the 577 patients who completed the questionnaries, the 6-port minimally invasive approach represents the option preferred by 52% of the participants, followed by the Pfannestiel incision (46%), and the infraumbilical incision (11%), respectively. The univariate and multivariate analyses did not show statistically significant differences when comparing the approach preferred by the patients and the sub-analyses for demographic variables, except for patients who exercised who preferred the Pfannestiel incision (58%) instead of minimally invasive approach (42%) with statistically significant differences. CONCLUSION: The minimally invasive approach was the approach of choice for the majority of patients in the treatment of prostate cancer. The Pfannestiel incision represents an acceptable alternative. More research and investment may be necesary to improve cosmetic outcomes.

Radical urethrectomy with bladder preservation and continent catheterizable stoma (Yang-Monti tecnique).

Malignant melanoma originating in the urethra is considered extremely rare and has a very poor prognosis. Consequently, therapeutic reviews are retrospective describing assorted treatments. We report how to perform a radical urethrectomy with bladder preservation and a continent catheterizable stoma (Yang-Monti technique) Radical urethrectomy with bladder preservation and a continent catheterizable stoma may be appropriate in selected patients with tumours that do not invade the bladder neck.

Penile metastasis of rectal carcinoma. Case report and bibliographic review.

OBJECTIVE: Contribution of a case of penile metastasis in a patient with metastatic rectal carcinoma. METHODS: A 70-Year-old patient was referred to our consultation after the discovery of "penis indurations" having been diagnosed of rectal carcinoma 18 months before. After physical examination penile biopsies were carried out. RESULTS: The pathological results of the Glans biopsy was "rectal adenocarcinoma metastasis". CONCLUSIONS: Metastases in the penis are rare, and usually occur in the context of advanced oncological disease.

Laparoscopic transperitoneal radical prostatectomy in renal transplant recipients: a review of the literature.

OBJECTIVES: To report our experience with laparoscopic radical prostatectomy (LRP) for the treatment of localized prostate carcinoma in two renal transplant recipients and a review of the literature. PATIENTS AND METHODS: We retrospectively identified all patients who had undergone LRP for clinically localized prostate cancer between 2002 and 2008 at our institution (n = 1150). Of these patients, two were renal transplant recipients (one with donor renal transplant cadaver and the other with prior transplantectomy). We reviewed all available clinicopathological data and the scientific literature. RESULTS: The two patients underwent successful LRP with no major complications. The mean (range) operative time was 200 (180-220) min with a mean estimated blood loss of 300 (200-400) mL. There were no changes in renal graft function as measured by serum creatinine level. At pathology, the surgical margins were negative and disease was organ-confined in each case. The two patients tolerated the procedure well and had a mean (range) hospital stay of 3.5 (3-4) days. CONCLUSIONS: The data from our two patients suggest that LRP, as an accepted minimally invasive treatment for a middle-aged man with organ-confined prostate cancer, is a technically feasible and safe treatment of localized prostate cancer in renal transplant recipients.