A comparative evaluation of radical prostatectomy using laparoscopic and open method in view of surgical margins.

Introduction: A positive surgical margin (PSM) in the radical prostatectomy (RP) specimen is associated with biochemical recurrence (BCR) and the need for adjuvant radiation therapy, and is an analysis of surgical procedure quality. We present data describing the identification, anatomy, and management of PSM after RP performed via an open operation and laparoscopically. The aim of the study was to compare assessment of RP (open vs. laparoscopic) in terms of analysis of PSM in postoperative histopathological tissue. Material and methods: Patients with pT1 to pT3b prostate cancer with detailed surgical margin parameters and BCR status were analysed. The patients were divided into groups depending on the stage of neoplastic disease and the choice of operative procedure. Results: In total, we obtained data from 140 PC patients. Positive surgical margins were confirmed in 11 cases treated with open surgery and in 7 cases treated with laparoscopic procedure. There was no statistically significant (p >0.05) relationship between the frequency of positive margins and the type of procedure. There was no statistically significant (p >0.05) relationship between the frequency of positive margins and the type of procedure in subgroups according to the Gleason score. There was a statistically significant (p <0.05) relationship between the clinical stage of the tumor and the type of margin. This particularly refers to tumours with stage T3b (more numerous in the group of open surgeries) and T2c (more numerous in the laparoscopic group). Conclusions: There was no statistically significant correlation between the type of surgery and the incidence of a positive surgical margin.

13C Natural Isotope Abundance in Urothelium as a New Marker in the Follow-Up of Patients with Bladder Cancer.

Bladder cancer (BC) is the most common urological malignancy and has a high incidence of recurrence. BC cells alter their nutrient uptake and metabolic pathways in order to continue the production of sufficient levels of ATP and metabolic intermediates for proliferation and survival. Changes in metabolic pathways regarding the rate of the enzymatic reaction and transport lead to differences in the content of natural isotopes (13C, 15N, 34S) between normal and cancerous tissues. The assessment of the stable isotopes of carbon, nitrogen, and sulfur in normal urothelium and bladder cancer samples was performed using Isotope Ratio Mass Spectrometry (IRMS). The natural abundance of 15N and 13C was decreased in bladder cancer samples when compared to normal urothelium. No significant correlation was observed in BC specimens depending on the tumor grade and stage. Samples derived from bladder tumors and normal urothelium had a different pattern of 15N and 13C isotope abundance. Decreased 13C natural isotopes in the normal urothelium of BC patients were significantly associated with a shorter DFS. Our results suggest that isotopic analysis of normal urothelium of BC patients can be used to predict bladder cancer recurrence.

Rate of positive urine culture and double-J catheters colonization on the basis of microorganism DNA analysis.

INTRODUCTION: The aim of the trial was to estimate the relationship between colonization of the Double-J catheter, and the microorganisms cultured from urine. MATERIAL AND METHODS: 60 patients, who had Double-J catheters inserted, participated in the study. All the subjects had their midstream urine samples taken prior to the stent insertion and removal. A negative urine culture before catheterization was mandatory to participate in the study. The patients were assigned into three subgroups, according to stenting duration: 1) 20 to 30 days (18 cases); 2) 30 to 90 days (30 cases); 3) longer than 90 days (12 cases). Bacterial and fungal DNA was identified using electrophoresis in polyacrylamide gel with a denaturing gradient (PCR-DGGE). The relationship between the genetic analysis of the catheter and the urine culture was estimated. RESULTS: Urine cultures were positive in only 8 patients, while Double-J catheter analyses were positive in all cases. In 2 cases one type of microorganism was isolated from the stent surface while the remaining 58 catheters were colonized by more than one pathogen. In three cases fungi were isolated. There were only three types of pathogens cultured from urine specimens. Urine and stent cultures were consistent in 5 cases. In 3 cases urine culture and stent analysis were not consistent. CONCLUSIONS: Double-J catheter retention in the urinary tract is associated with an extremely high risk of bacterial colonization, while the risk of urine infection is about 8-fold lower. There is a great inconsistency between urine infection and catheter colonization, indicating a low predictive value of urine culture for estimating stent colonization.

Complication rates after prostate biopsy according to the number of sampled cores.

INTRODUCTION: A PROSTATE BIOPSY CAN RESULT IN SUCH COMPLICATIONS AS: hematuria, rectal bleeding, pain in hypogastrium, perineum or urethra, fever, nausea, vomiting, retention of urine or other adverse events. The aim of this research was to estimate complication rates after a prostate biopsy based on the number of cores. MATERIAL AND METHODS: The complication rate was evaluated on the basis of questionnaires filled out by patients. Questions were related to the occurrence of mentioned complications on the first and second day after prostate biopsy. Patients were divided into two groups: 1(st) group (41 patients) 5-8 cores and 2(nd) group (73 patients) 12 or more cores. RESULTS: There was no significant statistical difference in the occurrence of complications mentioned in the questionnaires in both groups. The biggest difference was recorded for hematuria - 1(st) day: 39% in the 1st and 53% in the 2nd group (p = 0.1398); 2(nd) day: 15% in the 1(st) and 30% in the 2(nd) group (p = 0.0650). Rectal bleeding on the 1(st) day also seems to vary: 12% in the 1st and 26% in the 2(nd) group (p = 0.0835). Other complications occurred in 3-8% of patients. 32% of patients in the 1(st) and 29% in the 2(nd) group (p = 0.7419) had no complications at all. CONCLUSIONS: The most common complications after a prostate biopsy are hematuria and rectal bleeding. Other complication rates are low. In general, complication rates after a prostate biopsy procedure are not related to the number of sampled cores.