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UP-1.62: Pelvic drain can be avoided after transvesical prostatectomy for prostate benign hyperplasia
UNMODERATED POSTER SESSIONS
than 50% improvement in voiding diary chart. Results: The main reason of the majority of cases who refused SNM therapy was cost of device in 68 patients, and fear of intervention in nerve roots in 10. Mean age of patients was 42.5 (18 -76) years old. Main symptoms in our patients were unobstructive retention in 8, refractory urgency and urge/incontinence symptoms in 3 and stress/urge incontinency in 4 cases. Three patients had previous history of hysterectomy and one case had undergone repair of disc herniation. Eight cases did clean intermittent catheterization (CIC) preoperatively. Mean operative time was 35 minutes and hospital stay in all patients was one day. Positive response was noted in ten patients, two cases revealed no improvement and electrical wire was displaced the day after operation in three other cases. No significant complications were observed. Conclusion: This is the first experience reported from our country. Even though the number of patients enrolled in this study was not significant, experience of SNM was concomitant with noticeable results and negligible side effects in patients with voiding dysfunction. The major reason in our group of patients who rejected trial of therapy was cost of device, and fear of intervention in nerve roots which prompts serious attention. UP-1.61 Prostatic inflammation and prostate cancer: is there evidence for a link? Engelhardt P1, Brustmann H2, Seklehner S1, Riedl C1 1 Dept. of Urology and Andrology, Landesklinikum Thermenregion, Baden, Austria; 2 Dept. of Pathology, Landesklinikum Thermenregion, Mödling, Austria Introduction and Objectives: Recent reports support the hypothesis that longstanding chronic inflammation of the prostate gland is a risk factor for the development of prostate cancer. In a controlled prospective trial we investigated the extent and association of chronic prostatic inflammation in patients with benign prostatic hyperplasia (BPH) and prostate cancer (PCa). Material and Methods: From 1/2009 to 12/2009 patients who underwent transurethral resection of the prostate (BPH group, n⫽83) or radical prostatectomy (PCa– group, n⫽57) were randomised in a prospective trial. The presence of chronic inflammation of the prostate was verified by histological examination and its extent was evaluated according to the grading
system by Irani et al. Additional immunohistochemical investigations were performed for interleukin-2-receptors (IL2) and interleukin-6-receptors (IL6). Histological and immunhistochemical findings were correlated with patient age, prostate volume, PSA levels, cholesterol, lipids, IPSS Score and body mass index in patients with BPH vs. PCa. Results: A significant difference between patient groups was found in age (63.4 vs. 69.1 years), volume of the prostate gland (34.9 vs. 51.0 ml) and lipids levels (163 vs. 132 mg/dl) in PCa versus BPH patients. All other parameters showed no significant difference. Chronic prostatic inflammation was verified in 10.53% (6/57 patients) of the PCa group versus 61.45% (51/83 pat.) of the BPH group (p⫽0.0001). The extent of chronic prostatic inflammation was significantly higher in BPH patients. We could not find any further correlation between chronic prostatic inflammation and Gleason score of PCa patients, IPSS Score in BPH or PCa patients, prostate volume, cholesterol, lipids or BMI. Conclusion: About 60% of our BPH patient group treated with TUR-P showed chronic prostatic inflammation. In contrast, prostatic inflammation was detected in only 10% of PCa patients. No further correlation of histological prostatic inflammation to BPH or PCa was found.
UP-1.62 Pelvic drain can be avoided after transvesical prostatectomy for prostate benign hyperplasia Ghoundale O, Touiti D Avicenne Military Hospital, Marrakech, Morocco Introduction and Objective: Open surgery still keeps its place in the management of benign prostate hyperplasia (BPH). We present our preliminary experience of open transvesical prostatectomy with a drain-free. Materials and Methods: We assessed prospectively 100 consecutive prostatectomies for BPH, performed by retropubic approach between June 2007 and July 2009. Adenoma enucleation was performed via sagittal incision of the bladder. In the first 50 patients (group 1), aspirative Redon drain were placed below peritoneum. In the following 50 (group 2), after positive watertight test, no drain was placed. Results: The two groups were matched for age and prostate size. Average hospitalization was one day greater in group 1.
UROLOGY 76 (Supplement 3A), September 2010
Overall rate of complications were identical in the two groups (10%). Conclusions: Drain-free simple retropubic prostatectomy for BPH is not associated with more complications than the classic procedure with a drain in the pelvis; it actually allows quite the reverse: a gain in hospital stay. UP-1.63 Use of hyperbaric oxygen therapy for hemorrhagic cystitis secondary to pelvic radiotherapy Parra C2, Go´mez R1, Felmer A1, Castillo O3, Rubio G3 1 Hospital del Trabajador; 2Universidad Catolica de Chile; 3Clinica Indisa, Santiago, Chile Introduction: Hemorrhagic cystitis (HC) after pelvic radiotherapy occurs in 2-8% of patients. A variety of treatments have been described, most of them with uncertain results. We assessed the efficacy of hyperbaric oxygen therapy (HBOT) in HC cases. Materials and Methods: Retrospective analysis of patients with HC after pelvic radiotherapy receiving HBOT between January 2002 and January 2010. Indications for pelvic radiation, elapsed time between radiotherapy and HC, between HC and HBOT, other treatments for HC and HBOT-related complications were recorded. HBOT was performed in a multiplace hyperbaric chamber with 90 minutes of 100% oxygen breathing at 2.2 atm. We defined complete response (CR) as definitive stop of gross hematuria and partial response (PR) as persistence of minor occasional self-limited episodes of gross hematuria. Telephone follow up was updated at the time of submission in all cases. Results: Twenty-five patients were treated (21 male, 4 female), mean age 66.7 years (range 42 - 80). Twenty men were irradiated for prostate cancer (17 post radical prostatectomy and 3 as monotherapy) and one for bladder cancer. Three women had cervix cancer and one endometrial cancer. All patients were initially managed by bladder clot removal/endoscopic cauterization under anesthesia plus saline irrigation. One case received alum irrigation. In all cases HBOT was considered only after other measures failed. Mean follow up was 21.2 months (range 3-66). Mean time between radiotherapy and HC was 31 months (range 1-106) and between the onset of HC and HBOT was 4.7 months (range 1-12). Median number of HBOT was 40 sessions (range 15-44). We observed CR in 64% (16 patients) and PR in
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than 50% improvement in voiding diary chart. Results: The main reason of the majority of cases who refused SNM therapy was cost of device in 68 patients, and fear of intervention in nerve roots in 10. Mean age of patients was 42.5 (18 -76) years old. Main symptoms in our patients were unobstructive retention in 8, refractory urgency and urge/incontinence symptoms in 3 and stress/urge incontinency in 4 cases. Three patients had previous history of hysterectomy and one case had undergone repair of disc herniation. Eight cases did clean intermittent catheterization (CIC) preoperatively. Mean operative time was 35 minutes and hospital stay in all patients was one day. Positive response was noted in ten patients, two cases revealed no improvement and electrical wire was displaced the day after operation in three other cases. No significant complications were observed. Conclusion: This is the first experience reported from our country. Even though the number of patients enrolled in this study was not significant, experience of SNM was concomitant with noticeable results and negligible side effects in patients with voiding dysfunction. The major reason in our group of patients who rejected trial of therapy was cost of device, and fear of intervention in nerve roots which prompts serious attention. UP-1.61 Prostatic inflammation and prostate cancer: is there evidence for a link? Engelhardt P1, Brustmann H2, Seklehner S1, Riedl C1 1 Dept. of Urology and Andrology, Landesklinikum Thermenregion, Baden, Austria; 2 Dept. of Pathology, Landesklinikum Thermenregion, Mödling, Austria Introduction and Objectives: Recent reports support the hypothesis that longstanding chronic inflammation of the prostate gland is a risk factor for the development of prostate cancer. In a controlled prospective trial we investigated the extent and association of chronic prostatic inflammation in patients with benign prostatic hyperplasia (BPH) and prostate cancer (PCa). Material and Methods: From 1/2009 to 12/2009 patients who underwent transurethral resection of the prostate (BPH group, n⫽83) or radical prostatectomy (PCa– group, n⫽57) were randomised in a prospective trial. The presence of chronic inflammation of the prostate was verified by histological examination and its extent was evaluated according to the grading
system by Irani et al. Additional immunohistochemical investigations were performed for interleukin-2-receptors (IL2) and interleukin-6-receptors (IL6). Histological and immunhistochemical findings were correlated with patient age, prostate volume, PSA levels, cholesterol, lipids, IPSS Score and body mass index in patients with BPH vs. PCa. Results: A significant difference between patient groups was found in age (63.4 vs. 69.1 years), volume of the prostate gland (34.9 vs. 51.0 ml) and lipids levels (163 vs. 132 mg/dl) in PCa versus BPH patients. All other parameters showed no significant difference. Chronic prostatic inflammation was verified in 10.53% (6/57 patients) of the PCa group versus 61.45% (51/83 pat.) of the BPH group (p⫽0.0001). The extent of chronic prostatic inflammation was significantly higher in BPH patients. We could not find any further correlation between chronic prostatic inflammation and Gleason score of PCa patients, IPSS Score in BPH or PCa patients, prostate volume, cholesterol, lipids or BMI. Conclusion: About 60% of our BPH patient group treated with TUR-P showed chronic prostatic inflammation. In contrast, prostatic inflammation was detected in only 10% of PCa patients. No further correlation of histological prostatic inflammation to BPH or PCa was found.
UP-1.62 Pelvic drain can be avoided after transvesical prostatectomy for prostate benign hyperplasia Ghoundale O, Touiti D Avicenne Military Hospital, Marrakech, Morocco Introduction and Objective: Open surgery still keeps its place in the management of benign prostate hyperplasia (BPH). We present our preliminary experience of open transvesical prostatectomy with a drain-free. Materials and Methods: We assessed prospectively 100 consecutive prostatectomies for BPH, performed by retropubic approach between June 2007 and July 2009. Adenoma enucleation was performed via sagittal incision of the bladder. In the first 50 patients (group 1), aspirative Redon drain were placed below peritoneum. In the following 50 (group 2), after positive watertight test, no drain was placed. Results: The two groups were matched for age and prostate size. Average hospitalization was one day greater in group 1.
UROLOGY 76 (Supplement 3A), September 2010
Overall rate of complications were identical in the two groups (10%). Conclusions: Drain-free simple retropubic prostatectomy for BPH is not associated with more complications than the classic procedure with a drain in the pelvis; it actually allows quite the reverse: a gain in hospital stay. UP-1.63 Use of hyperbaric oxygen therapy for hemorrhagic cystitis secondary to pelvic radiotherapy Parra C2, Go´mez R1, Felmer A1, Castillo O3, Rubio G3 1 Hospital del Trabajador; 2Universidad Catolica de Chile; 3Clinica Indisa, Santiago, Chile Introduction: Hemorrhagic cystitis (HC) after pelvic radiotherapy occurs in 2-8% of patients. A variety of treatments have been described, most of them with uncertain results. We assessed the efficacy of hyperbaric oxygen therapy (HBOT) in HC cases. Materials and Methods: Retrospective analysis of patients with HC after pelvic radiotherapy receiving HBOT between January 2002 and January 2010. Indications for pelvic radiation, elapsed time between radiotherapy and HC, between HC and HBOT, other treatments for HC and HBOT-related complications were recorded. HBOT was performed in a multiplace hyperbaric chamber with 90 minutes of 100% oxygen breathing at 2.2 atm. We defined complete response (CR) as definitive stop of gross hematuria and partial response (PR) as persistence of minor occasional self-limited episodes of gross hematuria. Telephone follow up was updated at the time of submission in all cases. Results: Twenty-five patients were treated (21 male, 4 female), mean age 66.7 years (range 42 - 80). Twenty men were irradiated for prostate cancer (17 post radical prostatectomy and 3 as monotherapy) and one for bladder cancer. Three women had cervix cancer and one endometrial cancer. All patients were initially managed by bladder clot removal/endoscopic cauterization under anesthesia plus saline irrigation. One case received alum irrigation. In all cases HBOT was considered only after other measures failed. Mean follow up was 21.2 months (range 3-66). Mean time between radiotherapy and HC was 31 months (range 1-106) and between the onset of HC and HBOT was 4.7 months (range 1-12). Median number of HBOT was 40 sessions (range 15-44). We observed CR in 64% (16 patients) and PR in
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