The Blind Spot of PSMA-PET Staging? Intraductal Carcinoma of the Prostate Is Overrepresented in Patients With No Uptake Pattern on Prostate-Specific Membrane Antigen Positron Emission Tomography and High-Grade Prostate Cancer.

Purpose: Prostate-specific membrane antigen positron emission tomography (PSMA PET) is increasingly used to diagnose and stage prostate cancer. A PRIMARY score uses anatomical localization and uptake patterns to improve diagnostic accuracy. We evaluated the histopathology of patients with no uptake pattern (PRIMARY score 1) and the prevalence of intraductal carcinoma of the prostate (IDC-P) in this subset compared with those with an uptake pattern (PRIMARY score ≥ 2).

Reoperation for Chronic Postoperative Inguinal Pain.

Importance: With a decrease in recurrence since modern hernia repair, chronic postoperative inguinal pain is the most important patient-centered outcome. Surgical intervention is often necessary in cases refractory to conservative measures but remains understudied.

Objective: To evaluate causes of refractory chronic postoperative inguinal pain and review the operative approaches used to treat patients who experience it.

A meta-analysis of Retzius-sparing and hood-technique robot-assisted radical prostatectomy.

Objectives: To compare Retzius-sparing (RS-) robot-assisted radical prostatectomy (RARP), hood-technique RARP and standard RARP, assessing functional, oncological and peri-operative outcomes.

Methods: A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The primary outcome was postoperative perfect continence rate (0 pad/day) at different time points over 12 months.

Groin hernia.

Groin hernias are among the most common indications for surgery worldwide, affecting both men and women, with a significantly higher prevalence in men. These hernias occur when intra-abdominal contents protrude through a weakened area in the groin region, most commonly as inguinal or femoral hernias. The pathogenesis of groin hernias is a complex interplay of genetic predisposition, connective tissue abnormalities and mechanical strain.

The Role of Prostate-specific Membrane Antigen Positron Emission Tomography for Assessment of Local Recurrence and Distant Metastases in Patients with Biochemical Recurrence of Prostate Cancer After Definitive Treatment: A Systematic Review and Meta-analysis.

Background And Objective: Positron emission tomography (PET) with prostate-specific membrane antigen (PSMA) radioligands has an established role in the assessment of recurrence of prostate cancer (PC) after primary treatment. However, an updated understanding of its diagnostic utility is warranted, particularly in the context of emerging targeted and systemic treatment options for recurrent PC. Our aim was to evaluate the diagnostic performance of PSMA PET for staging and detection of local or metastatic disease in patients with biochemical recurrence (BCR) following definitive treatment for PC.

A Comprehensive Systematic Review and Meta-analysis of the Role of Prostate-specific Membrane Antigen Positron Emission Tomography for Prostate Cancer Diagnosis and Primary Staging before Definitive Treatment.

Background And Objective: Positron emission tomography (PET) with prostate-specific membrane antigen (PSMA) in the diagnosis and primary staging of patients with prostate cancer (PCa) has an established role, but recent summative evidence on its actual diagnostic and staging value is still missing. We aimed to collect and analyze published studies reporting the accuracy of PSMA PET for the diagnosis of clinically significant prostate cancer (csPCa) and detection of distant metastases at primary staging before definitive treatment.

Methods: We performed a systematic review of the literature, by searching the PubMed/MEDLINE, Cochrane library's CENTRAL, EMBASE, and Scopus databases, from inception to April 2024.

Prevalence and Medium-Term Outcomes of Patients with Biopsy-Proven Intermediate- to High-Risk Prostate Adenocarcinoma with Low Intraprostatic Uptake on [Ga]Ga-PSMA-11 PET/CT in the proPSMA Study.

The current prevalence of low intraprostatic uptake for staging prostate-specific membrane antigen (PSMA) PET ranges between 4.4% and 17% in retrospective studies. We aimed to define the prevalence and describe the outcomes of patients with low intraprostatic uptake on PSMA PET/CT in the prospective proPSMA study.

Impact of intraprostatic PSMA maximum standardised uptake value following prostatectomy: a systematic review and meta-analysis.

Objective: To perform a systematic review and meta-analysis to assess the relationship between intraprostatic maximum standardised uptake value (SUV) of the dominant prostatic lesion as measured on preoperative prostate-specific membrane antigen (PSMA) positron emission tomography (PET) with radical prostatectomy International Society of Urological Pathology (ISUP) Grade Group, pathological tumour (pT) staging, and biochemical recurrence (BCR).

Methods: Prostate-specific membrane antigen PET may offer non-invasive assessment of histopathological and oncological outcomes before definitive treatment. SUV of the dominant lesion has been explored as a prognostic biomarker.

Unexpected presentation: metastatic adenoid cystic carcinoma (AdCC) of the breast masquerading as a large cystic-solid renal mass.

Adenoid cystic carcinoma (AdCC) of the breast is a rare histological subtype of breast cancer, which usually has a low propensity for metastasis and is associated with a good prognosis. AdCC metastasis to the kidney is rare, with only 29 cases reported in the literature. We report a case of a woman in her 60s with multiple right-sided large cystic-solid renal lesions after a recent diagnosis of marginal zone B-cell lymphoma.

Surgical management of chronic orchialgia after inguinal hernia repair.

Background: Orchialgia is a rare but significant complication experienced after open and minimally invasive inguinal hernia repairs with or without mesh. Causes have been theorized to include trauma to the spermatic cord, mesh-induced inflammation, vascular insult, fibrosis or mesh scarring of the cord, and neuropathic injury to the autonomic paravasal nerve fibers supplying the testicle. Though less frequently described than inguinodynia, orchialgia can be severely debilitating.

New persistent opioid use following robotic-assisted, laparoscopic and open surgery inguinal hernia repair.

Introduction: Post-operative prescription opioid use is a known risk factor for persistent opioid use. Despite the increased utilization of robotic-assisted surgery (RAS) for inguinal hernia repair (IHR), little is known whether this minimally invasive approach results in less opioid consumption. In this study, we compare long-term opioid use between RAS versus laparoscopic (Lap) versus open surgery for IHR.

Robotic transversus abdominis release using HUGO RAS system: our initial experience.

Background: Transversus abdominis release (TAR) is an effective technique for treating large midline and off-midline hernias. Recent studies have demonstrated that robotic TAR (rTAR) is technically feasible and associated with improved outcomes compared to open surgery. There is no published experience to date describing abdominal wall reconstruction using the novel robotic platform HUGO RAS System (Medtronic®).

The Current Landscape of Prostate-Specific Membrane Antigen (PSMA) Imaging Biomarkers for Aggressive Prostate Cancer.

The review examines the vital role of prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) in the diagnosis, staging, and treatment of prostate cancer (PCa). It focuses on the superior diagnostic abilities of PSMA PET/CT for identifying both nodal and distant PCa, and its potential as a prognostic indicator for biochemical recurrence and overall survival. Additionally, we focused on the variability of PSMA's expression and its impact on personalised treatment, particularly the use of [Lu] Lu-PSMA-617 radioligand therapy.

The Role of Releasing Incisions in Emergency Inguinal Hernia Repair.

The majority of inguinal hernia repairs worldwide are performed on an outpatient basis. However, incarceration and concern for strangulation of abdominal contents necessitates emergent repair in order to address visceral ischemia. In the setting of salvageable ischemia, this necessitates release of strangulation of blood supply by the hernia defect and reduction of visceral contents into the abdominal cavity.