Degenerative Changes in Aging Human Pelvic Lymph Nodes-A Reason to Rethink Staging and Therapy of Regional Malignancies?

Lymph node metastases are common in pelvic urological tumors, and the age-related remodeling process of the pelvic lymph nodes influences metastatic behavior. The aim of this work is to characterize age-related degenerative changes in the pelvic lymph nodes with respect to their occurrence and extent. A total of 5173 pelvic lymph nodes of 390 patients aged 44 to 79 years (median 68 years, IQR 62-71 years) were histologically examined for degenerative structural changes.

To defer or not to defer? A German longitudinal multicentric assessment of clinical practice in urology during the COVID-19 pandemic.

Introduction: After the outbreak of COVID-19 unprecedented changes in the healthcare systems worldwide were necessary resulting in a reduction of urological capacities with postponements of consultations and surgeries.

Material And Methods: An email was sent to 66 urological hospitals with focus on robotic surgery (RS) including a link to a questionnaire (e.g.

Experience with One-Stage Repair of Urethral Strictures Using the Augmented Anastomotic Repair Technique.

Introduction: We report the results of augmented anastomotic repair (AAR) in the treatment of anterior urethral strictures.

Material And Methods: In this retrospective study, we evaluated 71 consecutive patients who had undergone AAR between June 2004 and June 2013. Medical records were reviewed to identify early postoperative complications based on the Clavien-Dindo classification (CDC).

Robot-assisted laparoscopic Y-V plasty in 12 patients with refractory bladder neck contracture.

We present preliminary results of a case series on refractory bladder neck contracture (BNC) treated with robot-assisted laparoscopic Y-V plasty (RAYV). Between 01/2013 and 02/2016, 12 consecutive adult male patients underwent RAYV in our hospital. BNC developed after transurethral procedures (n = 9), simple prostatectomy (n = 2) and HIFU therapy of the prostate (n = 1).

Airway Resistance in Patients with Obstructive Sleep Apnea Syndrome Following Robotic Prostatectomy.

Background: Because minimally invasive surgery can improve postoperative recovery, it became the preferred technique for patients with significant comorbidities. However, steep Trendelenburg position and abdominal CO-insufflation can lead to a significant increase in upper airway resistance and an alteration of overall lung function. In particular, patients who already suffer from an obstructive airway disease like obstructive sleep apnea syndrome (OSAS) might be at risk for postoperative airway complications.

Age and bupivacaine plasma concentrations following radical cystectomy.

Purpose: Continuous epidural analgesia with bupivacaine for postoperative analgesia can increase its plasma concentrations. Whether this effect can be aggravated with increasing age is unknown. Therefore, bupivacaine concentrations were prospectively monitored in patients undergoing radical cystectomies.

Simulated life-threatening emergency during robot-assisted surgery.

Background: With the increasing use of robot-assisted techniques for urologic and gynecologic surgery in patients with severe comorbidities, the risk of a critical incidence during surgery increases. Due to limited access to the patient the start of effective measures to treat a life-threatening emergency could be delayed. Therefore, we tested the management of an acute emergency in an operating room setting with a full-size simulator in six complete teams.

Comparison of early postoperative morbidity after robot-assisted and open radical cystectomy: results of a prospective observational study.

Objective: To evaluate early postoperative morbidity in patients undergoing either robot-assisted (RARC) or open radical cystectomy (ORC) for bladder cancer.

Patients And Methods: A total of 100 patients underwent RARC (between August 2009 and August 2012) and 42 underwent ORC (between October 2007 and July 2009) as treatment for bladder cancer. Data on the patients' peri-operative course were collected prospectively up to the 90th postoperative day for the RARC group and up to the 60th postoperative day for the ORC group.

Does changeover by an experienced open prostatic surgeon from open retropubic to robot-assisted laparoscopic prostatectomy mean a step forward or backward?

We assessed whether changeover from open retropubic [RRP] to robotic-assisted laparoscopic prostatectomy [RALP] means a step forward or backward for the initial RALP patients. Therefore the first 105 RALPs of an experienced open prostatic surgeon and robotic novice-with tutoring in the initial 25 cases-were compared to the most recent 105 RRPs of the same surgeon. The groups were comparable with respect to patient characteristics and postoperative tumor characteristics (all P > 0.

Robot-assisted reconstructive surgery of the distal ureter: single institution experience in 16 patients.

Unlabelled: WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Open reconstructive surgery of the lower ureteric segment in adults often requires large incisions, as the basic prerequisite for such complex procedures is wide exposure. Published experience on minimally invasive techniques in this challenging surgical field, e.g.

Tumour characteristics, oncological and functional outcomes in patients aged ≥ 70 years undergoing radical prostatectomy.

Unlabelled: Study Type - Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? The marked increase in life expectancy in recent years calls for reconsideration of the decision-making process for the treatment of prostate cancer, a condition particularly affecting the elderly. To date the general approach in elderly patients has tended to be more conservative, not least as it is generally thought that prostate cancer in these patients is less biologically aggressive. The present data showed that patients aged ≥70 years had biologically more aggressive tumours significantly more often than those aged <70 years.

Experience with robot-assisted laparoscopic surgery of the lower ureteral segment in adults.

Open reconstructive surgery of the lower ureteral segments in adults requires wide exposure as the basic prerequisite for such complex procedures. Thus, open surgical reconstruction in this area is an invasive procedure for the patient. Nevertheless, during the last few years robot-assisted laparoscopic techniques have emerged and have also already been used successfully for minimally invasive complex reconstructive procedures in urology.

Treatment of long ureteric strictures with buccal mucosal grafts.

Objective: To describe the reconstruction of long ureteric strictures using buccal mucosal patch grafts and to report the intermediate-term functional outcome.

Patients And Methods: Between November 2000 and October 2006 reconstruction of seven long ureteric strictures using buccal mucosal patch grafts and omental wrapping was performed in five women (one with bilateral strictures) and one man. The surgical steps of stricture reconstruction and wrapping with omentum are described in detail.

The incidence of lymph node metastases in prostate carcinoma depends not only on tumor characteristics but also on surgical performance and extent of pelvic lymphadenectomy.

Objectives: The purpose of the present study was to determine whether predictions of the incidence of pelvic lymph node metastases in patients with similar prostate cancer characteristics are influenced by the extent of pelvic lymphadenectomy or surgical performance.

Material And Methods: Data from a prostate cancer database were analyzed to investigate associations between incidence of lymph node metastasis and preoperative prostate-specific antigen level, clinical stage, biopsy Gleason score, extent of pelvic lymphadenectomy, and surgical performance. Subgroups of patients with the same characteristics were formed, and a multivariate analysis was performed.

Complications of pelvic lymphadenectomy in 1,380 patients undergoing radical retropubic prostatectomy between 1993 and 2006.

Purpose: We evaluated the perioperative complications associated with pelvic lymphadenectomy in patients undergoing radical retropubic prostatectomy. In particular the influence of the extent of pelvic lymphadenectomy and of other possible risk factors on the complication rate was examined.

Materials And Methods: All intraoperative and early postoperative complications in 1,380 patients who underwent radical retropubic prostatectomy were documented.

Intraoperative and early postoperative complications of radical retropubic prostatectomy.

Introduction: To determine the perioperative complications and morbidity of radical retropubic prostatectomy (RRP) and to analyze risk factors for observed complications.

Materials And Methods: Data of 1,000 patients undergoing RRP and pelvic lymphadenectomy (pLA) performed by different surgeons of the same hospital were collected. Uni- and multivariate analysis was performed to detect associations between intra- and postoperative complications and specific variables.

Disease progression and survival in patients with prostate carcinoma and positive lymph nodes after radical retropubic prostatectomy.

Objective: To determine disease progression and survival in patients with lymph node-positive prostate carcinoma after ascending radical retropubic prostatectomy (RP) and pelvic lymphadenectomy with different forms of postoperative adjuvant treatment.

Patients And Methods: We analysed 82 patients with lymph node metastases at the time of surgery and who had a RP between 1993 and 2002. Data from clinical records and follow-up questionnaires were used.

Association study of the G-protein beta3 subunit C825T polymorphism with disease progression in patients with bladder cancer.

The T-allele in the GNB3 C825T polymorphism has been associated with increased cell migration, a prerequisite for metastasis. In this study we investigated a potential association of the C825T-allele status and disease progression in patients with transitional cell carcinoma of the bladder (TCC). Genotyping of the GNB3 C825T polymorphism was performed in 389 patients with transitional cell carcinoma of the bladder and in 104 control subjects and clinical follow-up was worked up in 339 patients.