Prostate neoplasms
Robotic or Open Radical Prostatectomy After Previous Open Surgery In The Pelvic Region
Sun, 2015-02-01 11:54 — Mahmoud MustafaMaterials and Methods: Sixty-four patients, median age 65 years (range, 46-73) who underwent RP after prior pelvic surgery were included. Twenty-four (38%) underwent robotic and 40 patients (62%) underwent open RP. Bilateral lymph nodes dissection and nerve preservation were performed in 50 patients (78%) and 35 patients (55%) respectively. Variables evaluated included demographic characteristics, perioperative complications, functional and oncological outcomes. The median hospitalization and follow-up periods were 2 days (range, 1-12) and 21 months (range,1-108 months) respectively.
Results: No conversions from robotic to open surgery were performed and there were no intraoperative complications. Surgical margins were positive in 13 patients (20%), seminal vesicle involvement was detected in 6 patients (9%) and lymph nodes involvement was found in 2 patients (3%). Postoperative complications included; lymphocele in 1 patient, urethral stricture in 1 patient and bowel obstruction and persistent bladder leakage in 2 patients. Eighty eight percentages of patients were continent at 7 months and 80% of patients were able to achieve erection with or without medical aid.
Conclusion: Open or robotic RP can be done safely and effectively in patients who have previously undergone pelvic surgery. Although prior pelvic surgery of the large intestine was associated with increased morbidity, it shouldn't be contraindication for robotic or open RP.
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TwitterIs There an Association Between Serum Prostate-Specific Antigen Values and Serum Testosterone Levels in Healthy Men?
Sun, 2014-09-14 10:26 — Mahmoud MustafaPurpose
To evaluate the relationship between levels of total testosterone and
total prostate-specific antigen (PSA) in healthy men with PSA<4 ng/mL.
Materials
and Methods
The study comprised 179 men with a mean age of 59.19±12 years who visited
Osmaniye State Hospital, Osmaniye, Turkey, between January 2006 and January
2007 for a routine checkup. The patients were divided into two subgroups:
patients with PSA<2.5 mg/ml (group I, n=160 patients) and patients with PSA
of 2.5 to 4 ng/mL (group II, n=19 patients). The relationship between PSA and
testosterone levels was investigated in both groups and in patients aged <60
years. The mean testosterone level was calculated for patients aged <50
years and was compared with the mean value of patients aged ≥50 years.
Results
In all patients, the mean values for serum PSA and total testosterone
were 1.27±0.88 ng/mL and 404.04±158.86 ng/mL, respectively. No correlation was
detected between serum PSA and testosterone levels in either subgroup (group I,
r=0.072, p=0.363; group II, r=0.031, p=0.900) or in patients aged <60 years
(r=0.032, p=0.72). The mean values of testosterone in patients aged ≥50 years
and in patients aged <50 years were 417.01±163.35 and 344.16±120.21 ng/dL,
respectively (p=0.02).
Conclusions
No impact of testosterone was found on the PSA level in healthy men with
PSA <4 ng/mL. Therefore, a high serum testosterone level may not mandate
adjustment of PSA values. This serum sex hormone showed a significant increment
after the age of 50 years. Further studies including a larger number of
patients should be carried out to confirm these findings
