ORLANDO—Dutasteride, a drug widely prescribed for treating benign prostatic enlargement, lowers the risk of prostate cancer PCa progression in men undergoing active surveillance for the disease, researchers concluded.
Dutasteride has been used for BPH and is thought to help reduce the risk of developing prostate cancer. This study also supports its use for men on active surveillance. The medicine is mostly used for the treatment of benign enlargement of the prostate and can have sexual side effects in a small percentage of men.
Relationship between Serum Testosterone and Measures of Benign Prostatic Hyperplasia in Aging Men – Abstract
In our study, the serum testosterone levels in aging men did not correlate with the measures of BPH, including prostate volume and IPSS, regardless of whether total, free, or bioavailable testosterone was used. Age correlated with the measures of BPH, especially prostate volume. Additional large studies are needed to confirm these preliminary results.
To my surprise, patients with higher testosterone levels did not have larger prostates. As expected, patients with higher PSAs and older patients had larger prostates.
In October and November I performed 46 robotic surgeries, including 35 dvPs, 4 partial nephrectomies, 2 nephrectomies, 2 radical cystectomies including a bladder replacement in a woman, 1 simple prostatectomy, a stone procedure to remove a large left kidney stone, and a removal of a piece of ureter and re-implant for ureteral cancer.
The most important operation was the anterior exenteration (removal of bladder) and bladder replacement in a female, the first operation to be done completely robotic for me of this type.
One nice trend I have been noticing is a significant improvement in the recovery of urinary control with the reconstruction sutures I have added to the robotic prostatectomy. Most patients are having decent control by 4-6 weeks. I will be looking at the data in more detail in a few months to see how much of an improvement the addition of these sutures has added.
For the summer months I had the pleasure of inviting my new associate, Dr. Brent Yanke, into our practice.
We spent July together and he is now on his own performing most of his robotic surgery. He was well trained at Thomas Jefferson and had participated in over 100 robotic operations.
In July and August I performed 30 robotic surgeries, including 22 dvPs, a pyeloplasty, 3 nephrectomies, 1 nephro-ureterectomy, a lymph node dissection for testicular cancer, a simple prostatectomy, and a nerve-sparing cysto-prostatetcomy and neobladder for bladder cancer.
The most important accomplishment was the bladder cancer operation. This was the first time that I have made a new bladder with the robot. Our patient had only a small incision in the lower abdomen to remove the specimen and went home in 3 days.
I have been neglectful during the summer with keeping up on my blog.
I will hope to catch up and keep my monthly postings of how things are going in my practice.
In May and June I performed 32 dvPs, a nephrectomy, a simple prostatectomy, and a partial nephrectomy.
The nephrectomy was the live telecast for intuitive surgical at the AUA.
The cystectomy was notable because it was the first time that my team and I did a closed urinary diversion. Traditionally, we have been performing the second half of the operation with a small incision. This time we made an ileal conduit with the daVinci robot as well.
The simple prostatectomy was my 10th, giving me one of the worlds largest experience.
Berlin—A laparoscopic preperitoneal approach cannot only serve as a teaching platform for laparoscopic skills for surgeons, but it also demonstrates reproducible outcomes in the treatment of BPH, according to Belgian researchers who presented their results at the European Association of Urology annual congress here.
Researchers from the Institut Jules Bordet, Universite Libre de Bruxelles in Brussels, conducted a 102-patient prospective study comparing a classical open Millin’s retropubic transcapsular adenectomy in 51 patients and a laparoscopic preperitoneal approach in 52 patients according to a step-by-step transposition of Millin’s procedure described in European Urology (2004; 45:103-9).
Preoperative characteristics were comparable between the groups with respect to age, prostate volume measured by trans-rectal ultrasonography, preoperative micturition, post-void residual volume, and International Prostate Symptom Score (IPSS).
The 1st quarter of 2007 was my busiest for da Vinci Prostatectomies (dvP) for prostate cancer (52 operations), as well as my busiest total robotic surgery 3 month period (60 operations).
My dvP volume increased 63% from the previous year and 24% from the previous quarter, which was then a record.
My total robotic surgery volume increased 50% from the previous year and 15% from the previous quarter, which was then a record as well.
I am starting a new blog series where patients can discuss their stories.
Please understand that anyone can view this and as always patient outcomes can be different.
The thoughts shared on this web site are not in any way meant to represent the surgeons, but are a way for people to share their experiences and hopefully help others.
Posts may be edited at the discretion of the moderator or deleted.
This site does not deal with direct medical advice, but rather general principles. All patients should seek advice from their own physicians.
I will leave this entry open for stories about robotic surgery for BPH.