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Radical prostatectomy

All articles from this key word are listed below.

Volume 15, Number 4 Review Articles

Short-, Intermediate-, and Long-term Quality of Life Outcomes Following Radical Prostatectomy for Clinically Localized Prostate Cancer

Management Review

Tyler R McClintock Vinay Prabhu Ted Lee Herbert Lepor

Many clinically localized prostate cancers that are diagnosed today are low risk, and prevention of disease-specific mortality may only be realized decades after treatment. Radical prostatectomy (RP) may adversely impact health-related quality of life (HRQOL) by causing both transient or permanent urinary incontinence and erectile dysfunction. In contrast, RP may also improve HRQOL via relief of lower urinary tract symptoms in men suffering from these symptoms prior to surgery. Because the average man treated for prostate cancer has a life expectancy of approximately 14 years, it is imperative to consider the long-term impact of RP on both survival and HRQOL in treatment decision making. This comprehensive literature review examines short-, intermediate-, and long-term HRQOL following RP. In addition, the long-term results of RP are compared with other treatment modalities for treating clinically localized prostate cancer. [Rev Urol. 2013;15(4):161-177 doi: 10.3909/riu0604] © 2014 MedReviews®, LLC

Prostate cancer Radical prostatectomy Health-related quality of life

Volume 15, Number 2 Review Articles

Conservative Treatment for Postprostatectomy Incontinence

Treatment Update

Bilal Chughtai Alexis E Te Steven A Kaplan Richard Lee

Postprostatectomy incontinence (PPI) is a bothersome complication of radical prostatectomy. Although most men recover from PPI, some men continue to have persistent urinary incontinence. The initial management of persistent PPI usually consists of conservative measures such as pelvic floor muscle exercises. Surgical treatments are usually not entertained for men with urinary incontinence until conservative treatments have failed. This article discusses risk factors for PPI and various options for its treatment, including biofeedback and pharmacotherapy. [Rev Urol. 2013;15(2):61-66 doi: 10.3909/riu0569] © 2013 MedReviews®, LLC

Radical prostatectomy Postprostatectomy incontinence Pelvic floor muscle training

Volume 15, Number 2 Review Articles

The Use of Vacuum Erection Devices in Erectile Dysfunction After Radical Prostatectomy

Management Update

James Adshead Kimberley Hoyland Nikhil Vasdev

The risk of postoperative erectile dysfunction (ED) following radical prostatectomy (RP) is reported to be between 14% and 89%. With an increase in the detection of prostate cancer in younger men, there is a greater emphasis on the appropriate management of ED following RP. A number of options are available to manage ED after RP, including phosphodiesterase-5 inhibitors, intracorporeal injections, intraurethral alprostadil, and vacuum erection devices (VEDs). Penile rehabilitation programs are increasingly used to facilitate the return of natural postoperative erections; the VED is an ideal therapy given that it increases blood flow and oxygenation to the corpora to reverse the changes that result in ED after RP. [Rev Urol. 2013;15(2):67-71 doi: 10.3909/riu0574] © 2013 MedReviews®, LLC

Radical prostatectomy Erectile dysfunction Penile rehabilitation Vacuum erection device

Volume 16, Number 4 Review Articles

Post–Radical Prostatectomy Incontinence: Etiology and Prevention

Prevention Update

Ahmed Abrof Kimberley Hoyland Gregory Boustead Nikhil Vasdev

All patients undergoing a radical prostatectomy (RP) using any surgical approach, be it open, laparoscopic, or robotic, are at risk of developing postprostatectomy urinary incontinence. This side effect of RP has an effect on the patient’s quality of life and can be associated with moderate to severe postoperative morbidity. The authors present a review of the etiology and prevention strategies of postprostatectomy urinary incontinence. Based on the current literature, the authors conclude that there is a paucity of studies that can accurately answer the exact anatomic and physiologic etiologies of postprostatectomy urinary incontinence. The aim of urologic surgeons performing RP should be to reduce the rate of postoperative incontinence rather than attempting to treat it once it has occurred. Further studies aimed at providing a detailed anatomic map of the pelvic anatomy related to continence will help to improve surgical techniques and reduce postoperative urinary incontinence following RP. [Rev Urol. 2014;16(4):181-188 doi: 10.3909/riu0606] © 2014 MedReviews®, LLC

Radical prostatectomy Urinary incontinence Urethral length

Volume 16, Number 3 Meeting Reviews

Best of the 2014 AUA Annual Meeting

Adam JM Kern Alan W Partin Ellen Shapiro

[Rev Urol. 2014;16(3):139-144 doi: 10.3909/riu0636] © 2014 MedReviews®, LLC

Prostate cancer Vesicoureteral reflux Radical prostatectomy Metastatic castration-resistant prostate cancer Pediatric urology Cryptorchidism

Volume 19, Number 3 Case Review

High Postprostatectomy Prostate-specific Antigen Level Prior to Salvage Radiation Therapy Is Not Always a Bad Sign

Steven C Eberhardt Thomas M Schroeder John T Rathbun

Although radical prostatectomy is a popular treatment modality for clinically localized prostate cancer, 10-year biochemical recurrence can reach 28%. Before salvage radiation therapy (SRT), prostate-specific antigen (PSA) values alone should be used cautiously in predicting SRT eligibility. A long, slow PSA rise may suggest locally confined disease still amenable to SRT; corresponding imaging to identify potential gross recurrence is useful. Patients with local disease may safely benefit from higher doses of radiation. [Rev Urol. 2017;19(3):190–194 doi: 10.3909/riu0754] © 2017 MedReviews®, LLC

Prostate-specific antigen Radical prostatectomy Salvage radiation therapy