Robot-assisted versus open radical cystectomy: no clear signs of immediate benefit

Many readers of this blog have probably heard or read the reports like this one on the CBS Evening News or this one on the Reuters web site that there were no significant short-term (perioperative) differences in outcome between robot-assisted radical cystectomy (complete removal of the bladder) and the older open surgical procedure. … READ MORE …

ART or SRT in high-risk patients post-surgery?

As many of our regular readers will know, there is no clear answer to the question whether, among men at elevated risk of progressive disease after first-line surgery, it is better to have adjuvant radiation therapy (ART) within a few months of surgery or to wait until salvage radiation therapy (SRT) is clearly advisable. … READ MORE …

How much do you think you should pay for a radical prostatectomy?

We wish we’d seen this earlier, but apparently in March 2014 an article in Urology gave us an outstanding overview of the wildly different prices that you (but perhaps not your insurance company) might be asked to pay for a radical prostatectomy at 100 hospitals across the USA. … READ MORE …

Heterogeneity of outcomes after radical prostatectomy: the surgeon is a factor

It will come as no surprise to regular readers of this blog that there is variation among surgeons in the overall quality of their patients’ outcomes after radical prostatectomy. However, a newly published and large study of outcomes among surgeons in Sweden does expand our knowledge on this topic. … READ MORE …

Surgery vs. radiation therapy in first-line treatment of prostate cancer: a travesty

Almost exactly a year ago, we commented unfavorably on a media release issued by the European Association for Urology (EAU). The media release referred to a presentation made by Sooriakumaran et al. at the annual meeting of the EAU in 2013. … READ MORE …

The SPCG-4 trial: follow-up data after > 23 years

This week’s New England Journal of Medicine contains data from a fifth update to the Scandinavian Prostate Cancer Group Study Number 4 (SPCG-4) trial of radical prostatectomy vs. watchful waiting in “early” prostate cancer. … READ MORE …

The surgical learning curve and post-RALP outcomes over time

Two new and quite separate papers offer rather different perspectives on the value of robot-assisted laparoscopic prostatectomy (RALP) as a first-line treatment for the management of localized prostate cancer. … READ MORE …

5-year cumulative incidence of complications after surgery or radiation therapy

A new report just published in Lancet Oncology provides data on complications other than incontinence and erectile dysfunction (ED) after surgical or radiotherapeutic treatment of prostate cancer within 5 years of the initial treatment. … READ MORE …

Managing common side effects of radical prostatectomy

We have already mentioned the article on genomics and biomarkers in this month’s issue of AUA News, but there are two other articles in this issue of the publication that are likely to be of interest to at least some of our regular readers. … READ MORE …

Peripheral pain after treatment for prostate cancer

Every so often (but not frequently) we come across patients who complain of various types of peripheral pain after treatment for their prostate cancer, and we have never previously had a good or specific possible explanation of why such pain might occur. … READ MORE …

Xiaflex approved by FDA for treatment of Peyronie’s disease

Last week many media outlets covered the approval of a drug called Xiaflex (collagenase Clostridium histolyticum) for the non-surgical treatment of Peyronie’s disease. … READ MORE …

Better training needed for surgeons using da Vinci robots?

There is an interesting article on the Bloomberg web site today addressing the appropriate training of surgeons prior to unsupervised use of Intuitive Surgical’s da Vinci robot. … READ MORE …

Increasing transparency about quality of sexual function after surgery

A recent study in the Journal of Endourology reports prospective data on the recovery of potency following radical prostatectomy and concludes that the “overwhelming majority of men experience a deterioration in the overall quality of erection” after robot-assisted prostatectomy. … READ MORE …

Further recommendations from the “Choosing Wisely” initiative

The American College of Surgeons, as part of the American Board of Internal Medicine (ABIM) Foundation’s “Choosing Wisely” campaign, directed to physicians and their patients, has issued seven new recommendations to the surgical community, four of which are (at least to some degree) directly relevant to the surgical treatment of prostate cancer. … READ MORE …

Alan Partin interviewed on robot-assisted vs. “open” surgery for prostate cancer

Many readers may be interested in reading an interview given by Dr. Alan Partin of Johns Hopkins on the relative merits of robot-assisted and traditional (“open”) methods of radical prostatectomy. Dr. Partin is highly experienced in the use of both techniques.

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