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Friday, April 24, 2009

Blog Updates for April 2009

Apr 23/09/. In ED After Prostatectomy. Part 2 - Rehabilitation we add a reference to this Feb. 2009 paper in the Canadian Urological Association Journal: [PMID: 19293974] [Full Text] which reviews rehabilitation.

Apr 23/09. In Choosing a Surgeon - Part I. Considerations, Choosing a Surgeon - Part I. Considerations we added: Different primary care physicians have different approaches toward PSA testing [PMID: 19296843 ].

Apr 20/09. On the Calculators page under SWOP the link has changed and risk indicators 3-6 are no longer present.




Apr 24/09. In RP vs. LRP vs. RLRP - Part 4. What Surgeons and Others Say: Maurice Anidjar (papers) provides the following table (slightly abbreviated here) in Our Voice vol. 14 No. 1 pg. 10 (2009):
OpenLaparascopicRobotic
IncisionMideline abdominal opening from pubic bone to navel4-5 tiny incisions in the lower abdomen5-6 small lower abdominal incisions
Blood LossAbout 700 mlAverage 400 ml150 ml
Duration of procedure2.5 hours2 hours2 hours
Recoverybladder catheter in place for at least 2 weeks; in-hospital recovery usually 4 days; convalescence up to 6 weeksCatheter removed after 4-7 days; less pain; shorter hospital stay (2 days) and convalescence (4 weeks)Catheter usually removed after 7 days; shortest hospital stay (1 day)
ContinenceAs high as 90% at 1 yearLong-term results at least equivalent to those reported with open surgeryRecovery of urinary control appears to be earlier than with open surgery
PotencyDepending on nerve-sparing, can be up to 85%; takes 18 months or longerLong-term results at least equivalent to those reported with open surgeryResults at least equivalent to best results from open and laparascopic approaches
Surgeon skills involvedMeasured by ability to eliminate the entire tumor and preserve patient's continence and potencyMajor learning curve reuired for surgeon to master the techniqueShorter learning curve than with laparascopic surgery


Apr 24/09. In Radiation risks associated with Prostate Cancer we added: A study presented at the April 2009 American Roentgen Ray Society meeting based on 100 physician surveys in various specialities found that 63% underestimated radiation exposure from abdominal-pelvic CT scans and only 20% thought that radiation risk was a part of disclosure. See this PSA Rising article.

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