ABSTRACT
Objective To compare the clinical features and results between transperitoneal laparoscopic radical prostatectomy and extraperitoneal laparoscopic radical prostatectomy.Methods Thirty-three prostate cancer patients treated with laparoscopic radical prostatectomy. Among them,21 cases had been done transperitoneally and 12 cases had been done extroperitoneally. The two different approaches were evaluated and compared in respects of operating time, estimated blood loss, complications during surgery, postoperative complications, intestinal function recovery time, catheterization time and length of hospital stay.Results All the surgeries had completed successfully without conversion to open surgery. For transperitoneal approach and extraperitoneal approach, the operating time was (299±46)min and (309±64)min, blood loss was (618±448)ml and (677±469)ml. There were 3 cases with severe blood loss, 2 cases with bladder injuries and 1 case with ureteral injury in transperitoneal approach group. There were 1 case with severe blood loss, 1 case with obturator never injury, 1 case with cysto-ureteral injury and 1 case with peritoneum injury in extraperitoneal approach group. For transperitoneal approach and extraperitoneal approach,the catheterization time was(14.6±3.8)d and (12.3±2.9)d, intestinal function recovery time was (2.7±0.7)d and (2.1±0.5)d, length of hospital stay was (17.0±3.6)d and (11.2±3.5)d, respectively.Conclusions Laparoscopic radical prostatectomy is feasible and safe in clinical practice. Extraperitoneal approach has better vision, less impact on abdominal organs, faster recovery and shorter hospital stay comparing to transperitoneal approach.
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the value of percutaneous vasography in the diagnosis of the disorders of the seminal duct system.</p><p><b>METHODS</b>Percutaneous vasography was performed successfully in 63 male patients (24 cases of infertility, and 21 hemospermia, 16 chronic prostatitis, and prostate carcinoma) from November 1974 to December 2003.</p><p><b>RESULTS</b>Vasography revealed abnormal ducts in 28 and disorders in 38 (60.3%), including 8 cases of sterility, 13 seminal vesiculitis, 16 chronic prostatitis 5 seminal vesical cyst, and 2 prostate carcinoma.</p><p><b>CONCLUSION</b>Percutaneous vasography is an effective method to identify diseases of the seminal vesical and ductal system.</p>
Subject(s)
Adult , Aged , Humans , Male , Middle Aged , Ejaculatory Ducts , Diagnostic Imaging , Genital Diseases, Male , Diagnostic Imaging , Radiography , Methods , Seminal Vesicles , Diagnostic Imaging , Vas Deferens , Diagnostic ImagingABSTRACT
Objective To study the feasibility of transperitoneal laparoscopic radical prostatectomy. Methods Laparoscopic radical prostatectomy was performed according to Montsouris technique. Results All the operations were successfully completed. The operating time was 330~540 min (mean, 433 min) and the estimated blood loss was 100~550 ml (mean, 274 ml). No patients required a blood transfusion. Bladder injury was found in 1 patient and was sutured promptly during the operation. The postoperative hospital stay was 15~23 days (mean, 17 days). The catheterization time was 14~23 days (mean, 16 days). In 2 patients presenting with urinary leakage, the catheter was removed at 20 and 23 days after surgery respectively, while in the remaining 8 patients, at 2 weeks after operation. Mild urinary incontinence occurred in 3 patients and disappeared after 4 weeks of supportive treatment. Pathological examinations revealed stage pT_ 1c) in 3 patients, stage pT_2 in 6, and stage pT_3 in 1. A follow-up for 3~21 months (mean, 7.5 months) was carried out. The postoperative prostate-specific antigen (PSA) level was 0~2.70 ?g/L(mean,0.05 ?g/L). Two patients returned a normal sexual function. Conclusions Strict following surgical indications, adequate preoperative preparation, improvement of surgical techniques, and proper application of surgical instruments and devices make transperitoneal laparoscopic radical prostatectomy feasible.