ABSTRACT
Different modalities for treating prostate cancer are evolving worldwide. Radical prostatectomy is still ranking on top of the list for organ- confined disease. This study was conducted out to describe the indications, surgical technique, complications and outcome of radical retropubic prostatectomy for prostate cancer over an 8- year period at Prince Hussein Center of Urology and Organ Transplant, King Hussein Medical Center. Between August 1999 and June 2007, a total of 81 patients [age range 50-68 years] underwent radical retropubic prostatectomy for organ confined prostate cancer [stage Tla-T2c] based on Prostate Specific Antigen values, histopathology reports [Gleason Score 4-7] and negative metastatic work up. Follow-up of these patients ranged between 1 and 7 years. The medical records of these patients were reviewed, and analyzed regarding indications, surgical technique, complications, and outcome. None of the patients had pelvic lymph node involvement, and surgery accomplished in 2.5-3.5 hours. Estimated blood loss was between 500 and 2000ml. Early continence, within 4 weeks after surgery, was achieved in 51/81 [62.9%] and in 98.7% after one year. Potency within 1 year was achieved in 42 patients [51.8%], but with medications this number reached 52 [64%]. Margin positive histopathology reports were seen in 12 patients [14.8%] warranting further treatment with either radiotherapy or hormonal therapy. Mortality rate in the study group was 2.5% as a result of disease progression and dissemination. Radical Retropubic Prostatectomy stands the gold standard method of treatment for localized prostate cancer with excellent results in cure and tumor control
ABSTRACT
To present our experience with ureteroscopy for the treatment of ureteral calculi. A retrospective review of 904 ureteroscopies for ureteric lithiasis performed in 810 patients [mean age 39.3 years: range 14-70 years; 485 males, 325 females] at Prince Hussein Bin Abdullah Urology Center between January 2006 and January 2008 was conducted. A 9.5F rigid ureteroscope was used in all patients. Pneumatic lithoclast was used to fragment stones and the fragments were retrieved with forceps and/or baskets. Hospital and follow-up records of the patients were reviewed in this study. Success and complication rates are presented. Sixty one [7.5%] of the stones were located in the upper, 204 [25.2%] in the middle and 545 [67.3%] in the lower ureter. The size of the stones treated ranged between five to 20 mm. Ureteroscopy resulted in successful stone removal in 750 patients [92.6%]. Six hundred and fifty six stones were treated in a single session. Repeat ureteroscopy was performed in 94 patients [11.6%]. In 53 patients [6.5%] the stones were pushed up and successfully underwent ESWL. Antegrade renoureteroscopy was performed in three cases of ureteroscopy failure for fixed tipper ureteric stones. A total of four patients with ureteroscopy failure were referred for open surgery. Gross hematuria was observed in eight [1.0%] patients, 15 [1.9%] patients suffered from postoperative fever for an average of two days [range 1-4 days], 17 [2.1%] patients had persistent renal colic. Nine cases [1.1%] of ureteral perforation were successfully treated by JJ stent, and only one case of ureteral avulsion [upper ureter] was treated by open surgery. Four cases of postoperative ureteral stricture have been observed. On the basis of our experience, ureteroscopy is an effective interventional modality for ureteric stones w ith a low complication rate