feasibility and accuracy of transperitoneal laparoscopic lymphadenectomy in bladder and prostate cancer

To evaluate the procedure of transperitoneal laparoscopic lymphadenectomy and to assess the predictive value of stage and grade of nodal metastases in bladder and prostate cancer, 47 patients were evaluated for elective laparoscopic pelvic lymph node dissection [LPLND]. The procedure was done for prostatic cancer in 28 patients and bladder cancer in 19 patients. All patients were evaluated by history taking, urine analysis and culture, complete blood picture, liver function tests, serum urea and creatinine and blood sugar. In addition, bladder cancer patients were subjected to plain X-ray and intravenous urography, abdominal and pelvic sonography, CT scan, cystoscopy and biopsy. Prostatic cancer patients were subjected to an estimation of prostatic specific antigen, abdominal and pelvic sonography, transrectal ultrasound guided biopsy, CT scan and bone scan. Transperitoneal laparoscopic lymphadenectomy was done. A histopathological examination of lymph nodes removed laparoscopically was also done. The operative time, intra and postoperative complications encountered were recorded. The results showed that LPLND offers a relatively safe, accurate and minimally invasive alternative to st and ard open lymphadenectomy with minimal morbidity, short hospital stay and rapid recovery

Selection criteria for prostatectomy in benign prostatic hyperplasia

30 patients were selected for prostatectomy based on the conventional urological work up [Symptom score sheet, clinical examination, radiological investigations] in addition to urodynamic assessment. Postoperative symptom analysis and urodynamic examination were done 6 weeks after the operation in all patients to evaluate the outcome and to characterize selection criteria for prostatectomy. In addition to conventional methods of evaluating patients with BPH for prostatectomy, it was found that urodynamic assessment is of great value in certain patients as those with borderline obstructive scores or high irritative scores

Incidental prostatic carcinoma: Clinicopathological study in Ismailia area

Between 1982 and 1990, a total of 240 open prostatectomies were performed for benign prostatic hyperplasia [BPH]. Prostatic carcinoma was incidentally discovered on pathological examination of BPH in 27 [11.3 percent]. We evaluated these neoplasms as a distinctive group to characterize the particular features that may assist the discovery of unsuspected prostatic carcinoma. All of this group were stage A adenocarcinoma of which 12[44.4 percent] were stage Al and 15 [55.6 percent] were stage A2. Accurate grading and clinicopathological staging are imperative in determining the type of interference after surgery

Dry vesicostomy: a new technique in the management of ineffective bladder drainage

Eight patients have been thoroughly chosen to be subjected to a simple new operative technique to create a dry vesicostomy through which clean intermittent catheterization can be conveniently and safely performed to help them combat their lower urinary tract dysfunction. This is a preliminary report illustrating the rational beyond this technique, the eligibility criteria, the operative details together with discussing the short term results and critically reviewing the literature

Evaluation of post-tur instillation of BCG and thiotepa in the management of superficial bladder cancer

The natural history of superficial bladder tumors is characterized by two properties: the tendency of tumors to be multifocal, and the tendency of their recurrences and progression. In this study 45 patients, proved to have stage Pa and P1 transitional cell carcinoma of the urinary bladder, were randomly divided into 3 groups according to the line of treatment whether T.U.R. only, T.U.R. with B.C.G. instillation or T.U.R. with thiotepa instillation. The patients were followed cystoscopically up to 6 years, and the results were evaluated. We concluded that the primary and most effective treatment for superficial bladder tumors remains endoscopic resection. Intravesical BCG and thiotepa proved to be effective in lowering the incidence of recurrence, tumor progression, and invasion