Prostate laser vaporization is safe and effective in elderly men

There are few data on the safety and efficacy of laser photoselective vaporization [LVP] in elderly men. We compared the safety and efficacy of LVP for the treatment of symptomatic benign prostatic hyperplasia [BPH] in men >/= 75 years, who we defined as elderly, to those <75 years. Safety and efficacy outcomes in elderly men undergoing LVP for lower urinary tract symptoms secondary to BPH from 2005 to 2012 were compared with men <75 years. Differences between-groups in demographics, perioperative outcomes, complications, and postoperative changes in International Prostate Symptom Score [I-PSS] were calculated. Of 202 patients, 49 [24%] were elderly [range: 75-95 years] and 153 [76%] were <75 years. Preoperatively, elderly men were more likely to have heart disease [35% vs. 20%, P = 0.03], gross hematuria [6.1% vs. 0.7%, P = 0.05], urinary retention [57% vs. 41%, P = 0.07], and take anti-coagulants [61% vs. 35%, P = 0.002]. Elderly men had a longer median length of stay [1 day vs. 0 day, P = 0.001]. There were no significant between-group differences in transfusion frequency [4.4% vs. 0.7%, P = 0.14] or Clavien III complications [2% vs. 2.6%, P = 1.0]. One month postsurgery, elderly patients reported smaller median decreases in I-PSS [5.5 vs. 9, P = 0.02] and urinary bother [1 point vs. 2, P = 0.03] compared with preoperative values. At till 9 months follow-up, there were no significant between-group differences in median I-PSS or urinary bother scores. Despite a higher prevalence of preoperative comorbidity and urinary retention, elderly LVP patients experienced perioperative safety and shorter term efficacy outcomes comparable to younger men

Unclassified Mucinous Renal Cell Carcinoma: A Rare Histopathological Entity

Renal cell carcinoma (RCC) with mucin production is extremely rare. We present the case of a previously healthy 76-year-old woman who underwent a robotic-assisted laparoscopic right nephrectomy for a 5-cm heterogeneously enhancing right renal mass. Pathology revealed mucin-producing epithelial RCC. We discuss the presentation and pathological features of this case and comment on its definitive treatment.

Management of pelvic lymphoceles following robot-assisted laparoscopic radical prostatectomy

Pelvic lymphocele is a potential complication of radical prostatectomy. Although lymphoceles often regress spontaneously, many may progress, precipitate clinical symptoms, and ultimately require intervention. To date, the best treatment of pelvic lymphoceles has not yet been fully defined. However, laparoscopic marsupialization is a definitive and efficacious surgical alternative to percutaneous drainage. It is effective, results in minimal patient morbidity, and allows for rapid recovery. We report our experience with management of clinically symptomatic pelvic lymphoceles following robotic-assisted prostatectomy using laparoscopic marsupialization