Complete puborectalis, puboperinealis muscle and urethral rhabdomyosphincter preservation in laparoscopic radical prostatectomy: Anatomical landmarks to achieve early urinary continence.

OBJECTIVES: To describe our surgical technique of "muscle-sparing" laparoscopic radical prostatectomy and to review relevant anatomical landmarks during the procedure. METHODS: This was a prospective non-controlled case series of 120 consecutive patients who underwent laparoscopic radical prostatectomy, always carried out by the same surgeon (OL). The median follow-up period was 33 months. Dissection of the puboperinealis and puborectalis muscle consists of the precise dissection of the puborectalis and puboperinealis muscles from the periprostatic fascia. Rhabdomyo-dissection consists of an approach that spares the external urethral sphincter from the ventral surface of the prostate and membranous urethra. Clinical data were collected in a dedicated database. Intraoperative variables, postoperative complications and outcomes of urinary continence were assessed. A descriptive statistical analysis was carried out. RESULTS: Continence rates were 70.8%, 83.3% and 92.5%, at 0-2, 3-4 and 5-8 weeks after removal of the urethral catheter, respectively; 96.6% and 98.3% at 6 and 12 months after surgery. The positive surgical margin rate associated with rhabdomyo-dissection was 8.3%. CONCLUSIONS: Laparoscopic radical prostatectomy with dissection of the puboperinealis and puborectalis muscle, and rhabdomyo-dissection is an oncologically safe procedure, associated with very early recovery urinary continence in most patients. It is a technique that can be applied in most cases, as long as there is no invasion of the ventral side of the prostate.

[Targeted biopsies using magnetic resonance imaging/ultrasonograpgy fusion compared with sistematic biopsies prostate cancer detection. Initial experience.] / Comparación entre la biopsia prostática con fusión de imagen ecografía/resonáncia magnética y la biopsia sistemática para la detección de cáncer de próstata. Experiencia inicial.

OBJECTIVE: To describe the initial experiencein our center on targeted prostate biopsies (TB) using Magnetic Resonance imaging/ultrasonography (MRI/US) fusion and to compare PCa detection with systematic biopsies (SB). PATIENTS AND ME THODS: A retrospective, descriptive and comparative study was conducted on the first 94 men who underwent TB using MRU/US fusion in our center since February 2017 to March 2018. All patients underwent a protocol of 6-12 cores of systematic biopsies (SB) (except 9) and 2-6 targeted coreson the MRI index lesion. The Hitachi/HiVision Preirus equipment was used with RVS software (Real-time virtual sonography) and a biplane transducer for the fusion imaging procedure. Clinically significant PCa (csPCa) was defined as: at least one core with a Gleason score of 3+4. RESULTS: The proportion of patients diagnosed with PCa was higher in TB compared with SB (p=0.035) and the mean of core performed for diagnosis was lower in TB compared with SB (p<0.001). A trend towards an improved detection of csPCa in TB compared to SB was observed (p=0.063). CONCLUSIONS: The MRI/US fusion targeted biopsies (TB) showed a higher detection rate of PCa, with less cores taken for diagnosis and a tendency to better identification of csCaP compared to SB.

OBJETIVO: El objetivo de este estudio es describir la experiencia inicial en nuestro centro de las primeras 94 Biopsias de Próstata dirigidas (BD) con fusión de imagen ecografía/Resonancia magnética (US/RMmp) y comparar la tasa de detección de CaP con las biopsias sistemáticas.MATERIAL Y MÉTODOS: Se realizó un estudio retrospectivo, descriptivo y comparativo de los primeros 94 pacientes sometidos a BD por fusión de imagen US/RMmp en nuestro centro desde febrero de 2017 hasta marzo de 2018. Todos los pacientes fueron sometidos a un protocolo de 6-12 cilindros de biopsias sistemáticas (BS) (menos 9) y de 2-6 cilindros dirigidos a las lesiones diana visualizadas en la RMmp. Se utilizó el equipo Hitachi/HiVision Preirus con software RVS (Real-time virtual sonography) y un transductor biplanar para la fusión de imagen. Se definió como CaP clínicamente significativo un GS ≥ 3+4 en, al menos, 1 de los cilindros realizados. RESULTADOS: La proporción de detección de CaP fue mayor en las BD que en las BS (p=0,035) y el número de cilindros realizados para su diagnóstico fue menor en las BD comparado con las BS (p<0,001). Se observó  una clara tendencia a una mayor identificación de CaP clínicamente significativo (CaPcs) en las BD comparado con las BS (p=0,063). CONCLUSIONES: Comparado con las BS, las BD por fusión de imagen US/RMmp presentaron una mayor tasa de detección de CaP y una tendencia a una mayor identificación de CaPcS con una necesidad menor de cilindros realizados.

Comparación entre la biopsia prostática con fusión de imagen ecografía/resonáncia magnética y la biopsia sistemática para la detección de cáncer de próstata. Experiencia inicial / Targeted biopsies using magnetic resonance imaging/ultrasonograpgy fusion compared with sistematic biopsies prostate cancer detection. Initial experience

OBJETIVO: El objetivo de este estudio es describir la experiencia inicial en nuestro centro de las primeras 94 Biopsias de Próstata dirigidas (BD) con fusión de imagen ecografía/Resonancia magnética (US/RMmp) y comparar la tasa de detección de CaP con las biopsias sistemáticas. MATERIAL Y MÉTODOS: Se realizó un estudio retrospectivo, descriptivo y comparativo de los primeros 94 pacientes sometidos a BD por fusión de imagen US/RMmp en nuestro centro desde febrero de 2017 hasta marzo de 2018. Todos los pacientes fueron sometidos a un protocolo de 6-12 cilindros de biopsias sistemáticas (BS) (menos 9) y de 2-6 cilindros dirigidos a las lesiones diana visualizadas en la RMmp. Se utilizó el equipo Hitachi/HiVision Preirus con software RVS (Real-time virtual sonography) y un transductor biplanar para la fusión de imagen. Se definió como CaP clínicamente significativo un GS ≥ 3 + 4 en, al menos, 1 de los cilindros realizados. RESULTADOS: La proporción de detección de CaP fue mayor en las BD que en las BS (p = 0,035) y el número de cilindros realizados para su diagnóstico fue menor en las BD comparado con las BS (p < 0,001). Se observó una clara tendencia a una mayor identificación de CaP clínicamente significativo (CaPcs) en las BD comparado con las BS (p = 0,063). CONCLUSIONES: Comparado con las BS, las BD por fusión de imagen US/RMmp presentaron una mayor tasa de detección de CaP y una tendencia a una mayor identificación de CaPcS con una necesidad menor de cilindros realizados

OBJECTIVE: To describe the initial experience in our center on targeted prostate biopsies (TB) using Magnetic Resonance imaging/ultrasonography (MRI/US) fusion and to compare PCa detection with systematic biopsies (SB). PATIENTS AND METHODS: A retrospective, descriptive and comparative study was conducted on the first 94 men who underwent TB using MRU/US fusion in our center since February 2017 to March 2018. All patients underwent a protocol of 6-12 cores of systematic biopsies (SB) (except 9) and 2-6 targeted cores on the MRI index lesion. The Hitachi/HiVision Preirus equipment was used with RVS software (Real-time virtual sonography) and a biplane transducer for the fusión imaging procedure. Clinically significant PCa (csPCa) was defined as: at least one core with a Gleason score of 3+4. RESULTS: The proportion of patients diagnosed with PCa was higher in TB compared with SB (p = 0.035) and the mean of core performed for diagnosis was lower in TB compared with SB (p < 0.001). A trend towards an improved detection of csPCa in TB compared to SB was observed (p = 0.063). CONCLUSIONS: The MRI/US fusion targeted biopsies (TB) showed a higher detection rate of PCa, with les cores taken for diagnosis and a tendency to better identification of csCaP compared to SB

Metastasis of rectal adenocarcinoma to the penis.

OBJECTIVE: To report a clinical case of penile metastasis of a rectal adenocarcinoma. METHODS: We report the case of a 78-year-old male with a clinical history of rectum adenocarcinoma. The management included an anterior rectum-resection and postoperative combination of neoadjuvant chemo and radiotherapy. Eight months after the operation, a painful solitary nodular lesion on the glans penis was diagnosed. We performed a needle biopsy (Tru-cut). RESULTS: Histological examination confirmed metastasis of the rectal tumour. We performed partial penectomy. CONCLUSIONS: The incidence of penile metastasis is extremely low. In a large number of cases the primary tumour is localized in the genito-urinary tract, less likley they originate from other organs. The treatment, depending to each case, is mostly palliative due to the poor prognosis of disease.

Metástasis de adenocarcinoma de recto en el pene / Metastasis of rectal adenocarcinoma to the penis

OBJETIVO: Aportar un caso de metástasis peneana de adenocarcinoma de recto. MÉTODOS: Presentamos el caso clínico de un varón de 78 años con tumoración de recto, localizado en el tercio medio. Se realizó una resección anterior de recto con combinación de quimioradioterapia neodayuvante. A los 8 meses de la intervención presenta un nódulo solitario doloroso con ulceración central en el glande. Realizamos biopsia de la lesión por aguja fina (Tru-cut). RESULTADO: Estudio de anatomía patológica confirma metástasis de adenocarcinoma intestinal compatible con tumor primario de recto. Tras descartar otras lesiones metastásicas mediante el TAC, realizamos penectomía parcial. CONCLUSIONES: La incidencia de las metástasis peneanas es muy baja. Este tipo de lesiones proceden, sobre todo, de los tumores primarios de los órganos genitourinarios y raras veces de otros órganos. El tratamiento es variado dependerá de cada caso y habitualmente paliativo debido a mal pronóstico de la enfermedad

OBJECTIVE: To report a clinical case of penile metastasis of a rectal adenocarcinoma. METHODS: We report the case of a 78-year-old male with a clinical history of rectum adenocarcinoma. The management included an anterior rectum-resection and postoperative combination of neoadjuvant chemo and radiotherapy. Eight months after the operation, a painful solitary nodular lesion on the glans penis was diagnosed. We performed a needle biopsy (Tru-cut). RESULTS: Histological examination confirmed metastasis of the rectal tumour. We performed partial penectomy. CONCLUSIONS: The incidence of penile metastasis is extremely low. In a large number of cases the primary tumour is localized in the genito-urinary tract, less likley they originate from other organs. The treatment, depending to each case, is mostly palliative due to the poor prognosis of disease

Next generation sequencing based development of intron-targeting markers in tetraploid potato and their transferability to other Solanum species.

Intron-targeting (IT) markers were developed from next generation sequencing (NGS) derived transcript sequencing data from the potato cultivar White Lady. The applicability of the IT markers was analyzed in other potato genotypes, and their transferability was studied in other Solanum species: section Archaesolanum (5 species), sect. Solanum (6 species) and a Solanum nigrum population (11 genotypes). Out of 250 randomly chosen transcript sequences, 144 intron harboring loci could be identified for which primer pairs were designed on exons flanking the putative introns. The usefulness of the IT primers was experimentally analyzed on a subset of 40 randomly chosen loci. Statistical analysis of diversity parameters was performed using the ATETRA and POPGENE software packages. By localizing the detected 17 polymorphic loci 11 of the 12 potato chromosomes could be identified. Specificity of the designed IT primers was tested by sequence analysis of amplified IT fragments in a randomly chosen locus. The results revealed the efficiency of NGS derived IT marker development and indicated their utility in diverse molecular analyses including their applicability for cross-species studies.