Long-term outcome of detectable PSA levels after radical prostatectomy.

Detectable prostate-specific antigen levels (PSA) following radical prostatectomy (RP) are believed to represent treatment failure. In this retrospective review, we characterize long-term PSA outcomes following RP (n = 204) in a non-referral hospital performed between 1984 and 1994. With an average follow-up of 10 y, 90 (44%) patients developed a PSA recurrence: 15 (17%) died of prostate cancer despite hormonal intervention, 39 (43%) responded to hormonal therapy with stable remission and 36 (40%) were observed without intervention. Following RP many patients may have a detectable PSA that does not require treatment. PSA doubling time (< 12 months) was the best predictor of disease progression.

Laparoscopic radical prostatectomy: review and assessment of an emerging technique.

BACKGROUND: Several recent reports have affirmed the feasibility of the laparoscopic approach for radical prostatectomy. In this review, we discuss the morbidities associated with this technique and compare outcomes and convalescence with standard open radical prostatectomy. METHODS: We reviewed all currently published data on laparoscopic radical prostatectomy and our series of 45 robotic-assisted radical prostatectomies and compared them to several landmark series of open retropubic and perineal radical prostatectomies. RESULTS: Although the initial series reported long operating times, these times have been significantly reduced in more recent series. Data on blood loss, convalescence, impotence, and incontinence rates have also been promising. CONCLUSIONS: Although follow-up has been short thus far, laparoscopic radical prostatectomy has been shown to be similar to open radical prostatectomy in several areas.

Prostate needle biopsy infection after four or six dose ciprofloxacin.

OBJECTIVE: This retrospective analysis is to determine rates of clinical infection after prostate needle biopsy with four versus six doses of ciprofloxacin to previous literature. MATERIALS AND METHODS: Two groups were treated with pre and post biopsy 500 mg of ciprofloxacin twice daily by either six doses (n=337) or four doses (n=288) with the first dose given 24 or 12 hours prior to the procedure respectively. RESULTS: Six (0.96%) of the 625 patients had symptomatic urinary tract infections with a positive urinalysis and/or culture. One (0.3%) infection occurred among patients receiving six doses of ciprofloxacin, and five infections (1.7%), were identified among four dose patients. Two febrile episodes occurred in the four dose group, one requiring hospitalization. CONCLUSION: A low infection rate associated with prophylactic regimens. Six doses of ciprofloxacin appears more effective than four doses in reducing the clinical and febrile infection rate following ultrasound guided biopsy of the prostate. No obvious financial benefit was observed.