Occurrence of carcinoma prostate in the Pune Metropolitan Region: A 5-year study from 2007 to 2011.

BACKGROUND: A retrospective study was carried out to know only the occurrence of carcinoma prostate (CAP) in the Pune Metropolitan Region (PMR) over a period of five years (January 01, 2007 to December 31, 2011). All the histopathological (HPE) reports of all prostate specimens were collected from 23 medical colleges, private institutions and stand-.alone HPE laboratories in PMR. MATERIALS AND METHODS: Four types of prostate specimens were examined - endoscopic resection, open prostatectomy, transrectal needle biopsy of prostate and prostate from the cystoprostatectomy specimen (surgery carried out for primary carcinoma bladder). Specimens of radical prostatectomy were excluded as the biopsy was carried out earlier. RESULTS: A total of 5006 reports of the prostate specimens were examined out of which 779 showed the presence of CAP. Analysis of annual occurrence of CAP revealed that there was no significant variation in the CAP cases. Thus giving an average of CAP cases of 155.8 per year in PMR. Population data of the PMR was obtained from the official Government of India Census department for the year 2011. Total population of PMR in 2011 was 5,049,968 out of which the male population was 2,659,484. Thus the occurrence of CAP in the PMR works out to 5.86/100,000 male population. Results were compared with the published reports of CAP by the Indian Council of Medical Research (ICMR) of 7.2/100,000 and Globocon of 4.2/100,000 males. CONCLUSIONS: Occurrence of CAP in PMR is low at 5.86/100,000 male population is comparable with published figures of ICMR & Globocon 2012.

Radical cystoprostatectomy: an extraperitoneal retrograde approach.

PURPOSE: We describe a new technical approach for the surgical management of bladder cancer. MATERIALS AND METHODS: Patients with invasive bladder cancer underwent radical cystoprostatectomy using a technically different approach than the conventional method. The important features of this modification include a small infraumbilical incision, completely extraperitoneal dissection to maintain the bowel loops away from the operating field, urethral dissection performed earlier in the operation rather than at the end to preserve the striated urethral sphincter with the neurovascular bundles, completely retrograde dissection of the rectovesical plane for increased safety and reperitonealization done at completion to isolate the urinary anastomoses from the bowel anastomosis. RESULTS: More than 50 consecutive patients with early bladder cancer underwent this operation during a 2-year period. The technique was safe and satisfactory. CONCLUSIONS: Radical retrograde extraperitoneal cystoprostatectomy is based on a finer knowledge of anatomy. It requires accurate dissection, making it inherently superior to the conventional method.