Long-term functional outcomes of vesicourethral anastomosis with bladder neck preservation and distal urethral length preservation after videolaparoscopic radical prostatectomy.

Introduction: Radical prostatectomy (RP) is the standard surgical treatment for localized prostate cancer (PCa), with excellent oncologic outcomes; however, complications such as post-prostatectomy incontinence could significantly affect quality of life. Aim: To provide data on long-term urinary functional outcomes of bladder neck preservation (BNP) combined with distal urethral length preservation (DULP) in patients treated with videolaparoscopic prostatectomy. Material and methods: In this retrospective study, data were analysed from 619 consecutive patients who underwent laparoscopic radical prostatectomy (LRP) due to localized prostate cancer between November 2014 and December 2018 in a single tertiary care centre in Poland. Of these patients, 227 had BNP and DULP during the procedure. Urinary continence status was assessed in patients at 3, 6, 12, and 18 months after LRP. Cancer resection was assessed by surgical margin status. Results: In the group with BNP and DULP, urinary continence recurred earlier than it did in the control group up to 3 months after surgery: 204 (89.8%) patients in this group were fully continent compared with 283 (72.2%) in the control group (p < 0.001). The difference was also significant after 6 months (95.1% vs. 80.6%, respectively; p < 0.001). Despite these early promising results, there was no difference in urinary continence recovery after 12 and 18 months. There was also no difference between the 2 groups regarding surgical margin status of the resected tissue. Conclusions: Our study showed that BNP combined with DULP is a safe procedure that helps to improve early urinary continence rates after surgery without altering the risk of positive surgical margin.

Polish translation and cross-cultural adaptation of the five-item International Index of Erectile Function.

Introduction: Erectile dysfunction (ED) affects men worldwide and impairs physical and mental health and quality of life. Use of specific ED-dedicated tools is currently recommended to assess ED severity. A widely used instrument is the International Index of Erectile Function short form (IIEF-5). The IIEF-5 was not yet rigorously translated and adapted in Polish. Therefore, the aim of this study was to translate and culturally adapt the IIEF-5 in Polish to extend its applicability as an evaluation tool for clinical and research settings. Material and methods: Professional, sworn, independent translators, in cooperation with Polish language specialists and the authors, translated the IIEF-5 into Polish according to standardized forward-backward procedures. The final translated version was further assessed during direct interviews with 30 men who had ED and who were recruited from the Department of Urology, Jagiellonian University, Poland. The content, wording, applicability, and cultural relevance of the translation were discussed with all the included patients. Results: The expert panel composed of the authors, translators, and Polish language specialists produced the Polish version of the IIEF-5. Thirty Polish-speaking men with ED, most with organic and severe ED, completed the questionnaire. All the participants agreed that the instrument was clear, easy to understand, complete, and quick to finish. No items were missing. Conclusions: The Polish version of the IIEF-5 is a valid tool to determine ED severity. This evaluation instrument is valuable for clinical and research use, including use for population-based studies on ED prevalence and for interpreting findings among international studies.

Investigation of Chromosome 1 Aberrations in the Lymphocytes of Prostate Cancer and Benign Prostatic Hyperplasia Patients by Fluorescence in situ Hybridization.

PURPOSE: Radiotherapy is one of the most common treatments for prostate cancer. Finding a useful predictor of the therapeutic outcome is crucial as it increases the efficacy of treatment planning. This study investigated the individual susceptibility to radiation based on chromosome 1 aberration frequency measured by the FISH (fluorescence in situ hybridization) method. PATIENTS AND METHODS: Whole blood samples were collected from 27 prostate cancer (PCa) patients and 32 subjects with benign prostatic hyperplasia (BPH), who were considered as a control group. Samples were irradiated with 2 Gy of x-rays, cultured, harvested, and used in the FISH procedure. RESULTS: After irradiation, significantly higher levels of all studied chromosome 1 aberrations (except for deletions) in the group of PCa patients were revealed. Furthermore, in the lymphocytes of cancer patients, nearly five-fold higher frequencies of acentric fragments were observed compared to the BPH group. The highest individual radiosensitivities for all estimated biomarkers were seen in PCa patient cells who reported cancer incidence in the immediate family (CIF+). CONCLUSION: The differences in chromosome 1 aberrations between PCa and BPH demonstrate that lymphocytes taken from patients with prostate cancer have higher radiosensitivity which might be related to hereditary or familiar inclinations. Therefore, this technique may find future application in searching biomarkers of the cellular radiotherapy response in prostate cancer patients.

Correlation of urinary incontinence with depression severity of patients treated for depression.

INTRODUCTION: Urinary incontinence (UI) is a major public health issue because of the high number of individuals affected, its adverse effects on job-related functioning, and the decline in quality of life. The association between UI and symptoms of depression has been evaluated extensively for the general population. However, relationships between UI and depression have not been adequately assessed for specific patient groups. Thus, we investigated the association between UI and depression severity in patients treated for depression. MATERIAL AND METHODS: This study was a single-center, prospective, cross-sectional inquiry. We analyzed questionnaire data on UI and depression from depressed patients treated in our Department of Adult Psychiatry. Patients completed the International Consultation on Incontinence Questionnaire Short Form and General Health Questionnaire whereas psychiatrists administered the Hamilton Rating Scale for Depression. RESULTS: One hundred two patients were enrolled in the study. Most patients had mild depression. Patients who were incontinent mostly reported moderate UI and UI was statistically more prevalent in women than in men. Further, with the General Health Questionnaire, depression severity in women was significantly associated with the severity of UI. We did not observe correlation between depression severity analyzed with the Hamilton Rating Scale for Depression and UI. CONCLUSIONS: In the cohort of patients treated for depression, UI affected more women than men. In wo- men, UI was associated with the severity of depression. Because UI and depression may coexist and share the symptom burden, particularly in women, clinicians should be aware of the interconnection between these two conditions.

[Surgical management of severe Peyronie's disease]. / Chirurgiczne leczenie ciezkich postaci choroby Peyronie.

Peyronie's disease (lat. induratio penis plastica) is a process of the fibrotic plaques oand other localized fibrotic conditions have been considered to be the result of an abnormal size, pain and improved penile curvature. At early stages intralesional injections may decrease penile curvature and decrease plaque volume although the exact mechanism of action on Peyronie disease is unknown. In serious cases surgery is recommended, based on ultrasound examination, cavernosography and cavernosometry. There are three mail surgical procedures to correct the curvature in Peyronie's disease: Nesbit plication, plaque excision followed by skin grafting, another autograft or synthetic material, and implantation of a penile prosthesis Aim of this study is to present our experience in surgical treatment of severe stadium in Peyronie's disease. Peyronie plaque was excised in 8 man, previously potent with severe satium of the disease. In every case saphenous autograft replacing excised plaque was used. In every case was not intra and postoperative complications. All patients reported satisfactory cosmetic and functional result. The satisfactory result of the treatment of severe stadium Peyronie disease is based on the surgical method. Saphenous graft is effective, safe and successful technique in our knowledge.