https://www.europeanurology.com/article/S0302-2838(06)01350-9/pdf/vattikuti-institute-prostatectomy-contemporary-technique-and-analysis-of-results

Vattikuti Institute Prostatectomy: Contemporary Technique and Analysis of Results

https://www.imop.gr/sites/default/files/review_anatomy22.pdf

A Critical Analysis of the Current Knowledge of Surgical Anatomy Related to Optimization of Cancer Control and Preservation of Continence and Erection in Candidates for Radical Prostatectomy

https://www.europeanurology.com/article/S0302-2838(08)01173-1/pdf/positive-surgical-margins-in-radical-prostatectomy-outlining-the-problem-and-its-long-term-consequences

Positive Surgical Margins in Radical Prostatectomy: Outlining the Problem and Its Long-Term Consequences

https://www.europeanurology.com/article/S0302-2838(12)01003-2/pdf/icud-eau-international-consultation-on-bladder-cancer-2012-urinary-diversion

ICUD-EAU International Consultation on Bladder Cancer 2012: Urinary Diversion

Potency following robotic radical prostatectomy: a questionnaire based analysis of outcomes after conventional nerve sparing and prostatic fascia sparing techniques

OBJECTIVE To accurately define the anatomy of the neurovascular bundle (NVB) in men. MATERIALS AND METHODS The NVB was microdissected in detail bilaterally in 12 fixed human male adult cadavers. The anatomy of the NVB and its relationship to surrounding pelvic structures was ascertained in each specimen. RESULTS Previous reports of the anatomy of the NVB have not mentioned its levator ani and anterior rectal component. The anatomy of the cavernosal nerves is such that accurate graft anastomosis to proximal and distal cavernosal nerve segments is extremely difficult. CONCLUSION The current anatomical description of the cavernosal nerve and NVB is inaccurate.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1464-410X.2004.05106.x

Anatomical studies of the neurovascular bundle and cavernosal nerves

OBJECTIVE To evaluate the implementation of a novel algorithm-based discharge programme for the community follow-up of men with prostate cancer. PATIENTS AND METHODS Men with prostate cancer considered suitable for discharge were identified from consultant-led and clinical nurse-specialist telephone clinics at Nottingham University Hospitals National Health Service Trust. Patients were discharged on to one of four discharge pathways: watchful waiting, androgen-deprivation therapy (ADT), post-prostatectomy, and post-radiotherapy. Primary care providers were asked to adhere to specific surveillance measures and refer patients back to secondary care after breach of pre-defined prostate-specific antigen (PSA) level threshold criteria. Reasons for non-compliance, re-referral, and cause of death were determined for all discharged men. RESULTS In all, 573 men were discharged across all four pathways; 169 on the watchful-waiting pathway, 229 on the ADT pathway, 95 on the post-prostatectomy pathway, and 80 on the post-radiotherapy pathway. All patients had ≥12 months of follow-up. In all, 48 of 54 (88.9%) men were re-referred promptly after a PSA-threshold breach. Of the remaining six patients there were three refusals, one unrelated death before referral, and two late referrals at 4 months. Three patients were lost to follow-up due to database non-registration and were subsequently recalled, none of whom had a PSA-threshold breach. There were three unexpected deaths attributed to prostate cancer: two were community deaths with no biochemical or clinical evidence of prostate cancer progression, while one was due to a likely progressive PSA non-secreting tumour. CONCLUSION Initial results suggest the algorithm-based protocol is a viable, effective, and oncologically safe method for the controlled discharge of men from secondary to primary care. Longer-term follow-up, patient satisfaction and cost-effectiveness data are required to assess the true impact of the initiative.

Initial experience of an algorithm‐based protocol for the community follow‐up of men with prostate cancer

Loco-regional recurrence of renal tumours after surgical excision is uncommon but can pose several difficulties in management. Improved imaging in the follow-up of patients after nephrectomy has inevitably detected smaller regional recurrences in asymptomatic patients. Local recurrence of RCC at the site of a previous nephrectomy responds poorly to both systemic therapy and radiotherapy. The same is true of the rare carcinoid tumour of the kidney, which is the case presented here. One treatment option is re-excision of the renal bed recurrence, which has been shown to prolong survival [1]. Fibrosis secondary to the initial nephrectomy can make complete re-excision of the tumour bulk, with clear histological margins, difficult [2]. Advances in interventional radiology have aided the surgeon in tumour excision. Preoperative localization of a tumour using a wire was first described for breast lesions [3]. Using a variety of imaging techniques it has also been used for lung nodules, musculoskeletal tumours, tissue scar neuromas, hepatic and intraperitoneal lesions [4–7]. We describe the innovative use of a Hawkins III breast localization needle (Medical Device Technologies, Gainesville, FL, USA) for renal bed tumour recurrence, which to the best of our knowledge, has not previously been described.

Owen J. Cole

Papers

Anatomical studies of the neurovascular bundle and cavernosal nerves

Initial experience of an algorithm‐based protocol for the community follow‐up of men with prostate cancer

Innovative use of a Hawkins III breast localization hookwire in preoperative computed tomography-guided localization of renal bed tumour recurrence.