Introduction: Retzius-sparing prostatectomy was promoted with the early continence result. The long-term oncologic outcome is still unknown. In this study, we aimed to compare the intermediate-term oncologic outcomes of these two approaches in patients' cohort who were treated as part of a randomized controlled trial. Methods: A total of 120 patients were previously randomized equally to receive Retzius-sparing robot-assisted laparoscopic radical prostatectomy (RS-RARP) vs standard robot-assisted laparoscopic radical prostatectomy (S-RARP) between January 2015 and April 2016. Baseline, surgical, and pathologic characteristics as well as oncologic outcomes were assessed. The analysis was done based on the treatment received. Result: Sixty-three patients underwent S-RARP, whereas 57 patients underwent RS-RARP. There was no statistically significant difference in the baseline nor surgical characteristics. The median follow-up was 71.24 (interquartile range: 59.75-75.75) months. There were more pathologic T3 diseases in RS-RARP. There was no significant difference in the positive margin status nor in the biochemical recurrence (BCR) rate among both groups. After S-RARP and RS-RARP, 6 and 10 patients had BCR, and the 5 years BCR-free survival was 91% and 85%, respectively (p = 0.21). Conclusion: In this cohort, there was no difference in BCR in the patients who received either technique. Further multi-institutional studies with a larger sample size and longer follow-up are required.

OBJECTIVE To evaluate the perioperative complications of Single-Port Robotic Radical Prostatectomy. MATERIALS & METHODS A retrospective review was performed on the prospectively-maintained, IRB-approved, multi-institutional Single-Port Advanced Research Consortium (SPARC) database. A total of 1103 patients were identified who underwent three different approaches of SP-RARP between 2019 and 2022 using the purpose-built SP robotic. In addition to baseline clinical, perioperative outcomes, this study comprehensively analyzed for any evidence of intraoperative complication as well as postoperative complication and readmission within 90 days of the respective surgery. RESULTS Of the 244, 712, and 147 patients who underwent transperitoneal, extraperitoneal, and transvesical SP-RARP, respectively, intraoperative complications were noted in 5 patients (0.4%), all of which occurred during the transperitoneal approach. Two patients had bowel serosal tears, two had posterior button-holing of the bladder necessitating repair, and one patient had an obturator nerve injury. Postoperative complications were noted in 143 patients (13%) with major complications (Clavien Grade ≥3) only identified in 3.7% of the total cohort. The most common complications were lymphocele (3.9%), acute urinary retention (2%), and urinary tract infection (1.9%). The 90-day readmission rate was 3.9%. CONCLUSION SP-RARP is a safe and effective procedure with low complication and readmission rates regardless of the approach. These results are comparable to current multi-port robotic radical prostatectomy literature.

You have accessJournal of UrologyHistory of Urology Forum II (HF02)1 Sep 2021HF02-14 JOHN KELSO ORMOND: MORE THAN A SYNDROME Naveen Kachroo, Craig Rogers, and James Peabody Naveen KachrooNaveen Kachroo More articles by this author , Craig RogersCraig Rogers More articles by this author , and James PeabodyJames Peabody More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001993.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: John Kelso Ormond is remembered for his seminal paper providing the first description in English medical literature of Idiopathic Retroperitoneal Fibrosis (IRF) or Ormond’s Syndrome. We examine the many contributions this progressive Urologist provided in advancing the field of urology. METHODS: A comprehensive literature review concerning the life and works of Dr John Kelso Ormond was performed via online search, review of published historical texts and published material on PubMed. Contemporary records held by The Conrad R. Lam medical archives at Henry Ford Hospital were also reviewed. RESULTS: John Kelso Ormond (1886-1978) received his MD degree from Johns Hopkins University in 1914 and was the first surgical resident at the newly established Henry Ford Hospital in Detroit in 1916. During his training, he also provided medical services in Europe during World War I. On his return, he founded the Division of Urology as the inaugural Chief of Urology from 1920-1952. During his accomplished tenure, in addition to training a future generation of urologists, he published on eclectic areas such as intra-abdominal testis torsion, female stress incontinence treatment, genito-urinary trauma management and even recognition of deep vein thrombosis and targeted prevention of pulmonary embolism in urologic patients in 1952 where “early ambulation was pioneered at Henry Ford Hospital”. His surgical outcome observations following radical perineal prostatectomy were exemplary for that era. His 1947 publication revealed “in as much as at least half of the patients were still sexually active”, testament to his surgical prowess being 35 years prior to Patrick Walsh’s nerve sparing radical prostatectomy and over 50 years prior to Viagra. Regarding urinary incontinence, “I no longer fear it greatly. Some patients have satisfactory control from the start…of 27 patients…none has had incontinence at night”. His indelible mark on medicine was made in 1948 with his seminal description of the clinical and pathologic features of IRF based upon 2 cases he had treated. Seventeen years later, he correctly postulated the systemic nature of the disease related to IgG4 diseases. Today, there are 3457 PubMed results related to Ormond’s syndrome alone. Urology was his life’s passion, practicing until 88 and still writing about his syndrome until his death aged 91. CONCLUSIONS: Dr Ormond’s contribution to urology stretches beyond his eponymous syndrome. His pioneering establishment of the Henry Ford Urology Department and the work he accomplished with his enduring academic passion even to his death, is something to be emulated. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e241-e241 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Naveen Kachroo More articles by this author Craig Rogers More articles by this author James Peabody More articles by this author Expand All Advertisement Loading ...

In the T-group, IIEF-EF (maximum score: 30) increased by 8. 4AE0.4 [95% CI: 7.7;9.1]at 10 years (p<0.0001).The improvement was statistically significant vs. previous year for 9 years and significant vs baseline throughout the observation time.In CTRL, IIEF-EF declined by 12.8AE0.3[95% CI: -13.5;-12.1]at 10 years (p<0.0001)with statistical significance vs. previous year for 10 years.The estimated adjusted difference between groups at 10 years: 21.2 [95% CI: 20;22.4](p<0.0001).Diabetes and weight control: In the T-group, HbA 1c dropped by 2.9AE0.1% [95% CI: -3.2;-2.7](p<0.0001) while in CTRL patients it increased by 3.2AE0.1% [95% CI: 3;3.5] (p<0.0001) with statistical significance vs. previous year for 7 years (T-group) and 10 years (CTRL), respectively.In the T-group, men lost 19AE0.4% weight [95% CI: -19.8;-18.2](p<0.0001) while CTRL patients gained 4.8AE0.4% [95% CI: 4.1;5.6](p<0.0001) with statistical significance vs. previous year for 9 years (Tgroup) and 10 years (CTRL), respectively.Adherence to testosterone was 100% as all injections were administered in the office and documented.No patient dropped out.CONCLUSIONS: In hypogonadal men with T2DM, TTh improves and preserves urinary and erectile function for a prolonged period of time.Long-term testosterone therapy results in improved glycemic control and weight loss.

To determine the association between race/ethnicity and perioperative outcomes in individuals undergoing major oncologic and nononcologic surgical procedures in the United States.Prior work has shown that there are significant racial/ethnic disparities in perioperative outcomes after several types of major cardiac, general, vascular, orthopedic, and cancer surgical procedures. However, recent evidence suggests attenuation of these racial/ethnic differences, particularly at academic institutions.We utilized the American College of Surgeons National Surgical Quality Improvement Program database to identify 142,344 patients undergoing one of the 16 major cancer and noncancer surgical procedures between 2005 and 2011.Eighty-five percent of the cohort was white, with black and Hispanic individuals comprising 8% and 4%, respectively. In multivariable analyses, black patients had greater odds of experiencing prolonged length of stay after 10 of the 16 procedures studied (all P < 0.05), though there was no disparity in odds of 30-day mortality after any surgery. Hispanics were more likely to experience prolonged length of stay after 5 surgical procedures (all P < 0.04), and were at greater odds of dying within 30 days after colectomy, heart valve repair/replacement, or abdominal aortic aneurysm repair (all P < 0.03). Fewer disparities were observed for Hispanics, than for black patients, and also for cancer, than for noncancer surgical procedures.Important racial/ethnic disparities in perioperative outcomes were observed among patients undergoing major cancer and noncancer surgical procedures at American College of Surgeons National Surgical Quality Improvement Program institutions. There were fewer disparities among individuals undergoing cancer surgery, though black patients, in particular, were more likely to experience prolonged length of stay.