PURPOSE: We report our experience to date with 171 patients who underwent laparoendoscopic single-site surgery for diverse urologic diseases in a single institution. MATERIALS AND METHODS: Between December 2008 and August 2010, we performed 171 consecutive laparoendoscopic single-site surgeries. These included simple nephrectomy (n=18; robotic surgeries, n=1), radical nephrectomy (n=26; robotic surgeries, n=2), partial nephrectomy (n=59; robotic surgeries, n=56), nephroureterectomy (n=20; robotic surgeries, n=12), pyeloplasty (n=4), renal cyst decortications (n=22), adrenalectomy (n=4; robotic surgeries, n=2), ureterolithotomy (n=10), partial cystectomy (n=3), ureterectomy (n=1), urachal mass excision (n=1), orchiectomy (n=1), seminal vesiculectomy (n=1), and retroperitoneal mass excision (n=1). All procedures were performed by use of a homemade single-port device with a wound retractor and surgical gloves. A prospective study was performed to evaluate outcomes in 171 cases. RESULTS: Of the 171 patients, 98 underwent conventional laparoendoscopic single-site surgery and 73 underwent robotic laparoendoscopic single-site surgery. Mean patient age was 53 years, mean operative time was 190.8 minutes, and mean estimated blood loss was 204 ml. Intraoperative complications occurred in seven cases (4.1%), and postoperative complications in nine cases (5.3%). There were no complications classified as Grade IIIb or higher (Clavien-Dindo classification for surgical complications). Conversion to mini-incision open surgery occurred in seven (4.1%) cases. Regarding oncologic outcomes, no cancer-related events occurred during follow-up other than one aggressive progression of Ewing sarcoma. CONCLUSIONS: Laparoendoscopic single-site surgery is technically feasible and safe for various urologic diseases; however, surgical experience and long-term follow-up are needed to test the superiority of laparoendoscopic single-site surgery.
Adrenalectomy ; Cystectomy ; Follow-Up Studies ; Gloves, Surgical ; Humans ; Intraoperative Complications ; Kidney ; Laparoscopy ; Nephrectomy ; Operative Time ; Orchiectomy ; Postoperative Complications ; Prospective Studies ; Robotics ; Surgical Procedures, Minimally Invasive ; Ureter ; Urologic Diseases

A 62-year-old male patient with prostate cancer and bilateral renal cell carcinoma underwent a simultaneous robot-assisted bilateral partial nephrectomy and radical prostatectomy. We describe our initial experience of combined operation with a port strategy allowing reuse of ports and surgical considerations because of prolonged pneumoperitoneum.
Adenocarcinoma/*surgery ; Carcinoma, Renal Cell/*surgery ; Humans ; Kidney Neoplasms/*surgery ; Male ; Middle Aged ; Neoplasms, Second Primary/surgery ; Nephrectomy/instrumentation/*methods ; Prostatectomy/instrumentation/*methods ; Prostatic Neoplasms/*surgery ; Robotics ; Surgery, Computer-Assisted

A 44-year-old male patient who had undergone augmentation penoplasty 20 years previously presented with a slowly growing penoscrotal mass. The penile mass was excised totally and the pathologic diagnosis was an epidermal cyst. Epidermal cysts are benign disorders that can occur in any part of the body. However, an epidermal cyst as a late complication of augmentation penoplasty is extremely rare. We report this case of a penile epidermal cyst that developed after augmentation penoplasty.
Epidermal Cyst ; Humans ; Male ; Penis

Objective: To compare the prevalence of diabetes mellitus (DM) and metabolic syndrome (MetS) in prostate cancer patients with or without androgen deprivation therapy (ADT). Methodology: This is a cross-sectional analytic study of prostate cancer patients from the Integrated Surgical Information System database of the Philippine General Hospital from 2004-2010. Patients who received either continuous monthly GnRH agonist injection for at least 6 months or underwent bilateral orchiectomy at least 6 months prior (ADT group) were compared to those who did not (non-ADT group). Patients with DM and MetS were identified using the American Diabetes Association Standards of Medical Care in Diabetes 2010 and IDF Definition of Metabolic Syndrome. Results: The prevalence of DM in the ADT group is 42% and 19% in the non-ADT group (p = 0.0460). The probability of having DM is 2.17x higher among prostate cancer patients who received ADT compared to those who did not. The prevalence of metabolic syndrome in the ADT and non-ADT group is 37% and 28%, respectively (p=0.4620). Conclusions Prostate cancer patients have become an important emerging population of medically at risk older men. Our study showed that the prevalence of DM is significantly higher among the ADT group, with a trend towards greater prevalence of metabolic syndrome in the same group. These men may benefit from closer monitoring for the development of these metabolic complications.
Prostatic Neoplasms ; Diabetes Mellitus ; Metabolic Syndrome