PURPOSE: Despite the large number of analytical reports regarding the learning curve in the transition from open to robot-assisted radical prostatectomy (RARP), few comparative results with laparoscopic radical prostatectomy (LRP) have been reported. Thus, we evaluated operative and postoperative outcomes in RARP versus 100 simultaneously performed LRPs. MATERIALS AND METHODS: A single surgeon had performed more than 1,000 laparoscopic operations, including 415 cases of radical nephrectomy, 85 radical cystectomies, 369 radical prostatectomies, and treatment of 212 other urological tumors, since 2009. We evaluated operative (operation time, intraoperative transfusion, complications, hospital stay, margin status, pathological stage, Gleason score) and postoperative (continence and erectile function) parameters in initial cases of RARP without tutoring compared with 100 recently performed LRPs. RESULTS: Mean operation time and length of hospital stay for RARP and LRP were 145.5+/-43.6 minutes and 118.1+/-39.1 minutes, and 6.4+/-0.9 days and 6.6+/-1.1 days, respectively (p=0.003 and p=0.721). After 17 cases, the mean operation time for RARP was similar to LRP (less than 2 hours). Positive surgical margins in localized cancer were seen in 11.1% and 8.9% of cases in RARP and LRP, respectively (p=0.733). At postoperative 3 months, sexual intercourse was reported in 14.0% and 12.0%, and pad-free continence in 96.0% and 81.0% in patients with RARP and LRP, respectively (p=0.796 and p=0.012). CONCLUSIONS: Previous large-volume experience of LRPs may shorten the learning curve for RARP in terms of oncological outcome. Additionally, previous experience with laparoscopy may improve the functional outcomes of RARP.
Coitus ; Cystectomy ; Humans ; Laparoscopy ; Learning Curve* ; Length of Stay ; Nephrectomy ; Prostatectomy* ; Prostatic Neoplasms ; Robotics ; Treatment Outcome

No abstract available.
Blood Gas Analysis* ; Respiratory Function Tests* ; Tuberculosis, Pulmonary*

No abstract available.
Immobilization* ; Rib Fractures* ; Ribs*

No abstract available.

No abstract available.
Esophagus* ; Rupture*

No abstract available.
Esophagus* ; Rupture*

PURPOSE: This study aimed to evaluate the cancer detection rate in a Korean population with prostate-specific antigen (PSA) levels greater than or equal to 20.0ng/mL. MATERIALS AND METHODS: A total of 174 men 50 to 79 years old (median 69) included in the study. The median prostate volume of the patients was 44.8mL (range 14.1 to 210.0) and their serum PSA ranged from 20.0 to 9725.0ng/mL (median 44.8). RESULTS: Of 174 men 141 (81.0%) were diagnosed with prostate cancer on initial biopsy. In the total number of patients, the positive predictive value (PPV) was 62.9% for PSA 20 to 29.9, 72.7% for PSA 30 to 39.9 and 100% for PSA 40 to 49.9 ng/mL. In patients with an abnormal digital rectal examination (DRE), the values for these PSA ranges increased to 89.5%, 91.7% and 100%, respectively. The PPV was 81.0% for PSA cutoff of 20, 89.2% for a cutoff of 30, 95.4% for a cutoff of 40, and 94.7% for a cutoff of 50 ng/mL. In conjunction with an abnormal DRE, the values for these PSA cutoffs increased to 95.9%, 98.1%, 100%, and 100%, respectively. CONCLUSION: Our data suggest the ability to predict the presence of prostate cancer reliably on initial biopsy when PSA threshold is greater than or equal to 50ng/mL. This PSA threshold may be lowered to 40ng/mL in the presence of an abnormal DRE. In Korean men with high PSA, the detection rate of prostate cancer on biopsy appears to be comparable to that for American men.
Aged ; Biopsy ; Cohort Studies ; Digital Rectal Examination ; Humans ; Korea ; Male ; Middle Aged ; Predictive Value of Tests ; Prostate/pathology ; Prostate-Specific Antigen/*blood ; Prostatic Neoplasms/*diagnosis/metabolism/pathology

No abstract available.
Blood Transfusion, Autologous*

PURPOSE: This study was initiated to establish the hazard ratios for risk of urinary stone formation in chronic spinal cord injury (SCI) patients. MATERIALS AND METHODS: A total of 140 male patients who were injured before 1987 were eligible for this investigation and they were followed up on a yearly basis from January 1987 and December 2003. RESULTS: Over the 17 years, 39 patients (27.9%) and 21 patients (15.0%) were diagnosed with bladder and renal stones for a total of 59 and 25 episodes, respectively. On multivariate analysis, bladder stone was more common for the patients who were injured at 24 years old or older than is was for those patients who were injured at less than 24 years old (odds ratio [OR]: 2.490; 95% confidence interval [CI]: 1.092-5.677; p=0.030). In another model, the patients with complete injury had a greater risk of renal stone formation than those with incomplete injury (OR: 4.095; 95% CI: 1.295-12.944; p=0.016). We also found that renal stone was more common for the patients with urethral catheterization (UC) than for the patients who could spontaneous void (OR: 5.668; 95% CI: 1.306-24.604; p=0.021), and for patients with bladder stone than for those without bladder stone (OR: 4.678; 95% CI: 1.447-15.126; p=0.010). CONCLUSIONS: Injury characteristics are important for the development of urinary stone in chronic traumatic SCI patients. In addition, our findings suggest that for the cases who cannot undergo intermittent catheterization or when the bladder cannot empty spontaneously, suprapubic cystostomy is better than UC is regards to renal stone formation in this population.
Catheterization ; Catheters ; Cystostomy ; Follow-Up Studies* ; Humans ; Male* ; Multivariate Analysis ; Risk Factors* ; Spinal Cord Injuries* ; Spinal Cord* ; Urinary Bladder ; Urinary Bladder Calculi ; Urinary Calculi* ; Urinary Catheterization ; Urinary Catheters ; Young Adult

No abstract available.
Pregnancy* ; Pyelonephritis*