Biopsy, Needle ; Humans ; Male ; Prostate ; pathology ; surgery ; Prostatic Neoplasms ; pathology ; surgery ; Transurethral Resection of Prostate

OBJECTIVETo compare the postoperative depths of the coagulation zones and pathological changes between bipolar transurethral resection of the prostate with plasmakinetic energy (PKRP) and monopolar transurethral prostatectomy (TURP) in canines.

METHODSTwenty-five male dogs were randomly divided into a PKRP group (n = 12), a TURP group (n = 12) and a sham-operation control group (n = 1). The dogs were sacrificed, their prostates harvested at 0 week (immediately after surgery), 1 week, 2 weeks and 8 weeks postoperatively and sectioned for pathologic analysis and measurement of the coagulation zones.

RESULTSAt 0, 1 and 2 weeks after the operation, the coagulation depths were (237.73 +/- 20.12) microm, (113.03 +/- 16.65) microm and (106.01 +/- 16.36) microm in the PKRP group, and (200.75 +/-19.34) microm, (129.46 +/- 17.81) microm and (116.04 +/- 25.67) microm in the TURP group (P < 0.01). At 8 weeks, the coagulation zones completely peeled off and the wounds were covered by regenerated urothelial in both of the groups. At 0, 1, 2 and 8 weeks, different inflammatory reactions were observed in the prostates of the PKRP and TURP groups, with some glandular lumens beneath the coagulation zones expanded and epithelia damaged. However, none of these phenomena occurred in the sham-operation control group.

CONCLUSIONPathologically, PKRP and TURP inflicted basically similar effects on the prostate of the canine. However, the coagulation zone was deeper intraoperatively and became thinner postoperatively with the former than with the latter, which suggests that PKRP causes less bleeding and less penetrative thermal damage than TURP.

Animals ; Dogs ; Electrocoagulation ; Electrosurgery ; Male ; Prostate ; pathology ; surgery ; Transurethral Resection of Prostate ; methods

OBJECTIVETo explore the possibility of injury to the striated urethral sphincter by incision to the anterior lobe region in transurethral prostatectomy.

METHODSWe incised the anterior lobe region of 60 patients with benign prostatic hyperplasia (BPH) undergoing transurethral prostatectomy. The patients were divided into four groups according to the incision fields: proximate superficial (group 1), proximate deep (group 2), distal superficial (group 3) and distal deep (group 4). The tissues taken from the anterior lobe region were subjected to HE staining, and the smooth and striated muscles were detected by immunohistochemical identification of smooth muscle actin (SMA) and myoglobin (MYO) in the tissues. The prostate volume, age, and PSA level of the patients were analyzed against their positive or negative results. The relative contents of the striated muscle were compared among groups 2, 3 and 4. The independent-sample between-group t-test was used for statistic analysis.

RESULTSThe urethral rhabdosphincter was found in the anterior lobe region, with the smooth muscle intermixed with the striated muscle. The incision injury of the urethral rhabdosphincter was associated with the prostate volume. Increased urethral rhabdosphincter was observed in the anterior lobe region, approaching the apex of the prostate and extending to the urethral lumen.

CONCLUSIONThe anterior lobe region should not be excessively incised in transurethral prostatectomy so as to avoid direct injury of the striated urethral sphincter, which is especially important for prostates of smaller volume or operation near the apex of the prostate.

Aged ; Histological Techniques ; Humans ; Male ; Prostate ; anatomy & histology ; pathology ; Prostatic Hyperplasia ; pathology ; surgery ; Transurethral Resection of Prostate ; Urethra ; anatomy & histology ; pathology

The purpose of this review was to evaluate the current role of multiparametric magnetic resonance imaging (mp-MRI) in the management of prostate cancer (PC). The diagnosis of PC remains controversial owing to overdetection of indolent disease, which leads to overtreatment and subsequent patient harm. mp-MRI has the potential to equilibrate the imbalance between detection and treatment. The limitation of the data for analysis with this new technology is problematic, however. This issue has been compounded by a paradigm shift in clinical practice aimed at utilizing this modality, which has been rolled out in an ad hoc fashion often with commercial motivation. Despite a growing body of literature, pertinent clinical questions remain. For example, can mp-MRI be calibrated to reliably detect biologically significant disease? As with any new technology, objective evaluation of the clinical applications of mp-MRI is essential. The focus of this review was on the evaluation of mp-MRI of the prostate with respect to clinical utility.
*Disease Management ; Humans ; Magnetic Resonance Imaging/*methods ; Male ; Prostate/*pathology ; Prostate-Specific Antigen/blood ; Prostatectomy ; Prostatic Neoplasms/*diagnosis/pathology/surgery

The search for a minimally invasive approach to the treatment of Lower Urinary Tract Symptoms (LUTS) suggestive of Benign Prostatic Hyperplasia (BPH) is probably as old as Transurethral Resection of the Prostate (TURP). In an effort to overcome the limitations and morbidities of TURP, and in light of evidence suggesting that medical treatment for BPH has a limited life-span, laser-based treatments have emerged during the last decade. Photoselective Vaporization of the Prostate (PVP) by the "GreenLight" KTP laser is considered one of the most promising options, one that is constantly evolving new technologies in prostate surgery. In this overview of KTP laser usage in BPH treatment, we will briefly discuss the evolution of this modality since it was first introduced and focus on the available evidence regarding safety, efficacy and cost parameters of its application.
Humans ; Laser Therapy/*methods/trends ; Male ; Prostate/pathology/*surgery ; Prostatic Hyperplasia/*surgery

OBJECTIVE: The purpose of this study was to determine, when measuring prostate volume by TRUS, whether height is more accurately determined by transaxial or midsagittal scanning. MATERIALS AND METHODS: Sixteen patients who between March 1995 and March 1998 underwent both preoperative TRUS and radical prostatectomy for prostate cancer were included in this study. Using prolate ellipse volume calculation (height x length x width x pi/6), TRUS prostate volume was determined, and was compared with the measured volume of the specimen. RESULTS: Prostate volume measured by TRUS, regardless of whether height was determined transaxially or midsagittally, correlated closely with real specimen volume. When height was measured in one of these planes, a paired t test revealed no significant difference between TRUS prostate volume and real specimen volume (p = .411 and p = .740, respectively), nor were there significant differences between the findings of transaxial and midsagittal scanning (p = .570). A paired sample test, however, indicated that TRUS prostate volumes determined transaxially showed a higher correlation coefficient (0.833) and a lower standard deviation (9.04) than those determined midsagittally (0.714 and 11.48, respectively). CONCLUSION: Prostate volume measured by TRUS closely correlates with real prostate volume. Furthermore, we suggest that when measuring prostate volume in this way, height is more accurately determined by transaxial than by midsagittal scanning.
Human ; Male ; Middle Age ; Prostate/*pathology/*ultrasonography ; Prostatectomy ; Prostatic Neoplasms/pathology/surgery/*ultrasonography

OBJECTIVE: The purpose of this study was to determine, when measuring prostate volume by TRUS, whether height is more accurately determined by transaxial or midsagittal scanning. MATERIALS AND METHODS: Sixteen patients who between March 1995 and March 1998 underwent both preoperative TRUS and radical prostatectomy for prostate cancer were included in this study. Using prolate ellipse volume calculation (height x length x width x pi/6), TRUS prostate volume was determined, and was compared with the measured volume of the specimen. RESULTS: Prostate volume measured by TRUS, regardless of whether height was determined transaxially or midsagittally, correlated closely with real specimen volume. When height was measured in one of these planes, a paired t test revealed no significant difference between TRUS prostate volume and real specimen volume (p = .411 and p = .740, respectively), nor were there significant differences between the findings of transaxial and midsagittal scanning (p = .570). A paired sample test, however, indicated that TRUS prostate volumes determined transaxially showed a higher correlation coefficient (0.833) and a lower standard deviation (9.04) than those determined midsagittally (0.714 and 11.48, respectively). CONCLUSION: Prostate volume measured by TRUS closely correlates with real prostate volume. Furthermore, we suggest that when measuring prostate volume in this way, height is more accurately determined by transaxial than by midsagittal scanning.
Human ; Male ; Middle Age ; Prostate/*pathology/*ultrasonography ; Prostatectomy ; Prostatic Neoplasms/pathology/surgery/*ultrasonography

OBJECTIVETo investigate the clinical features, diagnosis and surgical treatment of giant prostatic hyperplasia

METHODSWe retrospectively analyzed the clinical data of 1 case of GPH, and reviewed the relevant literature published at (GPH). home and abroad.

RESULTSThe patient was 77 years of age. The main clinical features were increased nocturnal urine and gross hematuria. The maximum urinary flow rate was 10 ml/s, the total PSA was 37 pIg/L and the prostate volume was 11 x 10 x 8 cm. Suprapubic prostatectomy was performed successfully, and the removed prostate weighed 450 g. Pathologic examination showed the case to be benign prostatic hyperplasia. The patient was discharged 21 days after surgery, without any obvious complications. We identified 83 cases with the prostate weighing over 200 g in the domestic literature, and 14 cases with the prostate volume exceeding 500 g in the foreign literature, mostly treated by suprapubic prostatectomy and only a few by retropubic prostatectomy.

CONCLUSIONGPH, as a rare entity whose nomenclature is not yet agreed-on, can be diagnosed according to its clinical manifestations and the results of transrectal ultrasonography and prostate CT. Surgical methods most frequently adopted for its treatment include transurethral prostatectomy, transvesical suprapubic prostatectomy, retropubic prostatectomy, and laparoscopic prostatectomy.

Aged ; Humans ; Male ; Prostate ; pathology ; Prostatectomy ; Prostatic Hyperplasia ; diagnosis ; pathology ; surgery ; Retrospective Studies

Carcinoma, Intraductal, Noninfiltrating ; diagnosis ; pathology ; surgery ; Carcinoma, Pancreatic Ductal ; pathology ; Diagnosis, Differential ; Humans ; Male ; Prostate ; pathology ; Prostatic Intraepithelial Neoplasia ; pathology ; Prostatic Neoplasms ; diagnosis ; pathology ; surgery

OBJECTIVETo explore the impact of the 2005 International Association of Urological Pathology (ISUP) Gleason score (GS) system on prostatic carcinoma grading.

METHODSUsing the 1977 revision and ISUP version of GS system, 112 needle biopsies, 18 transurethral resections of the prostate and 55 radical prostatectomies were scored. The proportion of grading discrepancy was observed and compared between the two versions of GS.

RESULTSGleason scores of 3+3, 3+4 and 4+3 accounted for 47.0% (87/185), 11.4% (21/185) and 17.3% (32/185) in the modified system, and accounted for 25.9% (48/185), 21.6% (40/185) and 27.6 % (51/185) in ISUP system, respectively. The percentages of primary grade by modified vs. ISUP system were 62.7% (116/185) vs.50.8% (94/185) for grade 3, and 31.4% (58/185) vs. 41.6% (77/185) for grade 4. The percentages of secondary grade by modified vs. ISUP system were 65.9% (122/185) vs. 54.6% (101/185) for grade 3, and 21.1% (39/185) vs. 31.4% (58/185) for grade 4.

CONCLUSIONSISUP system is different from the modified system. Compared with the modified system, the proportion scored by ISUP system tends to decline for GS 3+3 but increase for GS 3+4 and 4+3.

Biopsy, Needle ; Carcinoma ; pathology ; surgery ; Humans ; Male ; Neoplasm Grading ; methods ; Prostate ; pathology ; surgery ; Prostatectomy ; Prostatic Neoplasms ; pathology ; surgery ; Societies, Medical ; Urology