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148 Analysis of Urethral Mobility After Radical Prostatectomy by Perineal Ultrasound

2010, European Urology Supplements

148 ANALYSIS OF URETHRAL MOBILITY AFTER RADICAL PROSTATECTOMY BY PERINEAL ULTRASOUND %RX]RXLWD$%HOKLED+&DUHPHO5'DFKHU-1*ULVH3 1 Charles Nicolle Hospital of Rouen, Dept. of Urology, Rouen, France, 2Charles Nicolle Hospital of Rouen, Dept. of Radiology, Rouen, France Introduction & Objectives: 8ULQDU\ LQFRQWLQHQFH DIWHU UHWURSXELF SURVWDWHFWRP\ PD\ EH GXH WR VSKLQFWHU ZHDNQHVV RU WR WKH PRGLᚏFDWLRQ RI WKH PRELOLW\ RI WKH YHVLFRXUHWKUDODQDVWRPRVLV,QWKHOLWHUDWXUHWKHUHಬVIHZDUWLFOHWKDWDQDO\VHWKH PRELOLW\RIWKHXUHWKUD:HPDGHDQXOWUDVRXQGIXQFWLRQDODQGPRUSKRORJLFVWXG\RI WKHYHVLFRXUHWKUDODQDVWRPRVLVIRULQFRQWLQHQWSDWLHQWVDIWHUUDGLFDOSURVWDWHFWRP\ 7KHDLPRIRXUVWXG\LVWRHVWDEOLVKXOWUDVRXQGSDUDPHWHUVWRVWXG\XUHWKUDOPRELOLW\ DQGWKHVSKLQFWHU7KHSXUSRVHRIWKHDQDO\VLVLVWKHDSSOLFDWLRQWRWKHWUHDWPHQWWR LPSURYHWKHXUHWKUDOVXSSRUWE\WDSHV Material & Methods: 7KH XOWUDVRXQG HTXLSPHQW FRQVLVWHG RI %.p SRO\YDOHQW XOWUDVRXQGZLWKWKUHHGLPHQVLRQDOPXOWLSODQDUHQGRUHFWDOWUDQVUHFWDOWUDQVGXFHU 7KHVH SDUDPHWHUV ZDV VWRRG LQ UHOD[HG DQG FRQWUDFWHG VWDWH IRU  SDWLHQWV EHIRUH DQG DIWHU D UDGLFDO SURVWDWHFWRP\ UHWUR FHUYLFDO DQJOH DQJOH RI FHUYLFDO LQFRPSHWHQFHURWDWLRQDQJOHSXELFXUHWKUDODQJOH Results: 7KHPHDQUHWURFHUYLFDODQJOHIRURSHUDWHGSDWLHQWLVrDWWKHUHOD[HG VWDWHDQGrDWWKHFRQWUDFWHGVWDWH7KHUHIRUHIRUQRQRSHUDWHGSDWLHQWVLWLV rDWWKHUHOD[HGVWDWHDQGrDWWKHFRQWUDFWHGVWDWH7KHDQJOHRIFHUYLFDO LQFRPSHWHQFH IRU RSHUDWHG SDWLHQWV LV r DW WKH UHOD[HG VWDWH DQG r DW WKH FRQWUDFWHGVWDWHIRUQRQRSHUDWHGSDWLHQWVLWLVrDWWKHUHOD[HGVWDWHDQGr DWWKHFRQWUDFWHGVWDWH7KHURWDWLRQDQJOHLVPRUHLPSRUWDQWIRURSHUDWHGSDWLHQWV rDQGrIRUQRQRSHUDWHGSDWLHQWV3XELFXUHWKUDODQJOHLVODUJHUIRUWKH RSHUDWHGSDWLHQWVrDWWKHUHOD[HGVWDWHDQGDWWKHFRQWUDFWHGVWDWHIRUWKH QRQRSHUDWHGSDWLHQWVLWLVrDWUHOD[HGVWDWHDQGrDWFRQWUDFWHGVWDWH Conclusions: 7KH SDUDPHWHUV RI XUHWKUDO PRELOLW\ PD\ EH H[SORUHG E\ SHULQHDO XOWUDVRXQG 7KH PRELOLW\ RI YHVLFRXUHWKUDO DQDVWRPRVLV LV PRGLᚏHG DIWHU UDGLFDO SURVWDWHFWRP\ 7KLV PRGLᚏFDWLRQ VXJJHVWV WKH SODFH RI SXERSURVWDWLF OLJDPHQW 7KHH[SORUDWLRQRIWKHPRELOLW\FRXOGEHDQDUJXPHQWWRVHOHFWWKHLQGLFDWLRQVIRU WKHWUHDWPHQWRILQFRQWLQHQFHSRVWUDGLFDOSURVWDWHFWRP\ 149 REAL-TIME ELASTOGRAPHY COMPARED TO 3.0 TESLA MRT FINDINGS IN THE LOCALISATION AND DIAGNOSIS OF PROSTATE CANCER: PRELIMINARY RESULTS OF A SINGLE CENTRE STUDY 3HO]HU$(+HLQ]HOEHFNHU-.LUFKQHU0)U¾KEDXHU-6FK¸QEHUJ6 6WURHEHO30LFKHO06'LQWHU'- 1 Mannheim Medical Centre, University of Heidelberg, Dept. of Urology, Mannheim, Germany, 2Mannheim Medical Centre, University of Heidelberg, Dept. of Pathology, Mannheim, Germany, 3Mannheim Medical Centre, University of Heidelberg, Dept. of Clinical Radiology and Nuclear Medicine, Mannheim, Germany Introduction & Objectives: 5HDOWLPH VRQRHODVWRJUDSK\ +,57(  KDV EHHQ SURYHQ FDSDEOH WR YLVXDOL]H SURVWDWH FDQFHU 3&D  DUHDV DQG WKHUHIRUH FDQ EH XVHGIRU3&DGHWHFWLRQ:HHYDOXDWHGWKHUROHRI+,57(E\DSSO\LQJWKLVPHWKRG WR SDWLHQWV XQGHUJRLQJ UDGLFDO UHWURSXELF SURVWDWHFWRP\ 553  DQG FRPSDULQJ WKH UHVXOWV WR  7HVOD 057 LPDJLQJ ZLWK  SURWRFROV DQG WR ZKROH PRXQWHG VHFWLRQV Material & Methods: 3DWLHQWVZLWKELRSV\SURYHQSURVWDWHFDQFHUVFKHGXOHGIRU 553 ZHUH LQFOXGHG DQG XQGHUZHQW +,57( DQG  7HVOD 057 EHIRUH VXUJHU\ +,57(ZDVGRQHE\XVLQJDWUDQVUHFWDOXOWUDVRXQGSUREH (8%+9+LWDFKL PHGLFDOV\VWHPVZLWK(839:SUREH 7KUHH7HVOD05, 6LHPHQV0DJQHWRP 7ULR ZDVGRQHZLWKDQHQGRUHFWDOFRLODVZHOODVDERG\SKDVHGDUUD\FRLOXVLQJWKH IROORZLQJVHTXHQFHSURWRFROPXOWLSODQDU7ZGLᚎXVLRQZHLJKWHGLPDJLQJ ':,  KLJK UHVROXWLRQ LVRWURSLF YROXPH LQWHUSRODWHG EUHDWKKROG H[DPLQDWLRQ 9,%(  FKHPLFDOVKLIWLPDJLQJVSHFWURVFRS\ &6,056 DQGG\QDPLFFRQWUDVWHQKDQFHG 7 Z GFH 05,  IRU HYDOXDWLRQ RI SURVWDWH SHUIXVLRQ $UHDV VXVSLFLRXV IRU 3&D ZHUHGHSLFWHGDQGGRFXPHQWHGLQDEOLQGHGIDVKLRQ553VSHFLPHQVZHUHVHULDOO\ VWHS VHFWLRQHG DQG ZKROH PRXQWHG DIWHU D PRGLᚏHG 6WDQIRUG SURWRFRO DFFRUGLQJ WRVWDQGDUGSURWRFROVWXPRXUDUHDVZHUHPDUNHGE\IHOWSHQDQGHDFKSURVWDWH ZDVGLYLGHGLQWRVHFWRUV DSLFDOQHDUWRWKHDSH[PLGEDVDOGRUVDOYHQWUDO ULJKWOHIW $UHDVVXVSLFLRXVIRU3&DZHUHFRUUHODWHGZLWKWKHFRUUHVSRQGLQJZKROH PRXQWHGVHFWLRQVE\VHFWRU+,57(LPDJHVDQG057UHVXOWVFRPSDUHGWRZKROH PRXQW VHFWLRQV ZHUH HYDOXDWHG EDVHG RQ WKH UHSRUWV RQ GLDJQRVWLF ᚏQGLQJV RXW DW WKH GD\ RI H[DPLQDWLRQ LQ EOLQGHG IDVKLRQ (YDOXDWLRQ ZDV EDVHG RQ ᚏQGLQJV FRQFHUQLQJWKHLGHQWLᚏFDWLRQRIWKHLQGH[WXPRXU $ DQGFRQFHUQLQJ3&DGHWHFWLRQ LQHDFKVHFWRU %  Results: 8QWLOQRZVSHFLPHQVZLWKSURVWDWHVHFWRUVZHUHHYDOXDWHG0HDQ 36$ZDVQJPOZLWK*OHDVRQ6FRUHVLQEHWZHHQ0HDQSDWLHQWDJHZDV  \HDUV ZLWK SURVWDWH YROXPHV IURP FFP WR FFP 0HDQ H[DPLQDWLRQ WLPH ZDVPLQXWHV WRPLQXWHV DQGPLQXWHV VWDQGDUGWLPHIRUSURWRFROV IRU +,57(DQG057H[DPLQDWLRQVUHVSHFWLYHO\ S 6HQVLWLYLW\DQGVSHFLᚏFLW\ FRQFHUQLQJLGHQWLᚏFDWLRQRIWKHLQGH[WXPRXU $ ZHUHDQGIRU+,57( DQGDQGIRU057UHVSHFWLYHO\6HQVLWLYLW\DQGVSHFLᚏW\FRQFHUQLQJ LGHQWLᚏFDWLRQRI3&DLQHDFKRIWKHVHFWRUV % ZHUHDQGIRU+, 57(DQGDQGIRU057UHVSHFWLYHO\ Conclusions: +,57( LV D VHQVLWLYH LPDJLQJ PRGDOLW\ IRU WKH GHWHFWLRQ RI 3&D DQG SURYHG WR EH D KLJKVSHFLᚏF LPDJLQJ PRGDOLW\ IRU OHVLRQ FKDUDFWHUL]DWLRQ ,Q FRPSDULVRQ WR  7HVOD 057 LQFOXGLQJ  SURWRFROV LW KDV VLPLODU VHQVLWLYLW\ DQG VSHFLᚏFLW\+RZHYHULQFRQWUDVWWRRWKHULPDJHPRGDOLWLHVHODVWRJUDSK\VHHPVWR RᚎHUDOHVVWLPHFRQVXPLQJDQGPRUHHFRQRPLFWHFKQLTXHIRU3&DGHWHFWLRQ 150 VALUE OF REALTIME ELASTOGRAPHY TARGETED PROSTATE BIOPSY IN PATIENTS WITH A PSA BELOW 4 NG/ML 0LWWHUEHUJHU0-$LJQHU)3DOOZHLQ/%DUWVFK*+RUQLQJHU: :HUQHU:)UDXVFKHU) 1 Medical University Innsbruck, Dept. of Urology, Innsbruck, Austria, 2Medical University Innsbruck, Dept. of Radiology, Innsbruck, Austria Introduction & Objectives: 7R HYDOXDWH FDQFHU GHWHFWLRQ UDWH RI UHDOWLPH HODVWRJUDSK\ 57( WDUJHWHGSURVWDWHELRSV\LQSDWLHQWVZLWKD36$EHORZQJPO Material & Methods: %HWZHHQ-XO\DQG$XJXVWPHQ PHDQDJH  \HDUV UDQJH  \HDUV  ZLWK 36$ VHUXP OHYHOV !QJPO DQG QJ PO PHDQ SVD QJPO UDQJH QJPO  XQGHUZHQW D 57(  FRUH WDUJHWHG SURVWDWHELRSV\$IWHUZDUGVDFRUHV\VWHPDWLFJUD\VFDOHWUDQVUHFWDOXOWUDVRXQG SURVWDWHELRSV\ZDVSHUIRUPHG57(ZDVGRQHRQD(8%+LWDFKL8OWUDVRXQG 8QLW +LWDFKL0HGLFDO7RN\R-DSDQ ZLWKD0+]HQGᚏUHWUDQVUHFWDOSUREHWR DVVHVVWLVVXHHODVWLFLW\ Results: 2YHUDOO  RXW RI WKH  PHQ VKRZHG SURVWDWH FDQFHU   57( GHWHFWHG FDQFHU LQ  SDWLHQWV   ZKHUHDV V\VWHPDWLF ELRSV\ GHWHFWHG FDQFHU LQ  FDVHV   7KHUH ZHUH QR VWDWLVWLFDOO\ VLJQLᚏFDQW GLᚎHUHQFH LQ WKHSHUSHUVRQFDQFHUGHWHFWLRQUDWHIRUWKHWHFKQLTXHV S! %XWWKHUHZDV DVLJQLᚏFDQWGLᚎHUHQFHFRQFHUQLQJFDQFHUSRVLWLYHFRUHV S 57(WDUJHWHG FRUHVZHUHFDQFHUSRVLWLYHLQRIFDVHV  DQGV\VWHPDWLFFRUHVZHUH FDQFHUSRVLWLYHLQRIFDVHV   Conclusions: (YHQLQDORZ36$JURXS57(VHHPVWREHDXVHIXOWRROIRUSURVWDWH FDQFHUGHWHFWLRQE\DVVHVVLQJWLVVXHHODVWLFLW\(VSHFLDOO\WDUJHWHGFRUHVVKRZHG D VLJQLᚏFDQW EHWWHU GHWHFWLRQ UDWH WKDQ V\VWHPDWLF FRUHV VR ZH FRQFOXGH WKDW LQ IXWXUHWKHQXPEHURIELRSV\FRUHVFDQEHUHGXFHG 151 PREOPERATIVE PROSTATE CANCER ASSESSMENT: COMPARISON OF THE LATEST GENERATION OF TRANSRECTAL SONOELASTOGRAPHY AND MODERN GRAYSCALE ULTRASOUND WITH WHOLE MOUNT SECTIONS AFTER RADICAL PROSTATECTOMY %URFN01ROGXV-6RPPHUHU)(JJHUW7 1 Marienhospital Herne, Ruhr-University Bochum, Dept. of Urology, Herne, Germany, 2Bergmannsheil GmbH Bochum, Ruhr University Bochum, Dept. of Pathology, Bochum, Germany Introduction & Objectives: 7R HYDOXDWH ZKHWKHU WUDQVUHFWDO VRQRHODVWRJUDSK\ 6( LPSURYHVYLVXDOL]DWLRQRISURVWDWHFDQFHU 3&D LQFRPSDULVRQZLWKWUDQVUHFWDO JUD\VFDOHXOWUDVRXQG *68 LQSDWLHQWVZLWKELRSV\SURYHQ3&D Material & Methods: %HWZHHQ$XJXVWDQG-XO\SDWLHQWVZLWKELRSV\ SURYHQ3&DXQGHUZHQWSUHRSHUDWLYH6(ZLWKWKHODWHVWVRQRHODVWRJUDSKLFGHYLFH +LWDFKL (8%+9  7KH LQYHVWLJDWRU ZDV EOLQGHG IRU WKH UHVXOWV RI GLJLWDO UHFWDOH[DPLQDWLRQ '5( WUDQVUHFWDOJUD\VFDOHXOWUDVRXQG *68 DQGELRSV\7KH SURVWDWHZDVGLYLGHGLQWRDUHDVದEDVHPLGJODQGDSH[IRUHDFKVLGH Q   DQGVXEVHTXHQWO\VFUHHQHGIRUFDQFHUVXVSLFLRXVDUHDV7KLVZDVSRVWXODWHGIRU K\SRHFKRLFOHVLRQVGXULQJ*68DQGVWLᚎHUEOXHFRORUHGOHVLRQVDFFRUGLQJWR6( UHVSHFWLYHO\ 7KHVH ᚏQGLQJV ZHUH FRUUHODWHG ZLWK KLVWRSDWKRORJLFDO ZKROHPRXQW VHFWLRQV DIWHU UDGLFDO SURVWDWHFWRP\ 53  7KH VHQVLWLYLW\ 6(16  DQG VSHFLᚏFLW\ 63(& RIFDQFHUGHWHFWLRQE\6(DQG*68ZHUHFRPSDUHG$GGLWLRQDOO\XVLQJ 6(ZHWULHGWRSUHGLFWWKHORFDWLRQRIWKHPDLQWXPRUEXUGHQ 07% DQGWKHVLGHRI H[WUDFDSVXODUH[WHQVLRQ Results: ,Q  RISURVWDWHDUHDVXQLDQGRUPXOWLIRFDO3&DZDV KLVWRSDWKRORJLFDOO\ FRQᚏUPHG  DQG  FDQFHU VXVSLFLRXV OHVLRQV ZHUH GHWHFWHG XVLQJ 6( DQG *68 UHVSHFWLYHO\ 6HQVLWLYLW\ DQG VSHFLᚏFLW\ ZHUH  DQG  IRU 6( DQG  DQG  IRU *68 ([WUDFDSVXODU H[WHQVLRQ ZDV KLVWRSDWKRORJLFDOO\ GHWHFWHG LQ Q   SDWLHQWV   7KLV ZDV LGHQWLᚏHG ZLWK D VHQVLWLYLW\DQGVSHFLᚏFLW\RIDQGXVLQJ6(FRPSDUHGWRDQG XVLQJ*68,PDJLQJRIH[WUDFDSVXODUH[WHQVLRQDQGORFDWLQJSURVWDWHFDQFHUOHVLRQV ZHUHVLJQLᚏFDQWO\EHWWHUXVLQJ6(LQFRPSDULVRQWR*68 SFKLVTXDUHWHVW  6RQRHODVWRJUDSK\ FRUUHFWO\ LGHQWLᚏHG WKH ORFDWLRQ RI WKH 07% ZLWK UHJDUG WR WKH SURVWDWHVH[WDQWDQGWRWKHVLGHRIWKHJODQGLQDQGUHVSHFWLYHO\7KH EHVWUHVXOWVIRULGHQWLI\LQJ07%ZHUHUHJLVWHUHGDWULJKWDSH[ 6(1663(&  DQGULJKWPLGJODQG 6(1663(& %HFDXVHRISRRUHUUHVXOWVDW WKHEDVHRISURVWDWH 6(1663(& WKHVHQVLWLYLW\DQGVSHFLᚏFLW\IRUWKH ZKROHJODQGZDVFDOFXODWHGZLWKDQG Conclusions: ,Q FRPSDULVRQ ZLWK WUDQVUHFWDO JUD\VFDOH XOWUDVRXQG VRQRHODVWRJUDSK\RIWKHSURVWDWHSURYLGHVDVLJQLᚏFDQWLPSURYHPHQWRQYLVXDOL]LQJ SURVWDWHFDQFHU/RFDWLQJSURVWDWHFDQFHUDQGHYDOXDWLQJH[WUDFDSVXODUH[WHQVLRQ LVPRUHSUHFLVHXVLQJODWHVWJHQHUDWLRQRIVRQRHODVWRJUDSK\ Eur Urol Suppl 2010;9(2):79