Salvage Prostatectomy After Brachytherapy External Beam Radiation and HIFU

During the past few decades, various minimally invasive alternative therapies have been developed with the aim of being as efficient as surgical therapy while minimizing side effects and complications. Some of the recently developed therapies are cryosurgical ablation of the prostate, HIFU and radiofrequency interstitial tumor ablation (RITA). These approaches are categorized in the European Association of Urology guidelines as experimental local treatments of prostate cancer 1 . Fig. 4.6. a, b...

And Radical Prostatectomy

Sphincter Muscle Radical Prostatectomy

A further point of controversy is the craniocaudal extension of the external sphincter over the prostate and bladder. Dorschner's groups and others advocate that the urethral sphincter is ventrally more strongly developed. Furthermore, the apex of the prostate is ventrally overlapped by the striated muscle fibres of the external urethral sphincter. In contrast, Oelrich et al. and Myers et al. described a vertically orientated sphincter muscle system, from the base of the bladder to the bulb of...

Inter and Intrafascial Dissection Technique of Nerve Sparing Radical Prostatectomy fc fc

Intrafascial Nerve Spare

Jens-Uwe Stolzenburg Jochen Neuhaus Thilo Schwalenberg Katharina Spanel-Borowski Sabine L ffler Rudolph Hohenfellner Evangelos N. Liatsikos The anatomy of the neurovascular bundle (NVB), the cavernosal nerves and the anatomic structures that surround the prostate have been evaluated in various studies 1-5 . Nevertheless, the nomenclature pertaining to the prostate's adjacent fascias and the level of dissection for a nerve-sparing procedure are under dispute. Walsh describes the NVB as located...

Atypical Size and Shape of Prostate Large Prostate Large Middle Lobe Asymmetric Prostate

Large Prostate

It is known that very small lt 30 g as well as very large prostates represent a challenge for open as well as laparoscopic endoscopic prostatectomy. Based on our personal experience we would suggest that prostates with a size of 100-150 g should not be selected during the learning curve of a surgeon. Prostates larger than 150 g or even over 200 g see Fig. 4.3 should be managed only by experienced surgeons. Especially the posterior apical dissection can be very demanding because of the size of...