The following are notable research studies:
* Dr. Ashutosh Tewari
The Ronald P. Lynch Professor of Urologic Oncology at Weill Cornell Medical College, and director of the Prostate Cancer Institute and the LeFrak Robotic Surgery Center at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.
Effectiveness of robotic prostatectomy
There is no clear evidence to support one form of surgical approach over another with regards radical prostatectomy. The aim of this meta-analysis study was to analyze the literature available between 2002 and 2008 and compare positive surgical margin and complication rates for open retropubic, laparoscopic and robotic radical prostatectomy.Dr. Tewari and his co-investigators showed that robotic-assisted laparoscopic radical prostatectomy has overall lower perioperative morbidity and improved early oncologic outcomes compared with conventional laparoscopic or open approaches. The open and laparoscopic surgical groups had similar overall positive surgical margin rates, with the robotic group having lower rates. Both minimally invasive approaches showed significantly lower estimated blood loss and rate of blood transfusions, and a shorter length of hospital stay when compared with an open approach.
A further decrease in these parameters was seen when robotic assistance was used. Total complication rates were highest for the open approach, intermediate for the laparoscopic cohort, and lowest for the robotic group. For the individual complication analysis, the rates for death; readmission; reoperation; ureteral, bladder, and rectal injury; ileus; pneumonia; fistula; and wound infection showed significant differences between groups.
"A Meta-Analysis Comparing Positive Surgical Margin and Complication Rates of 110,016 Patients Undergoing Open Retropubic, Laparoscopic and Robotic-Assisted Radical Prostatectomy." Sunday, May 15, 10:30 a.m.-12:30 p.m.
* Dr. Douglas S. Scherr
Associate professor of urology at Weill Cornell Medical College and a urologist at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.
Especially for elderly, the less invasive technique of robotic cystectomy is safe and effective
Because of the close relationships between age and incidence of bladder cancer, bladder cancer will become an enormous challenge with the growth of our aging population. However, elderly patients are less likely to be treated with extirpative surgery compared with their younger counterparts. Dr. Scherr and his co-investigators evaluated the feasibility and safety of robot-assisted radical cystectomy (RARC) in octogenarians.They report that RARC is feasible and safe for octogenarians. Despite a higher prevalence of comorbidities in octogenarians, RARC can provide similar disease control and survival outcomes with risks of major perioperative morbidity comparable to those in younger patients. Further follow-up in large cohorts of patients is necessary to confirm these observations and discern long-term oncologic and survival outcomes, they report.
"Robotic Radical Cystectomy Is Feasible and Safe in The Treatment of Adequately Selected Octogenarians." Sunday, May 15, 1:00-3:00 p.m.
Use of a specialized urine test for patients with blood in the urine is very helpful to identify the presence of bladder cancer for these patients
The ImmunoCyt immunocytology assay -- a specialized urine test -- detects cellular biomarkers for bladder cancer (BCa) in exfoliated urothelial cells. The role of ImmunoCyt for BCa detection remains controversial. Therefore, Dr. Scherr and his co-investigators assessed the performance of ImmunoCyt for detecting BCa in a large multi-institutional cohort of patients undergoing initial evaluation for asymptomatic hematuria.They report that ImmunoCyt is a strong, independent predictor of BCa presence in patients with hematuria; it outperforms cytology. Addition of ImmunoCyt into the clinical decision-making process may help with patient counseling, improve referral patterns (via increased awareness and prioritization), and possibly spare patients at extremely low risk of BCa from unnecessary hematuria workups.
"Immunocytology Is a Strong Predictor of Bladder Cancer Presence in Patients With Asymptomatic Hematuria." Monday, May 16, 3:30-5:30 p.m.
* Dr. Alexis E. Te
Professor of urology at Weill Cornell Medical College and director of the Brady Prostate Center at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.
Overweight men may not do as well after prostatectomy
Recent studies have shown that obese men have an increased risk of developing benign prostate hyperplasia (BPH) and lower urinary tract symptoms. However, data is lacking to explore the effect of body mass index (BMI) on surgical outcomes following treatment of bladder outlet obstruction due to BPH. Dr. Te and his co-investigators compared outcomes in men with normal versus elevated BMI following transurethral laser prostatectomy.They report that men with an elevated BMI had significantly less improvement in maximum flow rate following laser prostatectomy than men with normal BMI. However, BMI had no influence on improvement in International Prostate Symptom Score or post-void residual. This data may assist urologists when counseling overweight men regarding their expectations of symptom relief following laser prostatectomy.
"A Comparison of Clinical Outcomes Following Transurethral Laser Prostatectomy in Men With Normal Versus Elevated Body Mass Index." Tuesday, May 17, 1:00-3:00 p.m.
* Dr. Peter Schlegel
Chairman of Department of Urology and professor of urology and reproductive medicine at Weill Cornell Medical College and urologist-in-chief at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.
A novel imaging technique (multiphoton microscopy), developed in conjunction with Cornell University engineers in Ithaca, may provide the ability to help men with severe infertility who require surgical treatment to extract sperm for IVF
Successful microdissection testicular sperm extraction (micro-TESE) depends on the ability to identify tubules that harbor sperm. Multiphoton microscopy (MPM), with its ability to image intact, unprocessed tissue in real time, could significantly improve our ability to identify tubules with active spermatogenesis during micro-TESE. Dr. Schlegel and his co-investigators report that MPM can be used to identify spermatogenesis in the testis in ex vivo tissue of healthy rats.MPM may be useful in the future as an intra-operative imaging modality during micro-TESE. A unique advantage of this technique, they say, is the real-time acquisition of high-resolution images without necessitating any extrinsic labeling agent.
"Multiphoton Microscopy of Rat Testis for Real-Time Spermatogenesis Identification." Wednesday, May 18, 8:00-10:00 a.m.
* Dr. Marc Goldstein
The Matthew P. Hardy Distinguished Professor of Reproductive Medicine and a professor of urology at Weill Cornell Medical College, and surgeon-in-chief of male reproductive medicine and surgery at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.
Men may have low testosterone levels because of varicoceles, a surgically curable condition.
Men with clinically palpable varicoceles are at high risk for progressive decline in fertility, and more recent evidence suggests that these men are also at greater risk for androgen deficiency. Repair of a higher-grade varicocele has been shown to result in greater improvement in sperm count and quality than repairing a lower-grade varicocele. In this study, Dr. Goldstein and his co-investigators sought to determine whether grade is related to degree of improvement in serum testosterone levels after varicocelectomy.They report that microsurgical varicocelectomy results in significant increases in testosterone independent of varicocele grade. Microsurgical varicocelectomy should be offered to hypogonadal men regardless of varicocele grade.
"Varicocelectomy Is Associated With Increases in Serum Testosterone Regardless of Clinical Grade." Wednesday, May 18, 1:00-3:00 p.m.