We demonstrate the evolution of the clinical presentation and outcomes for patients with clinically localized prostate
cancer (PC) treated with radical retropubic prostatectomy (RRP) at our ...department, emphasizing epidemiologic significance
of changes during the 10-year period.We assessed the annual trends for changes in patients age, preoperative prostate
specific antigen (PSA), preoperative versus postoperative stages and Gleason grades, organ confined status and surgical
margin status. A total of 488 RRPs were performed from January 1996 to December 2005 with the annual frequency
increased from 8 to 129 (1512.5%). Mean patient age increased from 61.5 to 66.12 years in 2005, with the percentage
of men aged more than 70 years increased from 12.5 to 26.5%, respectively. The detection of PC based solely on pathological
PSA levels (as indication for prostate biopsy) rose impressively from 25.5 to 70% and the rates of postoperative organ-
confined disease also increased significantly from 25 to 74.7%. Mean preoperative PSA decreased from 16.7 to 9.89
ng/mL. On the contrary, there was an increase in percentage of patients with preoperative PSA values ranging from 4 to
10 ng/mL (from 20 to 65.4%). Positive surgical margin rate decreased from 49.4 to 25% and percent of patients receiving
neoadjuvant therapy decreased from 78.5 to 5.4%. Proportion of patients who were undergraded decreased from 75.1 to
31.7%. The rates of understaging have remained relatively stable over the years. During the study period, PC was increasingly
detected by prostate biopsy on the basis of a pathological PSA level only and shifted significantly to more organ-
confined stages with more favourable outcomes for pathological variables due to a more accurate assessment of clinical
stage prior to surgery, reduced use of neoadjuvant therapy and improved surgical technique. Our data also argue
strongly that routine PSA testing should be expanded and not restricted.
U radu su procijenjeni rezultati transuretralne incizije prostate (TUIP) na duži rok kod selekcioniranih bolesnika. Kod 50 bolesnika sa simptomima subvezikalne opstrukcije, koji su bili uzrokovani ...malom benignom prostatom (procijenjena težina 30 grama ili manja) učinjen je TUIP. Kod svih bolesnika učinjene su bileteralne incizije na .5 i 7. sati. Prijeoperacijska i poslijeoperacijska procjena kroz intervale praćenja obuhvaćala je ukupnu ocjenu težine simptoma (I-PSS), mikciometriju, ocjenu zadovoljstva bolesnika rezultatom operacijskog zahvata, te upitnik o seksualnim funkcijama. Poboljšanje srednjih vrijednosti maksimalne brzine protoka bilo je vidljivo u svih bolesnika. Poslijeoperacijski ukupni, iritativni i opstruktivni zbroj simptoma pao je značajno u svim razdobljima praćenja. Kod svih 28 bolesnika koji su prijeoperacijski bili seksualno aktivni potencija je sačuvana poslijeoperacijski, a samo je jedan bolesnik signalizirao retrogradnu ejakulaciju. Rezultati ispitivanja uspoređeni su s rezultatima studija transuretralne resekcije (TURP) malih prostata objavljenim u dostupnoj literaturi. TUIP je učinkovita metoda liječenja male benigne prostate, poglavito u mlađih, seksualno aktivnih te visokorizičnih bolesnika, s podjednako dobrim rezultatima na duži rok kao kod TURP-a, ali s puno manje komplikacija.
