Navigation Links
Quick, Innovative Procedure Helps Men Minimize Incontinence After Prostatectomy

Thousands of men facing surgical removal of the prostate due to cancer may someday have one less thing to worry about: post-surgical urinary incontinence.

That's because a team of expert urologic surgeons at NewYork-Presbyterian Hospital/Weill Cornell Medical Center has devised a simple, effective means of reconstructing key anatomical structures that ensure continence.

They describe the success of the procedure in the journal Urology.

"Modifying existing tissues, our technique added only a few minutes to standard robotic prostatectomy, yet attained a 95 percent continence rate among patients 16 weeks after their surgeries," explains lead researcher Dr. Ashutosh K. Tewari, director of robotic prostatectomy and outcomes research at NewYork-Presbyterian/Weill Cornell and the Ronald P. Lynch Associate Professor of Urologic Oncology at Weill Cornell Medical College.

"This is a real breakthrough in prostate cancer care, as a significant number of patients have post-prostatectomy urinary incontinence," adds senior researcher Dr. E. Darracott Vaughan, attending urologist at NewYork-Presbyterian/Weill Cornell and The James J. Colt Professor of Urology at Weill Cornell Medical College. He is also Weill Cornell's senior associate dean for clinical affairs.

"Too often, the threat of incontinence can be a key factor in a patient's decision for or against prostatectomy," Dr. Vaughan adds. "A simple intervention like this could make that choice a lot easier."

Prostatectomy involves the excision of the prostate gland, as well as some adjacent tissue, depending on the extent and aggressiveness of the tumor. "Unfortunately, this can weaken structures that control the retention and release of urine from the bladder, such as the puboprostatic ligaments, related muscle and other key anatomy," Dr. Tewari explains. "Together, these structures form a kind of sphincter that must remain strong and supported to maintain urinary continence."

Numerous attempts have been made to modify prostatectomy and preserve continence, but none have proven ideal. Trying to find a better way, Drs. Tewari and Vaughan reviewed 3-D videos that detailed the urological anatomy of patients who had retained full continence after prostatectomy. "We were trying to figure out what went right in those cases," Dr. Vaughan says.

Armed with those insights, they devised the new technique, modeling it first in cadaver tissues. They then tested the new procedure in 50 consecutive patients scheduled to undergo robot-guided prostatectomy for the treatment of localized prostate cancer.

The procedure added just two to five minutes to the standard prostate-removing operation.

"Our technique uses tissues that would normally remain behind after prostatectomy tissues that we can flip around and support to our advantage," Dr. Tewari explains. "We reconstruct the anterior and posterior parts of the sphincter and surgically join the bladder and the anastomosis (the gap in tissues left by prostatectomy) with the surrounding structures. In doing so, we reconstruct the major anatomical players controlling urinary continence."

The post-surgical results were impressive. One week after patients first had their urinary catheters removed, 29 percent were already fully continent; by six weeks, that figure rose to 62 percent; by eight weeks, 88 percent of the men were fully continent; and by 16 weeks, 95 percent had achieved continence.

The researchers stressed that the men involved in the study had all been diagnosed with non-aggressive, localized cancers. "With more aggressive tumors, surgeons must often excise the tissues that we need for reconstruction, so the technique is not useful in those cases," Dr. Vaughan says.

"But those cases are relatively uncommon, so most patients who undergo prostatectomy stand to benefit fr om the procedure," says co-author Dr. Alexis Te, director of the Brady Prostate Center at NewYork-Presbyterian/Weill Cornell and associate professor of urology at Weill Cornell Medical College.

"The technique entails no extra cost and very little added time in the OR, although surgeons would have to be trained, of course," Dr. Tewari says. "We're confident the procedure will enhance post-prostatectomy recovery, sparing men the significant loss in quality of life that chronic urinary incontinence can bring."


'"/>




Related medicine news :

1. Innovative device aids in advanced heart failure
2. Innovative footwear may prevent fall in elderly
3. Innovative yeast genome may handle Cancer Clues
4. Innovative solution to help reduce the waiting times for kidney transplants
5. Personalized Medicine and Innovative Pharmaceuticals
6. Creation of Cytomegalovirus Vaccine by an Innovative Method
7. Innovative Method for Creating a Human Cytomegalovirus Vaccine Outlined
8. Innovative treatment for Dementia
9. Innovative treatment for Skin Cancer
10. Innovative Movies Show Real-Time Immune-Cell Activity within Tumors
11. Research In A New Direction To Develop Innovative Psychotropic Drugs
Post Your Comments:
*Name:
*Comment:
*Email:


(Date:6/25/2016)... ... June 25, 2016 , ... On Friday, June 10, Van Mitchell, Secretary ... Work award to iHire in recognition of their exemplary accomplishments in worksite health promotion. ... Maryland Workplace Health & Wellness Symposium at the BWI Marriott in Linthicum Heights. iHire ...
(Date:6/24/2016)... ... June 24, 2016 , ... June 19, 2016 is World Sickle Cell Observance ... and the benefits of holistic treatments, Serenity Recovery Center of Marne, Michigan, ... Disease. , Sickle Cell Disease (SCD) is a disorder of the red blood cells, ...
(Date:6/24/2016)... ... June 24, 2016 , ... Dr. Amanda ... orthodontic treatment. Dr. Cheng has extensive experience with all areas of orthodontics, including ... accelerated osteogenic orthodontics. , Micro-osteoperforation is a revolutionary adjunct to orthodontic treatment. ...
(Date:6/24/2016)... Norcross, Georgia (PRWEB) , ... June 24, 2016 ... ... Year” awards today at the Clinical Decision Making in Emergency Medicine conference in ... who have authored journal articles published in Emergency Medicine Practice and ...
(Date:6/24/2016)... ... June 24, 2016 , ... National recruitment firm Slone Partners is ... sequencing and genomics experience, as Vice President of North American Capital Sales at ... for leading the sales team in the commercialization of the HTG EdgeSeq system and ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... June 24, 2016 Research and Markets ... for Companion Diagnostic Tests" report to their offering. ... Companion Diagnostics The World Market for Companion ... medicine diagnostics. Market analysis in the report includes the following: ... (In Vitro Diagnostic Kits) by Region (N. America, EU, ROW), ...
(Date:6/23/2016)... HOUSTON , June 23, 2016  MedSource ... platform as its e-clinical software solution of choice.  ... the best possible value to their clients by ... nowEDC.  The preferred relationship establishes nowEDC as the ... pricing for MedSource,s full-service clients.  "nowEDC has long ...
(Date:6/23/2016)... Roche (SIX: RO, ROG; OTCQX: RHHBY) announced ... BRAHMS PCT (procalcitonin) assay as a dedicated testing solution ... this clearance, Roche is the first IVD company in ... sepsis risk assessment and management. PCT is ... levels in blood can aid clinicians in assessing the ...
Breaking Medicine Technology: