Abstract:
PURPOSE OF REVIEW:To provide discussion on several recently published case series describing complete intracorporeal robotic cystectomy. Are we making a complex and expensive procedure more challenging or are there patient benefits to be realized from a complete minimally invasive approach? We discuss how effective and cost-efficient a complete intracorporeal approach is, review the updates and comment on the future direction of robot-assisted radical cystectomy (RARC). RECENT FINDINGS:Several centers have recently reported a series of RARC with intracorporeal urinary diversion. Baseline demographics, complication rates and oncological outcome data were comparable to previously published open radical cystectomy series, as well as robotic cystectomy with extracorporeal urinary diversion series. In centers experienced in robotics, comparable outcomes were achieved early in the series with no significant difference in lymph node yields, positive surgical margin rates or complication rates. However, operation times and patient's length of stay (LOS) continued to improve, suggesting that aspect of the learning curve is longer than previously thought. Benefits such as decreased blood loss and reduced LOS, commonly associated with minimally invasive surgery, were seen and while costs of RARC remain prohibitive, reducing operative times and LOS will improve cost analysis. SUMMARY:RARC with totally intracorporeal urinary diversion is technically feasible with good early and intermediate-term oncological and complication rate results. High-volume centers with expertise can deliver a complete intracorporeal robotic cystectomy with no increase in the complication rates or additional costs compared to RARC with extracorporeal urinary diversion. Further long-term oncological and functional data and the results of prospective randomized controlled trials are both pending to confirm these findings.
journal_name
Curr Opin Uroljournal_title
Current opinion in urologyauthors
Collins JW,Wiklund PN,Desai MM,Goh AC,Gill ISdoi
10.1097/MOU.0b013e32835d4cdasubject
Has Abstractpub_date
2013-03-01 00:00:00pages
135-40issue
2eissn
0963-0643issn
1473-6586pii
00042307-201303000-00007journal_volume
23pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:Therapies for the treatment of severe male factor infertility have advanced well beyond our knowledge of the conditions we are treating. An intact Y chromosome is necessary for optimal spermatogenesis. It is imperative for the clinician to understand the molecular basis and clinical implications of an...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0b013e32831367dc
更新日期:2008-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Examine and discuss novel focal therapy treatment options for prostate cancer. RECENT FINDINGS:With the widespread adoption of mpMRI-guided biopsies for prostate cancer, use of image-guided treatment of prostate cancer has increased. Focal therapies leading to partial gland ablation such as partial p...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0000000000000469
更新日期:2018-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Electrosurgical transurethral resection (TUR) of the prostate (TURP) has dominated symptomatic benign prostatic hyperplasia (s-BPH) surgical treatment for almost a century. We analysed recent TURP publications, with emphasis on durability, morbidity, new technology advantages, future generation traini...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0b013e3283411455
更新日期:2011-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Issues relating to the disease are critical in the diagnosis, management, and prognostication of prostate cancer. RECENT FINDINGS:New data have emerged regarding the disease of prostate cancer and its precursors. The diagnosis of prostate cancer on needle biopsy has been refined because of the recent...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/01.mou.0000193389.31727.9b
更新日期:2006-05-01 00:00:00
abstract:PURPOSE OF REVIEW:Radical cystectomy and urinary diversion is the accepted standard of care for invasive bladder cancer. Although orthotopic neobladder is the preferred method of urinary diversion in men, less experience is available for women. Recent studies and reports on this subject are summarized and reviewed. RE...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0b013e32834b31c4
更新日期:2011-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Minimally invasive options to treat low-risk prostate cancer are more desirable than radical therapy. Technological improvements in cryotherapy have increased its use, and long-term data on its efficacy are emerging. In this review, we discuss contemporary data on cryotherapy with specific focus on st...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/mou.0b013e32831e16ce
更新日期:2009-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Training in female urology in Europe so far has been a national focus of individual European countries. Because of reasons like differentiation in pathology, activities of other specialisms like gynaecology and reimbursement issues, the way in which extra training in female urology is organized varies...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0b013e32832ae1a4
更新日期:2009-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Ongoing controversy exists as to the extent of the necessary evaluation of the female presenting with lower urinary tract symptoms. Most would agree that a detailed history, a physical examination and a urine analysis are essential components of the initial evaluation of lower urinary tract symptoms i...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/00042307-200307000-00002
更新日期:2003-07-01 00:00:00
abstract::In the present review the eligible data on urethral pathologies are critically analysed, with special attention given to unresolved controversies in this topic. The entities discussed are as follows: female circumcision as a ritualistic tradition, with many associated complications; prostatourethritis and urethral syn...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/00042307-200009000-00004
更新日期:2000-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Urethrovaginal fistulae are a rare condition. It is a conceptual mistake to consider urethrovaginal fistulae to be synonymous with vesicovaginal fistulae. Urethrovaginal fistulae are a different entity requiring special attention and treatment. Due to the wide variety and individuality of the clinical...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0b013e3282feedd4
更新日期:2008-07-01 00:00:00
abstract:PURPOSE OF REVIEW:The article focuses on recently published original and review papers on current controversial aspects of pelvic reconstructive surgery. RECENT FINDINGS:A detailed Medline search was performed on records published in the previous 12 months. Controversial areas concerning which important work has been ...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/01.mou.0000250280.29743.54
更新日期:2006-11-01 00:00:00
abstract::The indications for ureteroscopic lithotripsy have increased with endoscope miniaturization and powerful, precise endoscopic lithotrites like the holmium: yttrium-aluminum-garnet laser. Successful ureteropyeloscopic treatment with the currently available instrumentation and techniques is independent of the size, compo...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/00042307-199907000-00010
更新日期:1999-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Testicular microlithiasis becomes a greater interdisciplinary issue among urologists, andrologists, gynecologists dedicated to reproductive medicine, pediatricians, radiologists and pathologists. Proposed management ranges from benign neglect, instructing self-examination over follow-up once, regular ...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0b013e3283314a1d
更新日期:2009-11-01 00:00:00
abstract:PURPOSE OF REVIEW:We outline a generic approach to using a nomogram to predict a continuous probability of failure in high-risk patients (rather than putting patients into groups), in order to identify patients whose risk exceeds a cutoff point. We discuss the goals of any staging system, what markers should be include...
journal_title:Current opinion in urology
pub_type: 杂志文章
doi:10.1097/00042307-200303000-00005
更新日期:2003-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Evidence is accumulating to consider erectile dysfunction as a vascular problem. This review focuses on background, pathophysiological mechanisms and clinical evidence of the link between erectile dysfunction and coronary artery disease. RECENT FINDINGS:The link between erectile dysfunction and coron...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/00042307-200411000-00012
更新日期:2004-11-01 00:00:00
abstract:PURPOSE OF REVIEW:The aim of this article is to outline the initial development of histotripsy, a noninvasive image-guided focused ultrasound technology that mechanically homogenizes targeted tissues and to describe the results of preclinical translational research directed toward urologic applications. RECENT FINDING...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0000000000000001
更新日期:2014-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Ureteral stents are a mainstay of today's urological armamentarium. This review critically evaluates the recent literature and provides a concise summary of the use of stents in urology today. While stents are used in many reconstructive urologic procedures, this review focuses on the use of stents in...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/00042307-200403000-00011
更新日期:2004-03-01 00:00:00
abstract:PURPOSE OF REVIEW:The purpose of this review is to provide a complete revision of two of the most widely used clinical guidelines in the management of lower urinary tract symptoms induced by benign prostatic hyperplasia and their importance and compliance among urologists. RECENT FINDINGS:Updates of the American Assoc...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0b013e32834d8e87
更新日期:2012-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Radical prostatectomy is the standard treatment for localized prostate cancer; its translation to a laparoscopic approach is considered today not only as feasible and reproducible but also as a valid and teachable alternative to its open counterpart. Beyond the "classical" transperitoneal antegrade ro...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/01.mou.0000160621.05742.a4
更新日期:2005-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Several novel treatment modalities have been introduced for patients across all renal cell carcinoma stages. Observation or a variety of minimally invasive approaches can be applied to small renal masses. Conversely, aggressive loco-regional resections may be performed for locally advanced disease. Cy...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0b013e3282a4a6b7
更新日期:2007-09-01 00:00:00
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journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0000000000000147
更新日期:2015-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Metastatic or unresectable urothelial cancer of the urinary bladder has traditionally been treated with systemic chemotherapy, which is most often platinum-based. The long-term survival data and the associated toxicities from this form of therapy have spurred continuing interest in finding novel treat...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/01.mou.0000176047.23089.c7
更新日期:2005-09-01 00:00:00
abstract::The proliferation of prostatic tissue as a result of ageing typically leads to prostatic enlargement, which often causes obstruction of urine outflow from the bladder, clinically lower urinary tract symptoms, detrusor instability, incomplete bladder emptying, urinary infection, and finally acute urinary retention. The...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/00042307-200201000-00006
更新日期:2002-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Patients who undergo urinary tract diversion are at an increased risk of urolithiasis for various reasons. The purpose of this article is to provide an up-to-date summary of the progress that has been made in the pathogenesis, diagnosis and treatment of stones in patients with urinary diversions. Fina...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/00042307-200207000-00007
更新日期:2002-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Partial nephrectomy has become the standard of treatment for renal tumors less than 4 cm in size. Recent reports have even applied this technique for T1b lesions as well. With advancement in minimally invasive techniques, laparoscopic and robotic surgeries are performed with the advantage of decreased...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0b013e3283337b76
更新日期:2010-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Minimally invasive surgeries such as conventional laparoscopic surgery and robotic assisted laparoscopic surgery (RALS) have significant advantages over the traditional open surgical approach including lower pain medication requirements and decreased length of hospitalization. However, open surgery ha...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0b013e32835b0ad2
更新日期:2013-01-01 00:00:00
abstract:PURPOSE OF REVIEW:The aim of this article is to look into recent updates on the management of neurogenic stress urinary incontinence (NSUI) in adult females. RECENT FINDINGS:Recently, a small number of studies have investigated different surgical modalities in treatment of NSUI in adult females including artificial ur...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0000000000000785
更新日期:2020-07-01 00:00:00
abstract:PURPOSE OF REVIEW:In the absence of an effective and well tolerated drug for stress urinary incontinence, pharmacological therapy for this condition has remained in the off-label prescription of some products particularly estrogens and alpha-adrenergic agonists. In this review we provide an update of the most recent de...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/01.mou.0000172394.60481.47
更新日期:2005-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Kidney cancer is associated with renal vein or inferior vena cava (IVC) thrombus in up to 10% of cases. The management of these cases is complex, and thus typically performed open surgically. At selected institutions, the robotic approach is being explored. We review the literature on robotic IVC surg...
journal_title:Current opinion in urology
pub_type: 杂志文章,评审
doi:10.1097/MOU.0000000000000033
更新日期:2014-03-01 00:00:00
abstract::After more than 100 years of innovation in hypospadias repair, new concepts regarding penile curvature, the urethral plate, and the means for urethroplasty are changing surgical practices. With the introduction of the tubularized incised plate technique it is possible to simplify decision-making algorithms in hypospad...
journal_title:Current opinion in urology
pub_type: 杂志文章
doi:10.1097/00042307-199911000-00004
更新日期:1999-11-01 00:00:00