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54. Investigating The Mechanism Underlying Urinary Continence Using Dynamic-MRI After Retzius-sparing Robot-assisted Radical Prostatectomy

Author

Kadono, Yoshifumi, primary, Nohara, Takahiro, additional, Kawaguchi, Shohei, additional, Kadomoto, Suguru, additional, Iwamoto, Hiroaki, additional, Iijima, Masashi, additional, Shigehara, Kazuyoshi, additional, Izumi, Kouji, additional, Yoshida, Kotaro, additional, Gabata, Toshifumi, additional, and Mizokami, Atsushi, additional

Published
2021
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56. Androgen replacement therapy for cancer‐related symptoms in male: result of prospective randomized trial (ARTFORM study)

Author

Izumi, Kouji, primary, Iwamoto, Hiroaki, additional, Yaegashi, Hiroshi, additional, Nohara, Takahiro, additional, Shigehara, Kazuyoshi, additional, Kadono, Yoshifumi, additional, Nanjo, Shigeki, additional, Yamada, Tadaaki, additional, Ohtsubo, Koshiro, additional, Yano, Seiji, additional, and Mizokami, Atsushi, additional

Published
2021
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60. Blood Cell Count Biomarkers Predicting Efficacy of Pembrolizumab as Second-line Therapy for Advanced Urothelial Carcinoma

Author

KADONO, YOSHIFUMI, primary, KAWAGUCHI, SHOHEI, additional, NOHARA, TAKAHIRO, additional, SHIGEHARA, KAZUYOSHI, additional, IZUMI, KOUJI, additional, KAMIJIMA, TAIKI, additional, SETO, CHIKASHI, additional, TAKANO, AKINOBU, additional, YOTSUYANAGI, SATOSHI, additional, NAKAGAWA, RYUNOSUKE, additional, MIYAGI, TOHRU, additional, AOYAMA, SHUHEI, additional, ASAHI, HIDEKI, additional, FUKUDA, RIE, additional, and MIZOKAMI, ATSUSHI, additional

Published
2021
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Author

Shigehara, Kazuyoshi, Shimamura, Masayoshi, Kawaguchi, Shohei, Nohara, Takahiro, Izumi, Kouji, Kadono, Yoshifumi, Shouda, Ryouchu, Mizokami, Atsushi, Shigehara, Kazuyoshi, Shimamura, Masayoshi, Kawaguchi, Shohei, Nohara, Takahiro, Izumi, Kouji, Kadono, Yoshifumi, Shouda, Ryouchu, and Mizokami, Atsushi

Abstract

Five mg tadalafil was administered once-daily to 48 patients for 6 months. Their International Prostatic Symptoms Score (IPSS), Overactive Bladder Symptoms Score (OABSS), Sexual Health Inventory for Men (SHIM), post-voided residual (PVR) volume, free testosterone (FT) level, prostate-specific antigen level, and highly sensitive C-reactive protein (hsCRP) value obtained before and 6 months after the treatment were analyzed. The treatment significantly improved the IPSS, OABSS, SHIM score, and PVR volume (P<0.05), and significantly increased the mean FT level from 6.68 to 7.10 pg/ml ; P<0.05. We observed no significant changes in the hsCRP value and PSA level. However, elevated FT values were noted in 25 (52.1%) patients 6 months after the treatment (FT-increased group). Compared with the non-FT-increased group, the FT-increased group had markedly lower baseline FT value and higher prostatic volume. In both groups, IPSS and OABSS improved considerably. Moreover, the PVR volume, SHIM score, and hsCRP value markedly improved in the FT-increased group (P<0.05). Thus, 5 mg tadalafil administered oncedaily improved IPSS, OABSS, and erectile function, and increased the FT value, in hypogonadal patients with lower urinary tract symptoms. Furthermore, the hsCRP value declined considerably in patients with posttreatment elevated FT level.

Published
2020

64. Similar Recurrence Rate Between Gleason Score of Six at Positive Margin and Negative Margin After Radical Prostatectomy

Author

KANO, HIROSHI, primary, KADONO, YOSHIFUMI, additional, KADOMOTO, SUGURU, additional, IWAMOTO, HIROAKI, additional, YAEGASHI, HIROSHI, additional, IIJIMA, MASASHI, additional, KAWAGUCHI, SHOHEI, additional, NOHARA, TAKAHIRO, additional, SHIGEHARA, KAZUYOSHI, additional, IZUMI, KOUJI, additional, IKEDA, HIROKO, additional, and MIZOKAMI, ATSUSHI, additional

Published
2021
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68. Transvaginal polytetrafluoroethylene mesh surgery for pelvic organ prolapse: 1‐year clinical outcomes

Author

Kawaguchi, Shohei, primary, Narimoto, Kazutaka, additional, Hamuro, Akihiro, additional, Nakagawa, Tomomi, additional, Urata, Satoko, additional, Kadomoto, Suguru, additional, Iwamoto, Hiroaki, additional, Yaegashi, Hiroshi, additional, Iijima, Masashi, additional, Nohara, Takahiro, additional, Shigehara, Kazuyoshi, additional, Izumi, Kouji, additional, Tachibana, Daisuke, additional, Kadono, Yoshifumi, additional, Mizokami, Atsushi, additional, and Koyama, Masayasu, additional

Published
2020
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69. Real-World Clinical Outcomes of Pembrolizumab as Second-Line Therapy for Advanced Urothelial Carcinoma

Author

Kadono, Yoshifumi, primary, Kawaguchi, Shohei, additional, Nohara, Takahiro, additional, Shigehara, Kazuyoshi, additional, Izumi, Kouji, additional, Kamijima, Taiki, additional, Seto, Chikashi, additional, Takano, Akinobu, additional, Yotsuyanagi, Satoshi, additional, Nakagawa, Ryunosuke, additional, Miyagi, Tohru, additional, Aoyama, Shuhei, additional, Asahi, Hideki, additional, Fukuda, Rie, additional, and Mizokami, Atsushi, additional

Published
2020
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71. MP72-09 INTRAOPERATIVE HYPOTENSION CAUSED BY ORAL ADMINISTRATION OF 5-AMINOLEVULINIC ACID FOR PHOTODYNAMIC DIAGNOSIS IN PATIENTS WITH BLADDER CANCER

Author

Nohara*, Takahiro, primary, Kato, Yuki, additional, Nakano, Taito, additional, Nakagawa, Tomomi, additional, Iwamoto, Hiroaki, additional, Yaegashi, Hiroshi, additional, Nakashima, Kazufumi, additional, Iijima, Masashi, additional, Kawaguchi, Shohei, additional, Shigehara, Kazuyoshi, additional, Izumi, Kouji, additional, Kadono, Yoshifumi, additional, and Mizokami, Atsushi, additional

Published
2020
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77. Identification of risk factors associated with oral 5-aminolevulinic acid-induced hypotension in photodynamic diagnosis for non-muscle invasive bladder cancer: a multicenter retrospective study.

Author

Fukuhara, Hideo, Nohara, Takahiro, Nishimoto, Koshiro, Hatakeyama, Yutaka, Hyodo, Yuki, Okuhara, Yoshiyasu, Oyama, Masafumi, Mizokami, Atsushi, Inoue, Keiji, Matsuyama, Hideyasu, and Japan Urological Photodynamic Society

Subjects
*BLADDER cancer, *MITOMYCINS, *CANCER invasiveness, *INVASIVE diagnosis, *HYPOTENSION, *SYSTOLIC blood pressure, *LOGISTIC regression analysis, *CYSTECTOMY, *DECISION trees, *RESEARCH, *GENERAL anesthesia, *PHOTOSENSITIZERS, *CALCIUM antagonists, *RESEARCH methodology, *REGRESSION analysis, *CARDIAC contraction, *DISEASE incidence, *RETROSPECTIVE studies, *EVALUATION research, *COMPARATIVE studies, *QUESTIONNAIRES, *AMINO acids, *SPINAL anesthesia, BLADDER tumors
Abstract

Background: To investigate risk factors for orally administered 5-aminolevulinic acid (ALA)-induced hypotension for bladder cancer patients receiving photodynamic diagnosis (PDD)-assisted transurethral resection of bladder tumor (TURBT).Methods: Patients were categorized into two groups intraoperatively: a hypotensive group (minimum systolic blood pressure (SBP) ≤80 mmHg) and a non-hypotensive group (minimum SBP > 80 mmHg). We examined differences between the hypotensive group and non-hypotensive groups to identify clinical risk of ALA-induced hypotension using multivariate logistic regression analysis and decision tree analysis.Results: Among 282 cases with ALA-PDD-assisted TURBT from three institutions who were screened, 245 patients were included in the final analysis. In total, 156 patients (63.7%) showed any grade of hypotension during ALA-PDD-assisted TURBT. General anesthesia and spinal anesthesia were induced intraoperatively in 113 patients (46.1%) and 132 patients (53.9%), respectively. Median SBP at baseline (before taking ALA) and at the beginning of anesthesia was 127 mmHg (range, 69-186 mmHg) and 124 mmHg (range, 69-186 mmHg), respectively. Median minimum SBP during ALA-PDD-assisted TURBT was 75 mmHg (range, 43-140 mmHg). Multivariate logistic regression analysis revealed that history of hypertension (odds ratio (OR) 7.568, p < 0.05) and general anesthesia (OR 14.435, p < 0.05) as significantly associated with an increased risk of hypotension incidence. Use of calcium antagonist showed significant negative associations with hypotension (OR 0.183, p < 0.05). Decision tree analysis showed presence of general anesthesia, age ≥ 74 years and American Society of Anesthesiologists physical status (ASA-PS) ≥2 as the most important discriminators.Conclusions: General anesthesia and hypertension were independent risk factors related to ALA-induced hypotension. In contrast, use of calcium antagonists was identified as a factor associated with reduced risk of ALA-induced hypotension. [ABSTRACT FROM AUTHOR]

Published
2021
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79. Intraoperative hypotension caused by oral administration of 5‐aminolevulinic acid for photodynamic diagnosis in patients with bladder cancer

Author

Nohara, Takahiro, primary, Kato, Yuki, additional, Nakano, Taito, additional, Nakagawa, Tomomi, additional, Iwamoto, Hiroaki, additional, Yaegashi, Hiroshi, additional, Nakashima, Kazufumi, additional, Iijima, Masashi, additional, Kawaguchi, Shohei, additional, Shigehara, Kazuyoshi, additional, Izumi, Kouji, additional, Kadono, Yoshifumi, additional, and Mizokami, Atsushi, additional

Published
2019
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81. Initial Experience With Radium-223 Chloride Treatment at the Kanazawa University Hospital

Author

NAKASHIMA, KAZUFUMI, primary, MAKINO, TOMOYUKI, additional, KADOMOTO, SUGURU, additional, IWAMOTO, HIROAKI, additional, YAEGASHI, HIROSHI, additional, IIJIMA, MASASHI, additional, KAWAGUCHI, SHOHEI, additional, NOHARA, TAKAHIRO, additional, SHIGEHARA, KAZUYOSHI, additional, IZUMI, KOUJI, additional, KADONO, YOSHIFUMI, additional, MATSUO, SHINRO, additional, and MIZOKAMI, ATSUSHI, additional

Published
2019
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82. Quantification of Bone Metastasis of Castration-resistant Prostate Cancer After Enzalutamide and Abiraterone Acetate Using Bone Scan Index on Bone Scintigraphy

Author

KADOMOTO, SUGURU, primary, YAEGASHI, HIROSHI, additional, NAKASHIMA, KAZUFUMI, additional, IIJIMA, MASASHI, additional, KAWAGUCHI, SHOHEI, additional, NOHARA, TAKAHIRO, additional, SHIGEHARA, KAZUYOSHI, additional, IZUMI, KOUJI, additional, KADONO, YOSHIFUMI, additional, NAKAJIMA, KENICHI, additional, and MIZOKAMI, ATSUSHI, additional

Published
2019
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83. Novel Prevention Procedure for Inguinal Hernia after Robot-Assisted Radical Prostatectomy: Results from a Prospective Randomized Trial

Author

Kadono, Yoshifumi, primary, Nohara, Takahiro, additional, Kawaguchi, Shohei, additional, Sakamoto, Jiro, additional, Iwamoto, Hiroaki, additional, Yaegashi, Hiroshi, additional, Nakashima, Kazufumi, additional, Iijima, Masashi, additional, Shigehara, Kazuyoshi, additional, Izumi, Kouji, additional, and Mizokami, Atsushi, additional

Published
2019
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84. A Case Report of Chyloretroperitoneum Post Living-Donor Transplantation

Author

Kawaguchi, Shohei, primary, Kadono, Yoshifumi, additional, Nohara, Takahiro, additional, Kato, Yuki, additional, Nakagawa, Tomomi, additional, Urata, Satoko, additional, Yaegashi, Hiroshi, additional, Nakashima, Kazufumi, additional, Iijima, Masashi, additional, Shigehara, Kazuyoshi, additional, Izumi, Kouji, additional, and Mizokami, Atsushi, additional

Published
2019
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86. The five-year effects of testosterone replacement therapy on lipid profile and glucose tolerance among hypogonadal men in Japan: a case control study

Author

Kato, Yuki, primary, Shigehara, Kazuyoshi, additional, Nakashima, Kazufumi, additional, Iijima, Masashi, additional, Kawagushi, Shohei, additional, Nohara, Takahiro, additional, Izumi, Kouji, additional, Kadono, Yoshifumi, additional, Konaka, Hiroyuki, additional, Namiki, Mikio, additional, and Mizokami, Atsushi, additional

Published
2019
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89. Health-related Quality of Life and Toxicity After Single-fraction High-dose-rate Brachytherapy With External Beam Radiotherapy for Localized and Locally Advanced Prostate Cancer

Author

MAKINO, TOMOYUKI, primary, NAKASHIMA, KAZUFUMI, additional, IIJIMA, MASASHI, additional, KAWAGUCHI, SHOUHEI, additional, NOHARA, TAKAHIRO, additional, SHIGEHARA, KAZUYOSHI, additional, IZUMI, KOUJI, additional, KADONO, YOSHIFUMI, additional, KUMANO, TOMOYASU, additional, and MIZOKAMI, ATSUSHI, additional

Published
2018
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91. Evaluating urinary incontinence before and after radical prostatectomy using the international consultation on incontinence questionnaire‐short form

Author

Machioka, Kazuaki, primary, Kadono, Yoshifumi, additional, Naito, Renato, additional, Nakashima, Kazufumi, additional, Iijima, Masashi, additional, Kawaguchi, Shohei, additional, Shigehara, Kazuyoshi, additional, Nohara, Takahiro, additional, Izumi, Kouji, additional, and Mizokami, Atsushi, additional

Published
2018
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92. Transvaginal polytetrafluoroethylene mesh surgery for pelvic organ prolapse: 1‐year clinical outcomes.

Author

Kawaguchi, Shohei, Narimoto, Kazutaka, Hamuro, Akihiro, Nakagawa, Tomomi, Urata, Satoko, Kadomoto, Suguru, Iwamoto, Hiroaki, Yaegashi, Hiroshi, Iijima, Masashi, Nohara, Takahiro, Shigehara, Kazuyoshi, Izumi, Kouji, Tachibana, Daisuke, Kadono, Yoshifumi, Mizokami, Atsushi, and Koyama, Masayasu

Subjects
VAGINAL surgery, PELVIC organ prolapse, COLPORRHAPHY, POLYTEF, TRANSVAGINAL surgery, TREATMENT effectiveness, DRUG efficacy
Abstract

Objectives: To evaluate the safety and efficacy of transvaginal mesh surgery using a polytetrafluoroethylene mesh to treat pelvic organ prolapse. Methods: This prospective observational study included women undergoing transvaginal mesh surgery for pelvic organ prolapse that used new polytetrafluoroethylene mesh cut into a shape similar to that of Elevate. We evaluated the subjective and objective outcomes at 3 and 12 months, as well as postoperative complication rates. Results: This study included 55 patients. The pelvic organ prolapse quantification scores improved significantly at 3 and 12 months after surgery compared with scores before surgery. In four patients (7.3%), a pelvic examination showed stage 2 objective recurrence without subjective symptoms. Clavien–Dindo grades 2 and 3 perioperative complications were observed in 9.1% and 1.8% of the patients, respectively. Vaginal mesh exposure occurred in one patient (1.8%) at the time of the 3‐month follow‐up evaluation. The mesh was exposed at the proximal midline of the anterior vaginal wall. Conclusions: These findings show the safe and effective use of the polytetrafluoroethylene mesh for transvaginal mesh surgery. [ABSTRACT FROM AUTHOR]

Published
2021
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93. The five-year effects of testosterone replacement therapy on lipid profile and glucose tolerance among hypogonadal men in Japan: a case control study.

Author

Kato, Yuki, Shigehara, Kazuyoshi, Nakashima, Kazufumi, Iijima, Masashi, Kawagushi, Shohei, Nohara, Takahiro, Izumi, Kouji, Kadono, Yoshifumi, Konaka, Hiroyuki, Namiki, Mikio, and Mizokami, Atsushi

Subjects
GONADAL diseases, TESTOSTERONE, BLOOD sugar, GLUCOSE, LIPIDS, INTRAMUSCULAR injections, THERAPEUTIC use of testosterone, THERAPEUTICS, HYPOGONADISM, HORMONES, CASE-control method, GLUCOSE tolerance tests, PROSTATE-specific antigen
Abstract

Objective: This study investigated the efficacy of 5-year testosterone replacement therapy (TRT) on lipid profile and glucose tolerance in Japanese hypogonadal men.Methods: Fourteen patients, who received continuous TRT for 5 years, and 22 controls with 5-year observations were enrolled. The patients in the TRT group had received intramuscular injections of testosterone enanthate (250 mg) every month for 5 years. We collected the following data: blood pressure, fasting blood sugar (FBS), hemoglobin A1c (HbA1c), total cholesterol, triglyceride (TG), high density lipoprotein-Chol values, and prostate specific antigen (PSA) level at baseline, 1-, 3-, and 5-years from initial intervention. These data were compared between the two groups.Results: There were no statistically significant differences in any other baseline characteristic, excluding SBP, between the two groups. FBS was significantly improved at 3- and 5-year visits in the TRT group compared to the control group. Furthermore, the HbA1c level and TG value demonstrated a significant decrease at 1-, 3-, and 5-years in the TRT group. However, no significant difference in changes to PSA levels from baseline in both groups was observed.Conclusions: Five-year TRT could improve FBS, HbA1c, and TG levels among Japanese hypogonadal men with no significant increase in PSA. [ABSTRACT FROM AUTHOR]

Published
2020
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95. Investigating the mechanism underlying urinary continence recovery after radical prostatectomy: effectiveness of a longer urethral stump to prevent urinary incontinence

Author

Kadono, Yoshifumi, primary, Nohara, Takahiro, additional, Kawaguchi, Shohei, additional, Naito, Renato, additional, Urata, Satoko, additional, Nakashima, Kazufumi, additional, Iijima, Masashi, additional, Shigehara, Kazuyoshi, additional, Izumi, Kouji, additional, Gabata, Toshifumi, additional, and Mizokami, Atsushi, additional

Published
2018
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97. Androgen replacement therapy for cancer-related symptoms in male advanced cancer patients : study protocol for a randomised prospective trial (ARTFORM study)

Author

Izumi, Kouji, Shigehara, Kazuyoshi, Nohara, Takahiro, Narimoto, Kazutaka, Kadono, Yoshifumi, Nanjo, Shigeki, Yamada, Tadaaki, Ohtsubo, Koushiro, Yano, Seiji, Mizokami, Atsushi, Izumi, Kouji, Shigehara, Kazuyoshi, Nohara, Takahiro, Narimoto, Kazutaka, Kadono, Yoshifumi, Nanjo, Shigeki, Yamada, Tadaaki, Ohtsubo, Koushiro, Yano, Seiji, and Mizokami, Atsushi

Abstract

Recent studies reveal that hypogonadism with low serum androgen levels is associated with advanced cancer and induction of most cancer-related symptoms.We designed an ARTFORM study to evaluate the efficacy of androgen replacement therapy in male advanced cancer patients. The ARTFORM study is an investigatorinitiated, randomised controlled trial comparing intramuscle injection of testosterone enanthate with non-administration in male advanced cancer patients with non-curative locally advanced or metastatic lesions. Serum total and free testosterone levels are measured and patients with low testosterone level are randomised. The primary endpoint is the difference in validated health-related quality of life questionnaires at week 12. Trial registration of the ARTFORM study is assigned to University hospital Medical Information Network, Center identifier UMIN 000010939.

Published
2017

98. Use of preoperative factors including urodynamic evaluations and nerve-sparing status for predicting urinary continence recovery after robot-assisted radical prostatectomy: Nerve-sparing technique contributes to the reduction of postprostatectomy incontinence

Author

Kadono, Yoshifumi, Ueno, Satoru, Kadomoto, Suguru, Iwamoto, Hiroaki, Takezawa, Yuta, Nakashima, Kazufumi, Nohara, Takahiro, Izumi, Kouji, Mizokami, Atsushi, Gabata, Toshifumi, Namiki, Mikio, Kadono, Yoshifumi, Ueno, Satoru, Kadomoto, Suguru, Iwamoto, Hiroaki, Takezawa, Yuta, Nakashima, Kazufumi, Nohara, Takahiro, Izumi, Kouji, Mizokami, Atsushi, Gabata, Toshifumi, and Namiki, Mikio

Abstract

Aims: To examine which preoperative factors, including urodynamic evaluations, and operative procedures could predict continence status after robot-assisted radical prostatectomy (RARP) in this study. Materials and Methods: Univariate and multivariate logistic regression analyses of preoperative factors such as age, body mass index, prostate-specific antigen level before biopsy, prostate size before surgery, membranous urethral length measured using magnetic resonance imaging (MRI), bladder compliance and maximum urethral closure pressure (MUCP) measured by urodynamic study (UDS), and nerve-sparing (NS) status predicting 24-hr pad test >2 g/day at 1 year after RARP were examined in 111 patients enrolled in this study. Results: The number of patients with incontinence at 1 year after RARP was 39 (35.1%). The only predictive factor for urinary continence was NS grades. To investigate the contribution of NS to urinary continence, 84 patients underwent UDS three times; before, immediately after, and 1 year after RARP. Chronological UDS revealed that recovery patterns of storage and voiding functions were the same among non-NS, unilateral-NS, and bilateral-NS groups, and that higher degrees of NS contributed to lesser decreases in MUCP and longer functional urethral length (FUL) after RARP. Conclusion: Preoperative factors, including the results of UDS, could not predict continence 1 year after RARP. The NS procedure contributed to continence status. NS favorably affected MUCP and FUL; however, it did not affect bladder function after RARP. Neurourol. Urodynam. 35:1034–1039, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc., Embarogo Period 12 months

Published
2017

99. Understanding prostate-specific antigen dynamics in monitoring metastatic castration-resistant prostate cancer: implications for clinical practice

Author

Mizokami, Atsushi, Izumi, Kouji, Konaka, Hiroyuki, Kitagawa, Yasuhide, Kadono, Yoshifumi, Narimoto, Kazutaka, Nohara, Takahiro, Bahl, Amit K, Mizokami, Atsushi, Izumi, Kouji, Konaka, Hiroyuki, Kitagawa, Yasuhide, Kadono, Yoshifumi, Narimoto, Kazutaka, Nohara, Takahiro, and Bahl, Amit K

Abstract

Availability of novel hormonal therapies as well as docetaxel and cabazitaxel treatment for metastatic castration-resistant prostate cancer (CRPC) has changed the outlook for this group of patients with improvements in progression-free survival and overall survival. Physicians often diagnose the progression of prostate cancer using serum prostate-specific antigen (PSA). However, serum PSA is not always correlated with the clinical status in CRPC. To evaluate the PSA dynamics with greater precision, understanding of the control of PSA and of the mechanisms of development of CRPC is needed. Moreover, it is necessary to use new hormonal therapies with an appropriate timing to optimally improve the prognosis and the QOL of the patients. In the present review, we ascertain the PSA dynamics and the mechanisms of the development of CRPC to assist in optimal utilization of the new treatments for mCRPC.

Published
2017

100. Changes in penile length after radical prostatectomy: Investigation of the underlying anatomical mechanism

Author

Kadono, Yoshifumi, Machioka, Kazuaki, Nakashima, Kazufumi, Iijima, Masashi, Shigehara, Kazuyoshi, Nohara, Takahiro, Narimoto, Kazutaka, Izumi, Kouji, Kitagawa, Yasuhide, Konaka, Hiroyuki, Gabata, Toshifumi, Mizokami, Atsushi, Kadono, Yoshifumi, Machioka, Kazuaki, Nakashima, Kazufumi, Iijima, Masashi, Shigehara, Kazuyoshi, Nohara, Takahiro, Narimoto, Kazutaka, Izumi, Kouji, Kitagawa, Yasuhide, Konaka, Hiroyuki, Gabata, Toshifumi, and Mizokami, Atsushi

Abstract

Objective: To measure changes in penile length (PL) over time before and after radical prostatectomy (RP), and to investigate the underlying mechanisms for these changes. Patients and Methods: The stretched PL (SPL) of 102 patients was measured before, 10 days after, and at 1, 3, 6, 9, 12, 18 and 24 months after RP. The perpendicular distance from the distal end of the membranous urethra to the midline of the pelvic outlet was measured on mid-sagittal magnetic resonance imaging (MRI) slice at three time points: preoperatively; 10 days after RP; and 12 months after RP. Pre- and postoperative SPLs were compared using paired Student's t-test. Predictors of PL shortening at 10 days and at 12 months after RP were evaluated on univariate and multivariate analyses. Results: The SPL was shortest 10 days after RP (mean PL shortening from preoperative level: 19.9 mm), and gradually recovered thereafter. SPL at 12 months after RP was not significantly different from preoperative SPL. On MRI examination, the distal end of membranous urethra was found to have moved proximally (mean proximal displacement: 3.9 mm) at 10 days after RP, and to have returned to the preoperative position at 12 months after RP. On univariate analysis, only the volume of the removed prostate was a predictor of SPL change at 10 days after surgery; on multivariate analysis, the association was not statistically significant. No predictor of SPL change was found at 12 months after RP. Conclusion: The SPL was shortest at 10 days after RP and gradually recovered thereafter in the present study. Anatomically, the glans and corpus spongiosum surrounding the urethra are an integral structure, and the proximal urethra is drawn into the pelvis during urethrovesical anastomosis. This is the first report showing that slight vertical repositioning of the membranous urethra after RP causes changes in SPL over time. These results can help inform patients about changes in penile appearance after RP. © 2017 BJU Internati, Embargo Period 12 months

Published
2017

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