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Due to the historically large number of patients with localized prostate cancer (CAP) treated by radiation therapy, an increasing number of patients are presenting local failure. The currently available concepts regarding its definition as well as management options are reviewed. The literature regarding radiation failure for localized prostate cancer was reviewed. Emphasis was made on articles concerning definition of radiation failure, patient evaluation and restaging and definitive as well as palliative management options. There is definitely a subset of patients with locally recurrent prostate cancer without evidence of metastasis that could potentially benefit from aggressive local therapy. A treatment algorithm is proposed but it should be emphasized that treatment options should be individualized to suit the need of a particular patient. [ABSTRACT FROM AUTHOR]

Background: Vesicourethral anastomosis (VUA) is the most technically challenging part in an open radical retropubic prostatectomy (ORRP). Traditionally, it is accomplished using interrupted anastomotic sutures. The objective of this study is to describe our surgical technique of continuous VUA and compare its outcomes with that of interrupted VUA as performed by a single surgeon. Methods: A total of 235 patients with clinically localised prostate cancer who underwent ORRP between February 2000 and June 2013 were included. They were divided into group 1 (n=121), treated with interrupted VUA and group 2 (n=114), treated with continuous VUA. The primary outcome measures to be evaluated included operative time, blood loss, anastomotic integrity, hospital stay, continence, potency, and occurrence of VUA stenosis. Analyses were done with Welch's t-test and Fisher's exact test. All statistical tests were done with SPSS 20.0. P values less than 0.05 indicate statistically significant differences. Findings: Patients who underwent continuous VUA had significantly shorter operative (210.05±1.91 versus 251.37 ±2.74min, p<0.001) and anastomotic times (20.86±0.49 versus 41.46±0.58min, p<0.001); there was less estimated blood loss (510.81±10.11 versus 623.89±26.60mL, p<0.001), and need for transfusion (7.89% versus 27.27%, p<0.001), fewer days before drain removal (3.13 ±0.05 versus 6.15 ±0.11, p<0.001), fewer of days in hospital (3.44 ±0.06 versus 6.36 ±0.11, p< 0.001), less leakage per voiding cystourethrogram (0.88% versus 5.76%, p=0.035), fewer days before urethral catheter removal (10.05 ±0.12 versus 14.94 ±0.2, p<0.001) and fewer weeks to gain continence (7.05 ±0.26 versus 12.46 ±0.31, p<0.001). There were two cases of VUA stenosis in each groups. There were no reported occurrences of pelvic infection, urinoma, and acute urinary retention after catheter removal. Interpretation: Our technique of continuous VUA for ORRP provides better outcome compared to standard interrupted VUA. [ABSTRACT FROM AUTHOR]