Tracey L. Krupski

Androgen deprivation therapy increases cardiovascular morbidity in men with prostate cancer

The use of androgen deprivation therapy (ADT) in the treatment of men with prostate cancer has risen sharply. Although cardiovascular disease is the most common reason for death among men with prostate cancer who do not die of the disease itself, data regarding the effect of ADT on cardiovascular morbidity and mortality in men with prostate cancer are limited. In the current study, the authors attempted to measure the risk for subsequent cardiovascular morbidity in men with prostate cancer who received ADT.

Positioning injuries associated with robotic assisted urological surgery.

PURPOSE Nerve injury associated with patient positioning during surgery is well documented. With the development of robotic surgery, surgeons are faced with new surgical positioning, requiring attention to ensure patient safety. Published reports that address positioning injury during robotic surgery are sparse and none address the overall incidence. In this study we determine the incidence of positioning injury during robotic assisted urological surgery, identify risk factors and describe the time to resolution of the neurological injury. MATERIALS AND METHODS We reviewed all adult urological cases at our institution that used the da Vinci® Si and da Vinci Standard® Surgical System from January 2010 to December 2011. We characterized risk factors into the 4 domains of positioning, operative, patient specific and anesthesia related. Within these 4 categories we collected data on 13 specific aspects of patient care to determine their association with positioning injury. RESULTS Of 334 operations 22 positioning injuries (6.6%) were documented. Of these injuries 13 (59.1%) resolved within 1 month, 4 (18.2%) resolved between 1 and 6 months, and 5 (22.7%) persisted beyond 6 months. We found operative time (p <0.0001), in-room time (p <0.0001) and ASA (American Society of Anesthesiologists) class (p = 0.0033) were significantly associated with injury. CONCLUSIONS Positioning injuries are under recognized in robotic assisted urological surgery and may persist beyond 6 months. Consideration must be given to counseling patients about the risks of positioning injuries, especially for long operations. Patients with multiple medical comorbidities (ASA class 4) are particularly at risk for these injuries.

Economic Costs of Overactive Bladder in the United States

OBJECTIVES To calculate, from a societal perspective, current direct (medical and nonmedical) and indirect costs of overactive bladder (OAB) in the United States and project them to future years. Existing cost assessments of OAB in the United States are incomplete and outdated. METHODS A prevalence-based model was developed incorporating age- and sex-specific OAB prevalence rates, usage data, and productivity data. On the basis of the information gathered from the recent 5 years of the medical literature, practice guidelines, Medicare and managed care fee schedules, and expert panel input, the annual per capita and total US costs were calculated for 2007. US census population forecasts were used to project the costs of OAB to 2015 and 2020. RESULTS In 2007, average annual per capita costs of OAB were

Geographic and Socioeconomic Variation in the Treatment of Prostate Cancer

1925 (

Natural history of bone complications in men with prostate carcinoma initiating androgen deprivation therapy

1433 in direct medical,

Radioactive implant migration in patients treated for localized prostate cancer with interstitial brachytherapy.

66 in direct nonmedical, and

Practice variation in the surgical management of urinary lithiasis

426 in indirect costs). Applying these costs to the 34 million people in the United States with OAB results in total national costs of

Correlates of Bother Following Treatment for Clinically Localized Prostate Cancer

65.9 billion (billion = 1000 million), (

The RAZOR (randomized open vs robotic cystectomy) trial: Study design and trial update

49.1 billion direct medical,

Partnership status influences quality of life in low-income, uninsured men with prostate cancer.

2.3 billion direct nonmedical, and