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INTRODUCTION AND OBJECTIVE:We assessed the impact of prostatic zone tumor origin on pathological prognostic features and subsequent biochemical outcomes after radical prostatectomy.METHODS:A total ...

INTRODUCTION AND OBJECTIVES:Various recent literature suggests that a negative multiparametric MRI (mpMRI) allows to rule out significant prostate cancer. The objective of our study was to investigate whether a specific portion of D'Amico intermediate risk group could be reclassified as low risk if the mpMRI is negative. We evaluated the histopathological results after radical prostatectomy (RP) in preoperative D'Amico intermediate risk patients that had a negative preoperative mpMRI.METHODS:We retrospectively identified 604 D'Amico intermediate risk patients and 355 low risk patients among 1,347 who underwent a preoperative mpMRI and radical prostatectomy in a single institution. Intermediate risk patients were sub-classified according to Gleason score, clinical stage and preoperative PSA level and the positivity of mpMRI. The final pathology from each RP specimen of each sub-classified group was compared with that of D'Amico low risk group. The MRIs were considered negative when no suspicious lesion was...

vs 2/26(7%), p=0.587). Symptom resolution was documented at 6 weeks post-operatively and was sustained at the mean follow up or 5.7 months (range 1-60 mo). CONCLUSIONS: In this retrospective cohort study, urodynamics confirmed obstruction in 54% with symptomatic voiding dysfunction after a sling procedure. The response to sling takedown was favorable and independent of urodynamic evidence of obstruction. Still, we believe urodynamics remains of value the evaluation of women with voiding dysfunction after anti-incontinence surgery in whom the decision for surgical intervention is often difficult if solely based on symptoms following sling surgery and supportive physical findings.