Journal of Yeungnam Medical Science

Case report

DaVinci SP-based simultaneous bilateral partial nephrectomy from the midline transperitoneal approach: a case report: Young Hwii Ko, Jong Gyun Ha, Jae Yoon Jang, Yeung Uk Kim; J Yeungnam Med Sci. 2024;41(1):48-52. Published online January 4, 2024; DOI: https://doi.org/10.12701/jyms.2023.01032

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Abstract PDF: While simultaneous bilateral partial nephrectomy with a conventional multiport robot has been consistently reported since the 2010s, the introduction of the DaVinci SP system (Intuitive Surgical, Sunnyvale, CA, USA) could provide a novel way to perform surgery on bilateral kidneys while innovatively reducing the number of incisions. In our first report worldwide, the patient with bilateral small renal mass (2.0 cm for the left and 1.5 cm for the right side) and preoperative normal renal function was placed in the lateral decubitus position on an inverted bed. After tilting the bed to be as horizontal as possible, a 4-cm incision was made in the lower part of the umbilicus for the floating trocar technique. The partial nephrectomy was performed reliably as with the conventional transperitoneal approach, and then the patient could be repositioned to the contralateral side for the same procedure, maintaining all trocars. Total operation time (skin to skin), total console time, and the left- and right-side warm ischemic times were 260, 164, 27, and 23 minutes, respectively, without applying the early declamping technique. The estimated blood loss was 200 mL. The serum creatinine right after the operation, on the first day, 3 days, and 90 days after surgery were 0.92, 0.77, 0.79, and 0.81 mg/dL, respectively. For 90 days after the procedure, no complications or radiologic recurrence were observed. Further clinical studies will reveal the advantages of using the DaVinci SP device for this procedure over traditional multiport surgery, maximizing the benefit of a single port-based approach.

Original article

Pelvic floor muscle exercise with biofeedback helps regain urinary continence after robot-assisted radical prostatectomy: Yeong Uk Kim, Dong Gyu Lee, Young Hwii Ko; Yeungnam Univ J Med. 2021;38(1):39-46. Published online June 22, 2020; DOI: https://doi.org/10.12701/yujm.2020.00276

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Background
To determine the benefit of pelvic floor muscle exercise with visual biofeedback on promoting patient recovery from incontinence, we investigated variables associated with the early restoration of continence for patients who underwent robot-assisted radical prostatectomy.
Methods
Of the 83 patients enrolled, 41 consecutive patients completed pelvic floor muscle exercise (the exercise group), and the other 42 consecutive patients just before the pelvic floor muscle exercise program commenced (the control group). The primary outcome was whether pelvic floor muscle exercise engagement was associated with zero pad continence restoration within 3 months of surgery.
Results
Continence restoration percentages (defined as zero pads used per day) at 1, 3, and 6 months after surgery were 49.4%, 77.1%, and 94.0%, respectively. The exercise group achieved significantly higher recovery rates at 1 month (p=0.037), 3 months (p<0.001), and 6 months (p=0.023). Cox regression analysis demonstrated that a lower Gleason score (<8; hazard ratio, 2.167), lower prostate specific antigen (<20 ng/dL; hazard ratio, 2.909), and engagement in pelvic floor muscle exercise (hazard ratio, 3.731) were independent predictors of early recovery from postprostatectomy incontinence. Stratification by age showed that those younger than 65 years did not benefit significantly from exercise (log-rank test, p=0.08), but that their elderly counterparts, aged 65–70 years (p=0.007) and >70 years old (p=0.002) benefited significantly.
Conclusion
This study suggests that postoperative engagement in pelvic floor muscle exercise with biofeedback speeds up the recovery of continence in elderly patients (≥65 years old) that undergo robot-assisted radical prostatectomy.

Citations

Citations to this article as recorded by

Urinary incontinence rehabilitation of after radical prostatectomy: a systematic review and network meta-analysis
Kai Yu, Fan Bu, Tengteng Jian, Zejun Liu, Rui Hu, Sunmeng Chen, Ji Lu
Frontiers in Oncology.2024;[Epub] CrossRef
Effect of Kegel exercises on the prevention of urinary and fecal incontinence in patients with prostate cancer undergoing radiotherapy
A.E. Urvaylıoğlu, S. Kutlutürkan, D. Kılıç
European Journal of Oncology Nursing.2021; 51: 101913. CrossRef

Review Article

Functional recovery after radical prostatectomy for prostate cancer: Young Hwii Ko; Yeungnam Univ J Med. 2018;35(2):141-149. Published online December 31, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.2.141

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Abstract PDF

With the enthusiasm regarding robotic application in radical prostatectomy in accordance with the widespread use of serum prostate-specific antigen as a screening test, the number of surgeries performed for complete removal of the gland is increasing continuously. However, owing to the adjacent anatomical location of the prostate to the nerve and urethral sphincter complex, functional recovery, namely improvement from post-prostatectomy incontinence (PPI) and post-prostatectomy erectile dysfunction, still remains a main problem for patients who are reluctant to undergo surgery and tend to choose alternative ways instead. Since the late 1980s, the introduction of radical prostatectomy by open surgical modalities, the depth of the anatomical understanding of the structure surrounding the prostate is getting tremendous, which leads to the development of new surgical modalities and techniques that are consequently aimed at reducing the incidences of PPI and erectile dysfunction. Briefly, recent data from robotic radical prostatectomy, particularly on PPI, are quite acceptable, but by contrast, the reported potency regain rate still remains <20%, which indicates the need for advanced surgical modification to overcome it. In this review, the authors summarized the recent findings on the anatomy and surgical techniques reported up to now.

Citations

Citations to this article as recorded by

The assessment of erectile dysfunction after radical prostatectomy using pudendal somatosensory evoked potential
Se Yun Kwon, Jin-Mo Park, Appuwawadu Mestri Nipun Lakshitha de Silva
PLOS ONE.2023; 18(11): e0292847. CrossRef
Fidgetin-like 2 negatively regulates axonal growth and can be targeted to promote functional nerve regeneration
Lisa Baker, Moses Tar, Adam H. Kramer, Guillermo A. Villegas, Rabab A. Charafeddine, Olga Vafaeva, Parimala Nacharaju, Joel Friedman, Kelvin P. Davies, David J. Sharp
JCI Insight.2021;[Epub] CrossRef

Original article

Comparison of three different endoscopic approaches in the treatment of bladder calculi: Jae Youn Jang, Young Hwii Ko, Phil Hyun Song, Jae Young Choi; Yeungnam Univ J Med. 2019;36(1):16-19. Published online December 19, 2018; DOI: https://doi.org/10.12701/yujm.2019.00045

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Abstract PDF

Background
This study compared the following three endoscopic techniques used to treat bladder stones: transurethral cystoscope used with a pneumatic lithoclast or nephroscope used with a pneumatic lithoclast and nephroscope used with an ultrasonic lithoclast.
Methods
Between January 2013 and May 2016, 107 patients with bladder stones underwent endoscopic treatment. Patients were classified into 3 groups based on the endoscopic techniques and energy modalities used in each group as: group 1 (transurethral stone removal using a cystoscope with pneumatic lithoclast), group 2 (transurethral stone removal using a nephroscope with pneumatic lithoclast), and group 3 (transurethral stone removal using a nephroscope with ultrasonic lithoclast). Baseline and perioperative data were retrospectively compared between three groups.
Results
No statistically significant intergroup differences were observed in age, sex ratio, and stone size. A statistically significant intergroup difference was observed in the operation time—group 1: 71.3±46.6 min; group 2: 33.0±13.7 min; and group 3: 24.6±8.0 min. All patients showed complete stone clearance. The number of urethral entries was higher in group 1 than in the other groups. Significant complications did not occur in any patient.
Conclusion
Nephroscopy scores over cystoscopy for the removal of bladder stones with respect to operation time. Ultrasonic lithoclast is a safe and efficacious modality that scores over a pneumatic lithoclast with respect to the operation time.

Citations

Citations to this article as recorded by

Comparison of nephroscopy and cystoscopy used in the treatment of bladder stones: a systematic review and meta-analysis of randomized controlled trials
Liping Gou, Zhenghao Wang, Ye Zhou, Xiaofeng Zheng
BMC Surgery.2021;[Epub] CrossRef

Original Article

Role of urine osmolality as a predictor of the effectiveness of combined imipramine and desmopressin in the treatment of monosymptomatic nocturnal enuresis.: Kwon Soo Lee, Jun Bo Chang, Jae Yoon Jang, Young Hwii Ko, Yong Hoon Park, Phil Hyun Song; Yeungnam Univ J Med. 2015;32(2):85-89. Published online December 31, 2015; DOI: https://doi.org/10.12701/yujm.2015.32.2.85

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Abstract PDF

BACKGROUND
We examined the usefulness of urine osmolality, as a predictive factor in the treatment of monosymptomatic nocturnal enuresis (NE) with combination therapy of imipramine and desmopressin. METHODS: From May 2014 to April 2015, 59 monosymptomatic NE patients participated in this study. Early morning urine osmolality was measured at 1 week and 1 day before combination therapy of imipramine and desmopressin, and at 1 week and 2 weeks after therapy. The response to combination therapy was evaluated at 3 months after treatment. The mean period of combination therapy was 6.4+/-4.2 weeks. Therapeutic response was classified as complete (0-1 wet night/week), partial (over 50% reduction of night) and non-responders (less than 50% reduction of night). RESULTS: The cumulative rate of the complete and partial responders was 76.3%. Among the 3 groups, the statistically lowest value of pre-treatment urine osmolality was observed in the complete responder group (p<0.001). Urine osmolality increased in all groups after treatment, however, statistically the greatest difference between pre and post-treatment urine osmolality was observed in the complete responder group (p=0.024). No serious side effects were observed. CONCLUSION: Early morning urine osmolality and change of urine osmolality between pre and post-treatment have predictive values in the response to combined imipramine and desmopressin for treatment of monosymptomatic NE.

Citations

Citations to this article as recorded by

First-morning urine osmolality changes in children with nocturnal enuresis at the end of treatment
Yun ha Lee, Jae Min Chung, Sang Don Lee
Childhood Kidney Diseases.2024; 28(1): 27. CrossRef

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