During this timeframe in Maryland, 4064 men underwent either RP or RALP. About 77% of the cases were handled by high-volume surgeons. When surgery was performed by a low-volume surgeon, the case was more likely to be robotic, and the patients were more likely to be of non-white ethnicity, have a longer LOS, and be

more likely to be readmitted and/or need an ICU stay. The analysis likewise showed that high-volume surgeons had patients with a lower LOS, readmissions, and need for ICU. Once again, surgical experience is demonstrated Inhibitors,research,lifescience,medical to markedly affect outcomes for prostate surgery. Wong and colleagues,5 from Melbourne, presented an excellent paper outlining an international multicenter study examining the various criteria used to select Inhibitors,research,lifescience,medical men for AS among men who elected to undergo RP. This group compared the “Klotz criteria” and the “Van den Berg Prostate Cancer Research International Active Surveillance (PRIAS) criteria” among a group of

800 men treated with RP from three centers in the United Kingdom, Canada, and Australia. They were specifically looking for upstaging (≥ 7 Gleason score) and upstaging Inhibitors,research,lifescience,medical (≥ pT3 disease). All 800 met the Klotz criteria and 410 met the PRIAS criteria as well. Klotz and PRIAS upgrading and upstaging was 51%, 43%, and 18%, 12%, respectively. They also reported that the predictors within criteria boundaries of finding high-risk disease at surgery were age, palpable disease, and more positive cores. The most interesting finding of this paper was that more men from Australia were reclassified (upstage Inhibitors,research,lifescience,medical or upgrade), 43% to 51%, when compared with Europe and North American sites, 23% to 25%, owing to, per the authors, more stringent selection criteria, thus less reclassification. These and other data presented all point to the need for an internationally agreed-upon

set of selection criteria for AS. Kim and associates,6 from New York, Inhibitors,research,lifescience,medical presented a paper analyzing the trends in use of incontinence procedures after RP. Among the procedures studied were bulking agents, urethral slings, and artificial urinary sphincters (AUS). This group used the Surveillance Epidemiology and End Results cancer registry linked to Medicare claims data to identify men > age 65 years who underwent open or minimally invasive (MIS) prostatectomy between 2000 and 2007. Overall, data from 16,348 men were included (3523 were MIS). Approximately 6% of the men received a Astemizole procedure (no difference between open and MIS). Risk increased with age, location (South), race (white), and comorbid state. Risk was lower for non-metropolitan residence. Wnt antagonist Fifteen percent had more than one procedure; 39%, 13%, and 34% received bulking agents, slings, and AUS, respectively. The median time from prostatectomy varied with year of surgery, between 16 and 29 months. It is quite interesting that, in many studies, incontinence is reported at levels between 15% and 70%, yet only 6% of men seem to be receiving treatment for this.