Diese Präsentation wurde erfolgreich gemeldet.
Wir verwenden Ihre LinkedIn Profilangaben und Informationen zu Ihren Aktivitäten, um Anzeigen zu personalisieren und Ihnen relevantere Inhalte anzuzeigen. Sie können Ihre Anzeigeneinstellungen jederzeit ändern.
NOVEMBRO AZUL – MÊS DA PRÓSTATA
Dr. Alex Meller
Médico assistente da Disciplina de Urologia – UNIFESP / EPM
Check up de próstata
•
•
•
•
•
•
•
•

HISTÓRIA
PRÓSTATA?
PSA?
QUEM E QUANDO?
COMO É REALIZADO?
BENEFÍCIO
MITOS
FUTURO
HISTÓRIA
• 1970 – PSA descrito por Richard Ablin
• 1981 – Marcador tumoral de câncer
– Wang MC et al, Prostate antigen: an...
PRÓSTATA
FUNÇÕES
• Produz 60% do sêmen
• Estrutura glandular – “esponja”
• Doenças relacionadas
– Hiperplasia
– Infecções
– Câncer
PSA
• Produzido quase exclusivamente na próstata
• Função – transporte e alimentação dos
espermatozóides
• Enzima – estrut...
PSA – Fatores que influenciam
•
•
•
•
•
•
•

Toque retal prévio
Ejaculação
Massagem prostática
Moto , cavalo , bicicleta
P...
QUEM?
•
•
•
•

Homens com expectativa de vida 10 a 15 anos
Início aos 45 anos – SBU
Início aos 55 anos – AUA
Maior risco –...
Grupos de risco
• Uso de pesticidas e herbicidas
– fazendeiros - >19%
– Aplicadores - > 28%
Grupos de risco
• Consumo de alimentos fritos (>1x/sem)
– Batata frita (> 13%)
– Donuts (> 35%)
– Frango frito (> 30%)
– P...
Riscos em estudo
• Consumo de derivados de leite (> 13%)
– Aumento de casos graves (> 49%)
Whole Milk Intake Is Associated...
Como realizar o check up?
• Toque retal anual
• PSA anual
• (EUA – bianual)
Porque repetir sempre o exame?
Toque retal
• Exame rápido e indolor
• Objetiva analisar limites e consistência
• Detectar nódulos
Porque fazer check up ?
• Câncer de próstata no Brasil
– Estimados 60.180 novos casos (2012)
– 62 casos novos / 100.000 ha...
INCA – ESTIMATIVA 2012
Distribuição por estados
Estimativas – EUA
EUA - MORTES
Incidência estável na última década
Taxa de mortes por câncer
Taxa de mortes por câncer

44%
Mito 1: Se o PSA for normal não
preciso fazer o toque retal.
Mito 2 : Sou jovem, câncer de próstata
é coisa de velho…
•
•
•
•

2001 – 2007 : Análise de banco de dados EUA
Incidência e...
Futuro do check up
• Precisamos exames mais específicos para
evitar biópsias desnecessárias
• PCA3 / PHI – ainda não dispo...
PSA / TOQUE ALTERADOS
• Necessário fazer uma biópia
• Feita sob sedação
• Analisar fragmentos de diversas regiões da
próst...
Riscos da biópsia

Sieber PR et cols. Antibiotic prophylaxis in ultrasound
guided transrectal prostate biopsy. J Urol 157:...
Tratamento
• Estágio da doença
– Localizada ou órgao confinada
– Regionalmente avançada
– Metastática
Câncer localizado
• Cirurgia radical
– Aberta
– Laparoscópica
– Robótica

• Radioterapia – casos selecionados
• Crioterapi...
Cirurgia radical
Cirurgia – aberta x laparoscópica x
robótica
TIPO DE CIRURGIA

ABERTA

LAPAROSCÓPICA

ROBÓTICA

PERDA
SANGUÍNEA

+++

+

+...
Sequelas - INCONTINÊNCIA
Sequelas – IMPOTÊNCIA

PRÓSTATA
Preservação dos nervos
Impotência - idade

Rabbani F et cols. Fators predicting recovery of erections after radical
prostatectomy. J Urol 164; 19...
Mito 3 : Ouvi falar que:
• Trauma na próstata causa câncer – NÃO
• Cigarro causa CaP – NÃO
• Nódulo na próstata sempre é c...
NOVEMBRO AZUL
OBRIGADO
Aula hsp novembro azul
Aula hsp novembro azul
Nächste SlideShare
Wird geladen in …5
×

Aula hsp novembro azul

8.954 Aufrufe

Veröffentlicht am

Veröffentlicht in: Gesundheit & Medizin
  • DOWNLOAD THIS BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download Full EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download Full doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book THIS can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer THIS is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story THIS Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money THIS the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths THIS Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
       Antworten 
    Sind Sie sicher, dass Sie …  Ja  Nein
    Ihre Nachricht erscheint hier
  • DOWNLOAD THIS BOOKS INTO AVAILABLE FORMAT (Unlimited) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { https://soo.gd/qURD } ......................................................................................................................... Download Full EPUB Ebook here { https://soo.gd/qURD } ......................................................................................................................... Download Full doc Ebook here { https://soo.gd/qURD } ......................................................................................................................... Download PDF EBOOK here { https://soo.gd/qURD } ......................................................................................................................... Download EPUB Ebook here { https://soo.gd/qURD } ......................................................................................................................... Download doc Ebook here { https://soo.gd/qURD } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book THIS can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer THIS is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story THIS Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money THIS the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths THIS Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
       Antworten 
    Sind Sie sicher, dass Sie …  Ja  Nein
    Ihre Nachricht erscheint hier
  • DOWNLOAD THIS BOOKS INTO AVAILABLE FORMAT (Unlimited) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { https://soo.gd/qURD } ......................................................................................................................... Download Full EPUB Ebook here { https://soo.gd/qURD } ......................................................................................................................... Download Full doc Ebook here { https://soo.gd/qURD } ......................................................................................................................... Download PDF EBOOK here { https://soo.gd/qURD } ......................................................................................................................... Download EPUB Ebook here { https://soo.gd/qURD } ......................................................................................................................... Download doc Ebook here { https://soo.gd/qURD } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book THIS can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer THIS is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story THIS Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money THIS the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths THIS Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
       Antworten 
    Sind Sie sicher, dass Sie …  Ja  Nein
    Ihre Nachricht erscheint hier
  • DOWNLOAD THIS BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download Full EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download Full doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book THIS can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer THIS is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story THIS Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money THIS the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths THIS Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
       Antworten 
    Sind Sie sicher, dass Sie …  Ja  Nein
    Ihre Nachricht erscheint hier
  • DOWNLOAD THIS BOOKS INTO AVAILABLE FORMAT (2019 Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download Full EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download Full doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book THIS can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer THIS is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBooks .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, Cookbooks, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, Ebooks, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story THIS Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money THIS the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths THIS Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
       Antworten 
    Sind Sie sicher, dass Sie …  Ja  Nein
    Ihre Nachricht erscheint hier

Aula hsp novembro azul

  1. 1. NOVEMBRO AZUL – MÊS DA PRÓSTATA Dr. Alex Meller Médico assistente da Disciplina de Urologia – UNIFESP / EPM
  2. 2. Check up de próstata • • • • • • • • HISTÓRIA PRÓSTATA? PSA? QUEM E QUANDO? COMO É REALIZADO? BENEFÍCIO MITOS FUTURO
  3. 3. HISTÓRIA • 1970 – PSA descrito por Richard Ablin • 1981 – Marcador tumoral de câncer – Wang MC et al, Prostate antigen: anew potential marker for prostatic cancer. Prostate. 1981; 2(1): 8996 • 1989 – Uso no diagnóstico e tratamento – Stamey TA et al, Prostate specific antigen in the diagnosis and treatment of adenocarcinoma of the prostate. I. Untreated patients. J Urol, 1989 May; 141(5): 1070-5 • 1991 – Proposição do check up como conhecemos atualmente. – Catalona WJ, Smith DS, Ratliff TL et al (1991) Measurement of prostate-specific antigen in serum as a screening test for prostate cancer. N Engl J Med 324(17):1156–1161
  4. 4. PRÓSTATA
  5. 5. FUNÇÕES • Produz 60% do sêmen • Estrutura glandular – “esponja” • Doenças relacionadas – Hiperplasia – Infecções – Câncer
  6. 6. PSA • Produzido quase exclusivamente na próstata • Função – transporte e alimentação dos espermatozóides • Enzima – estrutura molecular grande • Circula no sangue: – Livre – Ligada a proteínas
  7. 7. PSA – Fatores que influenciam • • • • • • • Toque retal prévio Ejaculação Massagem prostática Moto , cavalo , bicicleta Prostatite Uso de finasterida Passagem de sonda ou retenção urinária
  8. 8. QUEM? • • • • Homens com expectativa de vida 10 a 15 anos Início aos 45 anos – SBU Início aos 55 anos – AUA Maior risco – negros / antecedente familiar
  9. 9. Grupos de risco • Uso de pesticidas e herbicidas – fazendeiros - >19% – Aplicadores - > 28%
  10. 10. Grupos de risco • Consumo de alimentos fritos (>1x/sem) – Batata frita (> 13%) – Donuts (> 35%) – Frango frito (> 30%) – Peixe frito (> 32% ) Stott‐Miller et al. Prostate. 2013 Jan 17 epub PMID 23335051
  11. 11. Riscos em estudo • Consumo de derivados de leite (> 13%) – Aumento de casos graves (> 49%) Whole Milk Intake Is Associated with Prostate Cancer‐Specific Mortality among U.S. Male Physicians. Song et al. J Nutr. 143:189‐196, 2013 • Deficiência de vitamina D – 1990 – primeira descrição – Hoje – áreas com menos luz solar ‐ > mortalidade por câncer de próstata Sunlight/vitamin D may protect against prostate cancer PMID 23094920 Schwartz Antica Ag Med 2013; 13: 45‐57
  12. 12. Como realizar o check up? • Toque retal anual • PSA anual • (EUA – bianual)
  13. 13. Porque repetir sempre o exame?
  14. 14. Toque retal • Exame rápido e indolor • Objetiva analisar limites e consistência • Detectar nódulos
  15. 15. Porque fazer check up ? • Câncer de próstata no Brasil – Estimados 60.180 novos casos (2012) – 62 casos novos / 100.000 habitantes – Tipo mais comum entre os homens – 12.778 óbitos ao ano (2010) – 10% do total de mortes
  16. 16. INCA – ESTIMATIVA 2012
  17. 17. Distribuição por estados
  18. 18. Estimativas – EUA
  19. 19. EUA - MORTES
  20. 20. Incidência estável na última década
  21. 21. Taxa de mortes por câncer
  22. 22. Taxa de mortes por câncer 44%
  23. 23. Mito 1: Se o PSA for normal não preciso fazer o toque retal.
  24. 24. Mito 2 : Sou jovem, câncer de próstata é coisa de velho… • • • • 2001 – 2007 : Análise de banco de dados EUA Incidência estável Aumentou nos jovens – 40 a 49a (3%) Diminuiu nos idosos – 70 a 79a (-2,3%) Recent Trends in Prostate Cancer Incidence by Age, Cancer Stage, and Grade, the United States, 2001–2007. Li et al, Prostate Cancer. 2012
  25. 25. Futuro do check up • Precisamos exames mais específicos para evitar biópsias desnecessárias • PCA3 / PHI – ainda não disponíveis comercialmente • Ressonância multiparamétrica
  26. 26. PSA / TOQUE ALTERADOS • Necessário fazer uma biópia • Feita sob sedação • Analisar fragmentos de diversas regiões da próstata
  27. 27. Riscos da biópsia Sieber PR et cols. Antibiotic prophylaxis in ultrasound guided transrectal prostate biopsy. J Urol 157:2199, 1997
  28. 28. Tratamento • Estágio da doença – Localizada ou órgao confinada – Regionalmente avançada – Metastática
  29. 29. Câncer localizado • Cirurgia radical – Aberta – Laparoscópica – Robótica • Radioterapia – casos selecionados • Crioterapia – ainda sem estudos de longo prazo
  30. 30. Cirurgia radical
  31. 31. Cirurgia – aberta x laparoscópica x robótica TIPO DE CIRURGIA ABERTA LAPAROSCÓPICA ROBÓTICA PERDA SANGUÍNEA +++ + + TEMPO CIRÚRGICO + ++ ++ DIAS NO HOSPITAL ++ + + RESULTADO ONCOLÓGICO = = = SEQUELAS = = = CURVA DE APRENDIZADO + +++ +++ Vincenzo F et al. Retropubic, Laparoscopic, and Robot-Assisted Radical Prostatectomy: A Systematic Review and Cumulative Analysis of Comparative Studies. European Urology 55 ( 2 0 0 9 ) 1037–1063
  32. 32. Sequelas - INCONTINÊNCIA
  33. 33. Sequelas – IMPOTÊNCIA PRÓSTATA
  34. 34. Preservação dos nervos
  35. 35. Impotência - idade Rabbani F et cols. Fators predicting recovery of erections after radical prostatectomy. J Urol 164; 1929 -1934, 2000
  36. 36. Mito 3 : Ouvi falar que: • Trauma na próstata causa câncer – NÃO • Cigarro causa CaP – NÃO • Nódulo na próstata sempre é câncer – NEM SEMPRE • CaP é hereditário – SIM • Vasectomia aumenta a chance de CaP – NÃO
  37. 37. NOVEMBRO AZUL
  38. 38. OBRIGADO

×