Major Study Shows Dissatisfaction Following Robotic Prostatectomy

A major study of patient satisfaction and regret following open prostatectomy and robot-assisted laparoscopic prostatectomy provides some important lessons for surgeons.*
The research, recently published in the European Journal of Urology, shows 19 per cent of patients regretted their treatment choice and patients who had robot-assisted surgery were most likely to be dissatisfied.

The authors suggest the regret is “possibly because of higher expectation of an ‘innovative procedure'”.

Their conclusion is one for all urological surgeons to note. “We suggest that urologists carefully portray the risks and benefits of new technologies during preoperative counselling to minimise regret and maximise satisfaction.”

In recent years, the treatment of prostate cancer has been a rapidly developing field, providing patients with a wide range of different choices.

Brachytherapy and HIFU offer non-surgical options and for those who want surgery, there are open, laparoscopic and nerve-sparring options, depending upon your diagnosis and treatment provider.

At the same time, patients are becoming increasingly proactive, using the internet to research and consider the different options themselves, as well as the traditional consultation with the urologist.

Increased choice is without doubt a positive benefit for patients, but as urology centres – both private and NHS – seek to attract patients, we have a responsibility to carefully counsel them about the advantages and disadvantages of treatments.
There is a distinctive risk when a procedure is perceived to be new and especially “innovative”. The media will always be interested in the next “pioneering operation”, particularly one which involves robots.

A newspaper article will tend to portray the new procedure as an immaculate solution, which corrects all the risk and disadvantages of other procedures.
As surgeons, we have a responsibility to provide patients with a more sober and informative picture, acknowledging limitations as well as benefits.

The patient satisfaction study was based on the responses of 400 men who had undergone retropubic radical prostatectomy (RRP) or robot-assisted laparoscopic radical prostatectomy between 2000 and 2007 in the US.

The report’s authors also examined patients urinary domain scores, hormonal domain scores and found scores were independently linked with regret.

It is still early days for robotic surgery in the UK. In prostate cancer surgery, there are currently six Da Vinci robotic machines in the UK, compared with 350 in America.

There is no current evidence that robotic surgery provides better outcomes for patients, in terms of urinary symptoms, post operative sexual function or post-operative risks and complications.
It seems certain that robotic surgery will increase within the UK during the next decade, with NHS and private centres purchasing the Da Vinci machines.

This will provide even more choice for patients, which is in principle, a positive development.

It is however vital that patients are given accurate and comprehensive information to enable them to make an informed choice, rather than simply being over-sold a new product.

Enjoy With Family – Day Picnic Near Delhi

A picnic is a gateway for family, friends and corporate to get together in a relaxed and fun environment. A cluster of activity can be arranged to make the package attractive and memorable one.

We often gets frustrated from our daily hectic schedule of our work and life we rarely gives time to family and friends so for fun and enjoyment to get rid of the pressure of job we plans picnic. North India is full of diversity where one can explore nature, ancient monuments and heritages creativity of our ancestors.

Our national capital and its near by has many picnic destinations. There is option Places to enjoy day picnic around Delhi. Fun, adventure activities, fun games, cocking with family and friends helps in making the agenda interesting and enjoyable.

Destinations near Delhi/Gurgaon for enjoying picnic:

There is option of one day outing near Gurgaon the place which is highly modern with context to other cities, resorts located around Delhi as like golden huts, Manesar, Resort country club, club platinum resort, golf restaurant gurgaon, turtle farm resorts, Botanix resort damdama lake etc where one can go and hang out with families and friends for a day.

Camp carnival is one of the best picnic spots near Delhi at a distance of 60km from Rishikesh. The place is paradise for adventure picnic sport activities; one can take the pleasure of adventure in the gridline of parents. Common activities like Rappelling, Valley crossing, Parallel rope etc.

Turtle farm resort is famous picnic resort in Delhi near gurgaon. Place is heaven for enjoyment and fun, you can come along with your families and friends to enjoy the beautiful resort.

Club Platinum amusement and Water Park, place of a beautiful and unequaled dream world, your childrens will enjoy the most here. Running and lying on the green grass, view of fountains and landscape will get captured in your eyes for forever.
Tarudhan valley located at the corner of the capital, and if you are the lover of golf, this place is the best choice for you. Taraudhan valley provides a wonderful accommodation experience.

Basically young generations and corporate groups go for complete day outing to feel the enjoyment up to its limit. And what can be the best option other than Gurgoan if you are near by Delhi. The city has many picnic as well as outing locations. Some of the destinations are Sohna, Wet n wild, Sheesh mahal, Kingdome of dreams, pataudi palace, leisiure valley, iskate and etc.

If you have special requirement of night stay, birth day party, conferences we are having special package as per your requirement. Our package provides fun activity, adventures activity, team building games and techniques, recreational facilities etc. we have packages for complete one day outing. Our organizing committee will do their best to make your day memorable.

Parents Going Back To Work Should Consider Business Or Paralegal Courses

You decided to take time out of the work force to devote to your family, but children grow up, and now youre ready to go back to work. But like many people who may have taken up to a decade or more out of the work force, you may be nervous about leaping back in. Industries have changes and all your old business contacts may have moved on, your references might be out of date and youre not in a good position to network. Rest easy, because retraining with business or paralegal courses are a good way to bridge the gap from child to career and shows your news focus and dedication.

Paralegal Courses:

Paralegal training makes you invaluable to lawyers, and theyll appreciate an older employee with more experience. As a paralegal youll be doing a lot of the heavy lifting, research wise, with a reliable salary, good for your older childs education fund and equally steady employment. Paralegal courses generally take about two years to complete, and might be a good thing to bridge the transition when your family commitments are starting to ease up. Then, after you finish your studies and get certified by your provinces law society, youre ready to get to work.

Business Programs:

If two years is too long, you can find business training in lengths to suit every person. As well as going to get a university business degree, which may be either too much of a commitment or too redundant if you just need some updates on your skills, consider career and business colleges or programs at your local community college. The descendant of secretary and stenography schools, today you can find everything from the typing certificates of yore to marketing and payroll courses to prove to employers youre ready to fill their essential departments.

Other Reasons to Go Back To School:

If the course offerings werent enough to tempt you, another reason to go back to school is to ease back into the workplace mindset. For example if youre taking paralegal courses after a long stint spent around small children, you may appreciate the adult stimulation and professional expectations. Youll also find many schools feature career placement offices and practicums, to get you over the no experience hurdle, while business vocabulary and methods can change rapidly, and even if you were tech savvy to start with, popular software suites can change. Finally, things like accounting training also give you valuable life skills, for example in this instance youll be an expert with the family budget.

Whatever you choose, be it payroll courses or basket weaving, the first step to getting back to work is applying. Research the education opportunities in your area to find out how easy the transition can be.

Nursing Continuing Education Provider – Going Online

Who does not want a job as a registered nurse? Compared to many other jobs, registered nurses are well-paid, respected, and in high demand. In order to obtain the right knowledge and skill to qualify for such jobs, many people are now in the search for a good nursing continuing education provider.

But, have you thought about doing your study online?

Online education provide students with lots of flexibility, and this might be its biggest advantage. Studying online means a student does not have to rearrange their schedule in order to get to a campus at a certain time to take required classes. Transportation also is not a problem. To get to class, all a student has to do is sit down in front of their home computer.

Online education provider do not exercise rigid schedule requirements on students. This is a big advantage for those who have to juggle their nursing studies along with taking care of their homes and children and working at a full time job. In fact, many students in online nursing programs are able to complete their education faster than those in traditional programs. Some are able to earn a degree that usually takes four years in only two.

If you have financial constraint, online continuing education programs have another advantage. Often, studying online is less expensive than enrolling in an on-campus program.

Another bonus is that there are usually no waiting lists when studying online. As more people discover the advantages of becoming a registered nurse, traditional nursing schools are finding it harder and harder to accommodate all who want to enroll. In fact, they are only able to take a limited number of new students at any given time. Which could mean you might find yourself waiting for a spot to open up before you can even begin earning your degree. That usually is not a problem with online continuing education providers.

Finding a good online nursing degree program can be tough. But there are programs being offered by many reputable learning institutions. Some include:

* The University of Phoenix

* Walden University

* Kaplan University

* Vanderbilt University

You may also check CE4U.com as an alternative resource.

So, do you have the passion of becoming a registered nurse? Why not start today by checking for yourself the right nursing continuing education provider. We have discussed the advantages of online providers, and there are truly good ones out there if you do your search.

How To Convence Women For Sex Dating Personals

Dating women can be a challenge in itself, let alone having to get them attracted to sexual dating & then after ready for sex with him. We all buy into the platitude that passion weakened over time

Are you interested in having better sex with your partner? If you are it is very important that you take the time to express that to your partner. The problem is that it can be a little bit challenging to confront the issue of sex with swinger lifestyle person. Here are a few tips that can help things go a lot smoother.

Take a bath. Smelling fresh and clean can make you feel much more comfortable. Relaxing also makes you feel sexy. After getting out of the tub, moisturize your skin by rubbing on lotion in front of him. Use lamps instead of overhead lights. Some time man seeking woman for talk sexual story with her and sex with her Overhead lights can give your eyes dark circles and make lumps and bumps on the body look longer and soggier. Flip on lamps instead.

Most men automatically think their online dating partners are no longer attracted to them sexually. Although this can sometimes be the case, often times it is not. A womans body goes through an unbelievable amount of changes. Some women as they get older become fearful of showing off their bodies. Your dating partner may also be going through menopause or have a medical condition that is affecting her sex drive. It is important to talk to your wife but more important to listen.

You may wonder how you can turn a girl on and get her to not only like you, but get her in the mood sexually. Dating women can be a challenge in itself, let alone having to get them attracted to sexual dating & then after ready for sex with him. We all buy into the platitude that passion diminishes over time but just because many people say the same thing doesnt make it so. If you feel your relationship is stagnant.

Recovering from childhood sexual abuse and having an empowered sex life is a difficult process for most victims. However, your efforts will be worth it, so follow these steps to have an empowered sexual life after childhood sexual abuse. It may take a long time before you are able to view sex as a pleasurable activity. There are very important thing adult dating is everyone person is know but now everybody is know what is sexual life is them childhood.