308 Background: Prostate biopsy is one of the most frequently performed procedures in urology. Recently, there has been a nationwide shift towards offering transperineal (TP) biopsies due to a reduced rate of infectious complications compared to the transrectal (TR) route. While infection may be reduced, TP biopsy is not without complication, most notably, acute urinary retention (AUR). Estimates vary as to the true rate of AUR following TP biopsy. Further, some studies have reported higher rates of AUR following TP biopsy than TR. Here we report the rate of AUR following TP biopsy at a single academic institute and relate it to risk factors for developing AUR. Methods: Retrospective case-control study. All biopsies performed with TR ultrasound (TRUS) guidance using TP technique under general anesthesia in dorsal lithotomy with a grid template. TRUS volumes were recorded during the procedure, and MRI volumes were calculated by a trained radiologist pre-biopsy. Charts of men undergoing TP biopsy from 2012 to present were reviewed. AUR was defined as patients who reported inability to urinate within 72 hours post-biopsy and underwent thorough evaluation including PVR and relevant H&P and required catheter placement. Independent samples t-test was run to relate AUR to risk factors pre/post-biopsy. Results: A total of 767 TP biopsies were completed in the study window, but not all had TRUS/MRI data. Total rate of AUR was 5.48% (N=42/767). Risk factors for AUR were increased TRUS (p=0.009, [6.49, 42.30]) and MRI prostate volumes (p=0.027, [2.90, 43.13]). Age, number of cores taken, and number of previous biopsies were not associated with AUR. Conclusions: While data is scant, the rate of AUR at our institution is consistent with current estimates in the literature. There is a growing body of evidence that the rate of AUR post-TP biopsy is higher than TR, but more investigation is needed. There is also a gap in the literature on risk factors predicting AUR after TP biopsy, however our findings are relatively consistent with the few studies currently published. Urologists must recognize patients presenting for TP biopsy with large volume prostates and consider altering management to prevent AUR. [Table: see text]
314 Background: Determining the correct size (volume) of the prostate is imperative for patients with prostate cancer. Prostate size can affect many parameters in patient care such as cores in a biopsy taken and available treatment options. Traditionally, most patients underwent transrectal ultrasound (TRUS) during prostate biopsy to estimate prostatic volume. While TRUS is still used to estimate prostate volume, more recently prostate Magnetic Resonance Imaging (MRI) has also come into favor. Current literature indicates MRI is more accurate than TRUS for prostate size, but few studies exist, and whether differences in the two are clinically significant remains uncertain. The purpose of this study was to compare prostate volumes from TRUS and MRI to gross specimens after prostatectomy. Methods: Patients who underwent radical prostatectomy for prostate cancer between 2017–2022 were identified. TRUS and MRI measurements closest to the date of surgery were obtained. These were compared to gross prostate specimens after surgery, which was considered the gold standard. All TRUS volumes were recorded by a urologist during prostate biopsy using the ellipsoid formula (L*W*H*(π/6)). MRI measurements were done by a radiologist also using the ellipsoid formula. The weight and dimensions of gross specimens were measured by a pathologist. Ellipsoid formula was then used to calculate final volume measurements in gross specimens. Paired samples t-test was used to compare averages of TRUS and MRI to the gross specimen. Results: 83 patients were included in the study with an average age at prostatectomy of 65.47 years. TRUS volume significantly differed from gross specimen volume by an average of –4.56 mL (p=0.017) and gross specimen weight by -14.31 g (p <0.001). MRI volume was not significantly different from gross specimen volume, by an average of –0.56 mL (p=0.771) and was significantly different from prostate weight by –10.32 g (p <0.001). When compared to one another, TRUS and MRI significantly differed on average by –4 mL (p=0.033). Conclusions: MRI is more accurate than TRUS to estimate prostate volume. Both MRI and TRUS underestimate prostate weight. Urologists should be aware of potential inaccuracies when assessing preoperative prostate volume with TRUS, and recognize MRI is the best predictor of size. While imperfect, TRUS is still relatively accurate measuring prostate volume, and given its ease of availability and cost, we feel it is a useful modality to determine prostate size. [Table: see text]
DM), and a control group of 50 people without DM diagnosis were inoculated into modified Dixon agar (MDA) and CHROMagarä Malassezia (CAM; Paris, France) media. Samples were incubated at 32 C for one week.RESULTS: The age distribution of the patients did not show a statistically significant difference between the control and diabetes groups (p[0.759). Again, there was no difference between the groups according to marital status (p>0.999). Fasting blood glucose (ACS), HbA1c, insulin, HOMA-IR, and BUN were distributed at higher levels in the diabetes group (p<0.001, p<0.001, p<0.001, p<0.001 and p[0.032, respectively). There was no statistically significant difference between the groups regarding creatinine values (p[0.633). When the growth of MDA or CAM in the patients included in the study was examined, Malassezia or Candida grew in 93 (62%) patients in the diabetes group and 36 (72%) patients in the control group, and no statistically significant difference was found (p[0.18). When MDA and CAM were compared in terms of their growth, there was no significant difference between the groups. (p[0.65/0.54). Balanitis was not observed in any of the patients included in the study.CONCLUSIONS: The high rate of Candida and Malassezia in the normal penile flora strengthens the idea that it may cause higher rates of balanitis in people prone to infections such as diabetes.
Introduction: Patient navigation (PN) programs are used throughout the cancer continuum to address barriers faced by African American women and other vulnerable populations. Research has suggested PN can be effective in improving screening and diagnostic care uptake; however, less research has examined its effects post-diagnosis. Although effective for its short-term outcomes (e.g., receipt of screening; care decisions; stage at diagnosis), PN may be limited in its long-term effects during survivorship (e.g., quality of life). Therefore, the objective of this study was to assess the effect of PN on four outcomes of African American breast cancer survivors (BCS): shared decision making (SDM) when undergoing diagnostic care; receipt of an early stage diagnosis; and, current quality of life. Methods: This study was a secondary analysis of the OASIS (Offering African American Survivors Increased Support) study, which followed African American BCS who obtained care at a Chicago-based hospital during or after the Patient Navigation in Medically Underserved Areas (PNMUA) study. Navigated women experienced largely phone- based navigation through screening, diagnostic care, and treatment. Eligibility criteria included: African American race; 18+ years old; receipt of breast healthcare in the study hospital during or after PN trial was implemented; and, receipt of a breast cancer diagnosis. We conducted multivariate logistic (SDM, early stage diagnosis) and linear regression models (quality of life measured with current mental and physical well-being using SF-12 scale) that were adjusted by age, socioeconomic status (income, education, insurance status) and year of diagnosis. Results: The average age of our sample was 66.28 (SD = 9.54). Approximately 26% of the sample had ≤ 12 years of education; 35% were married; 49% had an annual household income of ≤$50,000; and 64% had private insurance. Navigated women had greater odds of reporting shared decision making with their providers during diagnostic visits, non-nav: 26% vs. nav: 44%, OR = 3.48, 95%CI [1.08, 11.15], p = 0.04. There were no differences, however, between navigated and non-navigated women regarding odds of an early stage diagnosis and current quality of life (ps = 0.62-0.94). Conclusion: Navigated women’s greater propensity to engage in SDM compared with non-navigated women aligns with past research and suggests PN is effective for changing patients’ behaviors when actively engaged with navigators. However, we did not find that PN was associated with stage at diagnosis. Further, the absence of an association on current mental and physical well-being suggests that PN may have limited long-term effects. Limitations include use of self-report data and a small, convenience-based sample. Further research should assess how patient navigation can be adapted to have more sustained effects in the long term. Citation Format: Agnieszka M. Mynarska, Shaila M. Strayhorn, Tynetta Hill-Muhammad, Nyahne Q. Bergeron, Desmona C. Strahan, Stephanie L. Jara, Nancy Rayas, Anita Rong, Misael Villegas, Dana Villines, Karriem S. Watson, Aditya Khanna, Yamilé Molina. An exploration of patient navigation on various outcomes of African American breast cancer survivors [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-062.
Introduction: African American women experience a disproportionate burden of breast cancer morbidity and mortality. For African American breast cancer survivors, members of their social networks often act as informal caregivers - offering social support and assisting with treatment adherence. They may thus serve as opinion leaders within their own social networks, given their personal experiences with the breast cancer survivor. Nonetheless, informal caregivers are not formally trained and may be vulnerable to breast cancer cultural beliefs and fear related to breast cancer. For this study, we examined: 1) if informal caregivers’ breast cancer cultural beliefs and fear were predictive of breast cancer misinformation shared among their social networks and, 2) if misinformation shared led to lower mammogram uptake among their networks. Methods: This is a secondary analysis of the Offering African Survivors Increased Support (OASIS) study, which assessed African American breast cancer survivors’ experiences with cancer care. To be eligible, subjects had to be: 1) identified as an informal caregiver by a survivor, 2) female, and, 3) of breast cancer screening age (50-74 years). Recruitment took place from Feb 2019 – Mar 2020. Subjects took part in 60-90 minute in-person or telephone surveys and received an incentive for participation. Validated scales were used in the survey tool to quantify cultural beliefs and fear, spread of breast cancer misinformation, and mammogram uptake. Results: 142 informal caregivers were recruited. All were African American, 56% were 50-62 years of age, 95% had a primary care provider, and 82% had a mammogram in the past year. Overall, 65% reported ≥1 breast cancer cultural belief and all reported breast cancer fear. On average, informal caregivers reported 1.55 (range: 0-15) cultural beliefs and a moderate level of fear (score=19.72, 8-32). 18.3% of informal caregivers shared breast cancer misinformation to their networks. Informal caregivers who reported ≥1 cultural belief had 74% greater odds of sharing misinformation to their networks (OR=1.74, 95%CI [1.32, 2.29], p<.0001). Among the 341 social network members of informal caregivers who were women and 50-74 years of age, those who received misinformation were 63% less likely to obtain a mammogram (OR=0.37, 95%CI [0.14, 0.94], p=0.04). Conclusion: Informal caregivers who reported breast cancer cultural beliefs were significantly more likely to share breast cancer misinformation to their social networks and social network members who received this misinformation were significantly less likely to receive mammograms. These results may inform planning for health education efforts and community-healthcare interventions that address breast cancer cultural beliefs and promote mammogram uptake among African American women. Future research will assess key themes in breast cancer misinformation shared and differences in misinformation shared from informal caregivers to their networks based on relationship type. Citation Format: Nyahne Q. Bergeron, Mona Strahan, Shaila Strayhorn, Anita Rong, Misael Villegas, Nancy Rayas, Stephanie Jara, Izalia Ruiz, Aditya Khanna, Dana Villines, Karriem Watson, Carol Ferrans, Yamilé Molina. Do African American informal caregivers’ breast cancer fear and cultural beliefs predict the dissemination of breast cancer misinformation and lower mammogram uptake among their social networks? [abstract]. In: Proceedings of the AACR Virtual Conference: Thirteenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2020 Oct 2-4. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(12 Suppl):Abstract nr PO-080.
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