The functional pyelocalyceal renal model serves as a functional patient surrogate to evaluate activities that facilitate calyceal renal calculi passage. The rear seating position on the roller coaster led to the most renal calculi passages.
Objective To measure the performance of multiparametric (mp) magnetic resonance imaging (MRI) to identify intraprostatic tumour deposits using a systematic and targeted MR‐guided transperineal prostate biopsy technique. Materials and Methods Patients underwent a combined systematic and targeted MR‐guided transperineal biopsy procedure in the dorsal lithotomy position under general anaesthesia. Systematic biopsies were spaced 10 mm or less apart and additional biopsies targeted any Prostate Imaging–Reporting and Data System (PI‐RADS) 3, 4 or 5 lesions identified on mpMRI. Cancer detection rates were calculated on a per patient and per lesion basis. Results A total of 125 patients underwent the biopsy procedure. The positive predictive value (PPV) of mpMRI per patient was 59% for any cancer and 49% for Gleason score (GS) ≥ 7 cancer. The negative predictive value (NPV) of mpMRI per patient was 67% for any cancer and 88% for GS ≥ 7 cancer. On a per lesion basis, the PPV of PI‐RADS 3 lesions for any and GS ≥ 7 cancer was 24% and 10%. For PI‐RADS 4 lesions it was 42% and 32%. For PI‐RADS 5 lesions, it was 76% and 70%. MpMRI failed to identify GS ≥ 7 cancer found on systematic biopsy in 22% of patients. Conclusion Based on a combination of systematic and targeted transperineal prostate biopsies, mpMRI showed a high NPV and low PPV for GS ≥ 7 cancer on a per patient basis. The PPV of mpMRI on a per lesion basis increased with increasing PI‐RADS score. However, there were a significant number of both false positive as well as false negative (mpMRI invisible) areas within the prostate that contained GS ≥ 7 cancer. Therefore, pathologic confirmation using both targeted and systematic mapping biopsy is necessary to accurately identify all intraprostatic tumour deposits.
156 Background: To assess clinical outcomes after transperineal template-guided prostate biopsy (TTPB) including detection rates, pathologic features, clinical relevance and morbidity. Methods: Forty eight men underwent TTPB. All patients had at least one (range 1–4) prior negative transrectal ultrasound-guided (TRUS) prostate biopsy and no prostate cancer diagnosis. The mean pre-biopsy PSA of the entire group was 13.1 ng/ml (range 4.5–46.4). The mean number of cores sampled was 24.7 (range 22–28). Results: The rate of prostate cancer detection was 52% (25/48). Clinically significant prostate cancer, defined as intermediate (n=9) and high (n=11) risk disease using D’Amico criteria, was found in 80% (20/25) of positive biopsy cases. Seventy-two percent of all positive biopsy cores were anatomically located in the anterior or anterolateral positions within the prostate. Urinary retention requiring catheterization after the procedure developed in 6% (3/48) of patients. No patients developed rectal or infectious complications after TTPB. Conclusions: TTPB is a well tolerated procedure resulting in a significant rate of cancer detection. Biopsies were frequently found to be positive in the anterior half of the prostate. Clinically significant disease was found in a high percentage of patients.
To evaluate the success and toxicity of a nonsurgical prostatic urethral lift system in patients with lower urinary tract symptoms (LUTS) with and without prior prostate cancer radiation therapy. Materials/Methods: From 2018 to 2020, thirty-eight patients underwent a nonsurgical prostatic urethral lift (PUL) procedure for LUTS refractory to alpha blocker medications. All patients had cystoscopic confirmation of lateral lobe obstruction. Nineteen patients underwent prior radiation therapy (RT) for prostate cancer completed an average of 15.3 months (range 3-28) prior to PUL procedure. Nineteen patients had no prior prostate cancer treatment. All patients were assessed with IPSS/quality of life (QOL) scores and urinary post void residual (PVR) ultrasound before and after PUL. Patients were also assessed for ability to discontinue alpha blocker medications for their LUTS and any post PUL toxicity based on CTCAE v5.0 criteria. Statistical comparisons before and after the PUL procedure were made with Wilcoxon signed rank test with P < 0.05 considered significant.Results: All patients underwent successful placement of the PUL implants. Median follow up was 10 months (range 3-30). Median prostate volume was 45cc (range 20-85) for no-RT group and 41cc (range 24-80) for RT group. Median pre-PUL IPSS score was 17 (range 9-33) in the no-RT and 20 (range 11-34) in the RT groups. At last follow up, the average improvement in IPSS score was 9 points for all patients (95% CI 7-11, P < 0.001), 8 points for the RT patients (95% CI 5-12, P < 0.001) and 9 points for the no-RT patients (95% CI 7-12, P < 0.001). QOL improved by 1.1 points on average (95% CI 0.6-1.6, P < 0.001) for all patients, with similar improvement for both the RT (0.9, 95% CI 0.1-1.9. P = 0.09) and the no-RT (1.3, 95% CI 0.7-1.8, P < 0.001) patients. The average reduction in PVR was 93cc (95% CI 56-130, P < 0.001) for all patients, similar for both RT (90cc, 95% CI 42-138, P = 0.001) and no-RT (96cc, 95% CI 37-155, P < 0.001) patients. The percentage of patients able to discontinue alpha blockade at last follow-up was 68% for the RT patients and 74% for the no-RT patients. There was no grade 3 or higher GU toxicity in either group. Conclusion: Use of a nonsurgical prostatic urethral lift system, results in significant improvement of LUTS after radiation therapy without complications, similar to patients without prior prostate radiation therapy.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.