OBJECTIVE: To document the VMMC Urethral Dilatation Protocol, established in Veterans MemorialMedical Center for male patients with urethral stricture who underwent urethrotomy and to determineif there is a significant difference in the International Prostate Symptom Score and Uroflowmetrystudies after urethral dilatation in male patients with urethral stricture who underwent urethrotomy. MATERIALS AND METHODS: The is a descriptive, retrospective chart review of male patients in VeteransMemorial Medical Center diagnosed with urethral strictures via voiding cystourethrogram or flexiblecystoscopy who underwent urethrotomy. A total of 24 patients were enrolled in this study, all ofwhom were post TURP patients. All patients with recurrent urethral stricture, history of trauma andpatients with infectious causes of stricture were excluded. Each patient's International ProstateSymptom Score and Uroflowmetry studies prior to urethrotomy and post urethrotomy who underwentthe VMMC urethral dilatation were collected. Median and range (Minimum-Maximum) were usedto describe the variables of the study. These variables are IPSS, peak flow rate, average flow rate,voided volume, and residual volume. RESULTS: The IPSS, was statistically lower after urethrotomy with urethral dilatation and theuroflowmetry parameters (peak flow rate, average flow rate, voided volume, and residual volume)were statistically improved after urethrotomy with urethral dilatation. CONCLUSION The Urethral Dilatation Protocol established in Veterans Memorial Medical Center andwhich is done every week for 1 month, then every 2 weeks for another 1 month, and monthly untilthere is markedly improved International Prostate Symptom Score showed that this timing may helpimprove IPSS and patient symptoms but not lessen recurrence rates.

Penile calciphylaxis is a rare penile condition associated with end-stage renal disease and is found in 1-4% of hemodialysis patients. The condition has an overall mortality of 64%. Literature has yet to provide a gold standard for the management of this condition. The first case is a 58-year-old diabetic and hypertensive on hemodialysis who presented with ulcerating lesions on the penis. The patient underwent partial penectomy. The patient contracted pneumonia during recovery and expired 3 months after the procedure. The second case is a 56-year-old diabetic with end stage renal disease on dialysis who presented with dry gangrene of the penis. He underwent partial penectomy and was sent home after recovery.

OBJECTIVE: To correlate male lower urinary tract symptoms between age, quality of life scores,parameters of uroflowmetry and prostate size. PATIENTS AND METHODS: Two hundred eight males were included in this study. Uroflowmetry parameters,age, International Prostate Symptom Score (IPSS), Quality of Life (QoL) scores and prostate sizewere gathered. For correlation, distribution of age, uroflowmetry parameters and prostate size werefirst compared to IPSS. Analysis of variance was used to compare age of patients, while Kruskall-wallis test was used to compare the QoL, uroflowmetry parameters, and prostate size on each IPSSgroups. Ordinal logistic regression analysis was used to correlate IPSS to age, quality of life,uroflowmetry parameters, and prostate size both for multivariate and univariate analysis. RESULTS: There was no significant correlation between age and IPSS. However, on profile distribution,the age distribution between symptom scores were statistically similar. Qol scores were directlyproportional to IPSS. Thus, patients with a worse QoL score were more likely to have higher IPSS.Qmax scores decreased as symptom severity increased. Patients with higher Qmax scores are lesslikely to have higher IPSS scores. Voided volume was observed to decrease as IPSS severity increased,but this was not statistically significant. Patients with higher post void residual scores were morelikely to have higher IPSS. There was also no significant correlation between prostate size and IPSS. CONCLUSION There were no significant correlation between IPSS and age, voided volume and prostatesize. On the other hand, patients with a worse QoL score and a high post void residual had higherIPSS. Patients with a high Qmax, are less likely to have an elevated IPSS.

Cancer is the leading cause of disease and death worldwide and among all cancers,prostate cancer (PCA) is the second most frequently diagnosed cancer of men after lungcancer. Despite the low incidence of prostate cancer, there is a rapid increase of prostate cancer's incidence and mortality in Asian countries due to a more westernized lifestyle and high proportion of advanced stage prostate cancer.
Prostate ; Neoplasm Grading ; Bone Neoplasms

OBJECTIVE: To provide an overview on the impact of healthcare disruption by the COVID-19 pandemic to urology training programs in the Philippines. METHODS: A survey questionnaire was used in collaboration with the study done by Rosen, et al. last May 2020. Telephone survey of the study population was done determining the status of resident staffing, workload, health/wellness, and didactics. Numerical and categorical data were analyzed and descriptive statistics are provided. RESULTS: All the observations on resident time in the workplace, including assignment to teams (81%), redeployment responses (55-97%), and remote clinical work (65%) were significant. Fifty one percent of residents have decreased research load. Eighty one percent have didactics in small groups. Fifty-five percent have 1 to 2 Video-based learning/conferences per week (p=0.007) followed by those with 3-4 with 98% (p=0.120) and those with >5 with only 6% (p=0.729). For Resident health and wellness, 87% of the residents were exposed to COVID-positive patients, but only 8% of residents were COVID positive (p=0.591). Lastly, 59% of the participants do not have access to wellness programs. CONCLUSION Data from respondents revealed significant changes in the different aspects of the present study. Urology residents spent more time away from their specialties, and have been re-deployed to COVID-19 floors. Ambulatory services, conferences, educational lectures have mostly shifted to virtual platforms. Resident concerns for COVID-19 exposure have been addressed properly; however, wellness programs have not been widely available for residents. As a first national survey, the present study may give significant insights on program changes and may be used as preliminary data for future studies.
Philippines

A hernia occurs when an organ or fatty tissue squeezes through a weak spot in surrounding muscle or connective tissue, called fascia. Hernia is classified as inguinal, incisional, femoral, umbilical, or hiatal. The bladder may herniate in 1%–3% of the cases through the inguinal canal. A herniated bladder with calculus is a more unique condition that has only 3 reported cases. Reported here is a case of a 65-year-old male with a known case of left bladder inguinal hernia. He presented with an inguinoscrotal bulge at the left groin and severe lower urinary tract symptoms, associated with a need to squeeze his scrotum to complete his voiding. A Computed Tomography scan revealed inguinoscrotal bladder hernia, left with urinary bladder calculi, and an enlarged prostate gland. The patient underwent cystoscopy, inguinal exploration left, cystolithotomy, hernioplasty left. Inguinoscrotal hernia of the bladder is a rare pathology and often goes unrecognized in during surgical hernia repair. Preoperative identification of bladder hernia is essential to prevent iatrogenic trauma and severe complications. It is mandatory for general surgeons and urologists to keep in mind this rare condition during surgical repair of inguinal hernia.