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.

Background: The Gleason Sum derived from transrectal ultrasound guided prostate needle biopsy (TRUS-PNB) is critical in the selection of an appropriate treatment and also important in predicting the possible outcome. Scoring is therefore critical in the selection of a proper management. The concordance between prostate needle biopsy and radical prostatectomy histopathology in terms of the Gleason Sum was here in evaluated. Methods: This is a retrospective cohort where a review and analysis of 28 charts were made. All patients who underwent TRUS-PNB and subsequently radical prostatectomy were included in the study. The concordance rates between prostate needle biopsy and radical prostatectomy histopathology were elucidated. Results: With the Gleason Sum 6 upon TRUS-PNB (n=17), 9 (53.9%) matched their postoperative pathological findings, while 8 (47.0%) were upgraded to Gleason Sum 7. No finding of downgrading was observed postoperatively. Tumors graded GS7 on TRUS-PNB upon biopsy (n=11) had the best concordance; with 11 (100%) matched at radical prostatectomy. No over grading or downgrading was observed. Conclusion GS6 tumors being upgraded to GS7 tumors are still being observed. Owing the diagnosis of prostate cancer relying heavily on biopsy may still yield discordance. Though improvements with regards to biopsy technique may evolve, the usual 12 core biopsy is still being applied. With this, different factors that may predict discordance and strategies to minimize discordance still remain important for the appropriate treatment of prostate cancer.
Biopsy

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.