<p style="text-align: justify;">OBJECTIVE: The purpose of this study was to determine the efficacy of transcutaneous nerve stimulation (TENS) in the treatment of neurogenic bladdder secondary to myelomeningocele (MMC).p> <p style="text-align: justify;">MATERIALS AND METHODS: A total of 14 children (7 boys and 7 girls) with neurogenic bladder secondary to MMC who were referred to our clinic between 2009 and 2011 were enrolled in the study. Urodynamic parameters including maximum bladder capacity (MBC) and detrusor leak point pressure (DLPP), maximum detrusor pressure (MDP) and bladder compliance (BC), daily incontinence score, constipation, and subjective improvement were recorded as outcome measures. After the first urodynamic session to get the baseline parameters, a 1 hour dose of TENS once a day for at least 3 months was applied at a certain dermatomal level. This was followed by another urodynamic session to assess its effects.p> <p style="text-align: justify;">RESULTS: Out of 14 subjects, 11 (78.5%) had improvement in continence profile and 8 (57%) had improvement in bowel movement. Thirteen out of 14 (92%) had subjective improvements such as higher catheterized and/or voided volume, lesser bedwetting episodes, spontaneous voiding, increased sensation to void, presence of urgency to void, and frequent voiding. One subject had no subjective improvement. The difference in DLLP, MBC, MDP, and BC pre and post treatment was not statistically significant.p> <p style="text-align: justify;">CONCLUSION: The efficacy of TENS in treating bladder dysfunction in patients with MMC remains uncertain. It did show slight improvement in urodynamic parameters specifically BC and MBC however, it was not statistically significant.p>
Human ; Male ; Female ; Adolescent ; Child ; Child Preschool ; Infant ; Transcutaneous Electric Nerve Stimulation-Treatment Outcome ; Meningomyelocele

<p style="text-align: justify;">A 9 year old boy presented with painless gross hematuria 1 month prior to admission. Ultrasound and CT scan of the whole abdomen with contrast showed a 2.6cm x 2.0cm papillary mass on the right posterolateral wall. Initial transurethral biopsy result showed negative for malignancy, fibrovascular tissue with mild chronic and acute inflammation. On repeat cystoscopy, a 4cm x 4cm pendunculated lobulated mass was located posterolateral encroaching on the right ureteral orifice. Subsequently a partial cystectomy with distal ureterectomy, right; right-to-left transureteroureterostomy with DJ stent insertion were done. Microscopic and immunostaining results support a diagnosis of rhabdoid tumor. Adjuvant chemotherapy and immunotherapy was given. On follow up, there was no evidence of recurrence.p> <p style="text-align: justify;">This case emphasizes the need to follow aggressively children with gross hematuria. Biopsy should include deep biopsies as rhabdoid tumors are infiltrating tumors. Coordination with the pathologist is of extreme importance since special stainings are needed for confirmation.p>
Human ; Male ; Child ; Rhabdoid Tumor-therapy, treatment, management ; Neoplasms ; Urinary Bladder ; Biopsy ; Ultrasonography ; Tomography Scanners, X-Ray Computed

OBJECTIVE: MRI-Ultrasound fusion guided targeted biopsy has revolutionized the diagnosis of prostatecancer through accurate identification, localization and characterization of prostatic lesions utilizingthe prostate imaging reporting and data system (PI-RADS) scoring system by multiparametric MRI(MPMRI). The fusion prostate biopsy system on the other hand, enables accurate targeting and easyaccess of the tumor. The study objective is to determine the detection rate of clinically-significantprostate cancer using fusion biopsy, and to establish the correlation between PI-RADS score andGleason's score. PATIENTS AND METHODS: A retrospective cohort study was conducted to determine the correlation betweenPI-RADS score and the presence of prostate cancer using MRI-Ultrasound fusion guided transperinealprostate biopsy. This was carried out from June 2017 to July 2018 in a single institution. One hundredthirty five (135) men were included in this study. They presented with an elevated PSA, abnormalDRE or a previous negative prostate biopsy, but with a persistent rise in PSA. A total of 220 prostatelesions were identified. The following characteristics were measured: patient age; the size, location,the PI-RADS score of each lesion, the maximum PI-RADS score for select patients; and the Gleasonscore of discovered tumors. RESULTS: Two hundred twenty PI-RADS 3, 4 and 5 lesions were detected in 135 patients by MPMRI.131 of the 220 lesions were scored as PI-RADS 3, 61 as PI-RADS 4 and 28 as PI-RADS 5. Theselesions were biopsied using the MRI-Ultrasound fusion guided transperineal prostate biopsy system.Thirty-three out of the 131 PI-RADS 3 lesions (25.2%), 44 out of the 61 PI-RADS 4 lesions (72.1%)and 24 out of the 28 PI-RADS 5 lesions (85.7%) respectively were positive for malignancy. Overall,there were 101 (45.9%) lesions classified as PI-RADS 3 to 5 that were positive for prostate carcinoma.Seventy four (74) of the 135 patients (54.8%) were diagnosed with prostate adenocarcinoma. Nineteenout of 65 patients with a maximum score of PI-RADS 3 (29.2%), 33 of 44 with a maximum of PI-RADS 4 (75%) and 22 of 26 with a maximum of PI-RADS 5 (84.6%) harbored malignancy. In termsof location, 45 of the 101 (44.6%) malignancies were in the peripheral sector, 31 (30.7%) in theanterior sector, and 25 (24.8%) in the central sector of the prostate. The mean Gleason grade of PI-RADS 3, 4 and 5 lesions were 6.61, 7.73, and 7.38, respectively. Using Spearman correlation, the rhocoefficient was 0.3153 (p-value =.00013) which denotes a significant positive relationship betweenGleason and PI-RADS score. CONCLUSION This is the first comprehensive Philippine study on Multiparametric MRI-Ultrasoundfusion-guided transperineal prostate biopsy. Present data validate the superiority of MPMRI in theidentification, localization and characterization of prostate cancers. The authors also verified thepositive correlation between PI-RADS score and Gleason score. Finally, they demonstrated theaccuracy of the MRI- ultrasound fusion-guided transperineal prostate biopsy system in targetingprostate lesions.