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The correlation of Gleason score and prostate specific antigen in predicting the presence of bone metastasis in patients with prostate adenocarcinoma: A retrospective descriptive study

Vincent Emanuel F. Malonzo ; Karl Marvin M. Tan

Philippine Journal of Urology.2017;27(2):85-88.

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

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Concordance of trans rectal ultrasound guided prostate needle biopsy and post radical prostatectomy final histopathology

Sid C. Sergio ; Meliton D. Alpas

Philippine Journal of Urology.2017;27(2):89-95.

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

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Outcome predictive values of the Society of Fetal Urology (SFU) Grading System and Urinary Tract Dilation (UTD) Classification in patients with high-grade ureteropelvic junction obstruction-like prenatal hydronephrosis

John Ivan S. Alonzo ; David T. Bolong

Philippine Journal of Urology.2017;27(2):96-102.

Objectives: This study aimed to determine the surgical predictive value of both SFU and UTD classifications in a specific subset of patients presenting with high-grade (SFU 3 and 4; UTD P2 and P3) UPJO-like hydronephrosis on prenatal ultrasound. Furthermore, this study also aimed to determine the likelihood of spontaneous resolution of high grade UPJO-like hydronphrosis based on both grading systems. Methods: Patients who presented with high-grade hydronephrosis on prenatal ultrasound based on the SFU grading system (Grades 3 and 4) were included in this study. The prenatal renal ultrasounds of these patients were reclassified by a single interpreter according to the UTD classification. Logistic regression was used to test the predictive value of SFU and UTD; ROC curves were plotted accordingly. Kaplan-Meier curves were used to model time to operation and mean time to operation was computed with a 95% confidence interval. Breslow Test was used to determine significant differences in survival curves across the different SFU grades and UTD classifications. Results: Of the 163 patients in the database who presented with prenatal hydronephrosis, 25 patients presented with high-grade UPJO-like hydronephrosis (50 renal units). Logistic regression revealed that the SFU grading system was able to explain only 18.7% of the variance of the occurrence of pyeloplasty, thus, was a poor predictor of the occurrence of surgery. In contrast, logistic regression of the UTD classification was able to explain 47.3% of the occurrence of pyeloplasy with an accuracy of 86% making it a good predictor of surgical intervention. Both SFU and UTD classifications were poor predictors of spontaneous resolution. Mean time to pyeloplasty from the time of diagnosis was 2.98 years (95% CI: 2.45-3.53) Kaplan-Meier curve analysis for the time of pyeloplasty for the SFU grading system revealed no significant difference in the time to operation among the different SFU grades (p=0.110) while for the UTD classification, there was a significant difference in time to pyeloplasty across the different UTD classes with the higher classes correlating to a shorter time to pyeloplasty. (p<0.05) Conclusion The UTD classification system is a good predictor of surgery in patients presenting with high-grade UPJO-like hydronephrosis on prenatal ultrasound with a predictive accuracy of 86%. High-grade hydronephrosis based on the UTD classification equates to a shorter time to surgical intervention from the time of diagnosis necessitating closer follow-up of these patients.
Ureteral Obstruction ; Hydronephrosis

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Efficacy of a single- dose fosfomycin as antibiotic prophylaxis prior to transrectal ultrasound-guided prostate biopsy

Claudette C. Calata ; Pedro L. Lantin, III

Philippine Journal of Urology.2017;27(2):103-109.

Objectives: The goal to prevent increasing antibiotic resistance in urologic procedures has a significant impact on the choice of preoperative antibiotic prophylaxis. The efficacy of an old-new antibioticfosfomycin in TRUS-guided prostate biopsy was also evaluated. Methods: Included were patients who underwent TRUS-guided prostate biopsy from August 1, 2015- July 31, 2016. Patients who satisfied the inclusion criteria were included. Patients were asked to take a single dose of 3g oral fosfomycin 1-3 hours prior to the procedure. Urinalysis was taken pre biopsy and post biopsy (at least 7-10 days). Occurrence of afebrile and febrile UTI were noted. Patients were informed of the signs and symptoms that need to be reported to the investigators. Results: There were 74 patients enrolled in the study. The mean average age of patients was 66.5(±7). Majority of patients were having moderate lower urinary tract symptoms (40.5%) followed by patients with indwelling foley catheter (31.1%). Seventeen percent of patients had concomitant diseases like diabetes mellitus, cystolithiasis, nephrolithiasis, hypertension, etc. Pre biopsy, 51.4% of patients had asymptomatic urinary tract infection and 35% of these patients showed resolution of UTI post biopsy. The incidence of febrile UTI was 4%, 3.8% of patients with UTI pre biopsy and 50% of patients without UTI pre biopsy. Finally, the presence of afebrile and febrile UTI pre and post biopsy was statistically significant at 5% level of significance. Conclusion Single dose oral fosfomycin as prophylactic antibiotic in TRUS- guided prostate biopsy can be an alternative to reduce the rate of fluoroquinolone- resistant infections.
Fosfomycin ; Urinary Tract Infections

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Renal cell carcinoma in a horseshoe kidney

Luis Antonio R. Balajadia ; Michael Jonathan R. Latayan ; Al-Widzrin M. Jupli

Philippine Journal of Urology.2017;27(2):110-115.

Horseshoe kidney is a rare form of congenital renal malformation. It occurs in 0.25 to 3% of the population and is usually asymptomatic. Occurrence of symptoms is usually related to infection, lithiasis, and rarely, malignancy. Presented is a case of a 62-year old male with a one-year history of occasional painless hematuria associated with epigastric discomfort. On physical examination, a palpable mass was noted on the right periumbilical area, 10cm x 10cm in size and was non-tender. CT-scan with IV contrast showed 10cm x 7cm x 12cm mass on the right side of a horseshoe kidney. He underwent Radical Nephrectomy, right with Isthmusectomy. Post-operative course was unremarkable. Histopathology result showed Renal Cell Cacrcinoma, clear cell type.. Although malignancy was present in an anomalous kidney, the prognosis is the same as with normal kidneys. To date, this is the first reported case of malignancy on a horseshoe kidney in the Philippines.
Fused Kidney ; Carcinoma, Renal Cell

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A bladder sparing approach in a case of prostate Rhabdomyosarcoma with bladder extension in a one-year old male

Rogerson D.G. Tiangco ; Jan Michael A. Silangcruz ; Audrey Clement V. So ; Jun S. Dy

Philippine Journal of Urology.2017;27(2):116-123.

Rhabdomyosarcoma (RMS) is a malignantneoplasm of the skeletal muscle. Skeletal musclescan be found in all parts of the human body andthus such type of tumor occurs in almost any partof the body.1 In the pediatrics. It is the mostcommon soft tissue sarcoma and the third mostcommon solid tumor among pediatric patients. Inreport in the United States, on 350 cases, 15 to 20percent of this type of tumor were found in thegenitourinary system, and only 5 to 10 percentwere found in the bladder and prostate.2 With theadvent of multimodality treatment approach,patients with RMS of the bladder/prostate had asignificant improvement in terms of survival overthe past 30 years.This report presents a treatment strategy inwhich an initial unresectable tumor was managedwith neoadjuvant chemotherapy followed byorgan preservation surgery. This is the firstreported case at this institution of a one year oldwho had prostate rhabdomyosarcoma withbladder extension treated with neoadjuvantchemotherapy followed by bladder preservationsurgery.The study aimed to report a case of prostaterhabdomyosarcoma with bladder invasion in a pediatric patient, and describe the managementapproach, bladder preservation, and follow-up.
Rhabdomyosarcoma ; Urinary Bladder

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Metastatic calcinosis cutis penis and scrotum with preserved erectile function post surgery in an ESRD patient on hemodialysis with secondary hyperparathyroidism

Eduardo M. Añ ; onuevo ; Kathleen G. Quezada ; Fercival Sabino ; Robert Leeh Pedragosa ; Eric Roudel Ecalnir

Philippine Journal of Urology.2017;27(2):124-130.

Metastatic calcinosis cutis of the penis and scrotum seen in a patient with End Stage Renal Disease (ESRD) on hemodialysis is a case not usually encounter in urology clinics. Review of the available literature mostly showed compromised erectile function of patients with metastatic calcinosis cutis of the penis. Presented is a case of a patient with ESRD on hemodialysis for five years who developed metastatic calcinosis of the penis and scrotum causing dysmorphic changes, however maintaining full erectile function. Preserving the erectile function after successful excision of the penile and scrotal calcification is imperative to maintain good quality of life.
Erectile Dysfunction ; Hyperparathyroidism, Secondary

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Liposarcoma of the spermatic cord presenting as an indirect inguinal hernia

Nytte Celle Janne G. Magallanes ; Fidel Tomas M. Manalaysay ; James Ronaldo A. Claveria

Philippine Journal of Urology.2017;27(2):131-137.

Liposarcoma of the spermatic cord is a rare condition with a limited number of published reports in literature. These tumors are mostly diagnostic dilemmas where they are mistaken for other inguinoscrotal masses preoperatively and are only accurately diagnosed after surgery. This case report presents a liposarcoma initially mimicking an indirect inguinal hernia on presentation and a definitive diagnosis was confirmed via histopathologic examination. A literature review of other cases that have been previously reported is also presented.
Liposarcoma ; Spermatic Cord ; Hernia, Inguinal

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A case of penile strangulation in a nine year old boy

Rajiv H. Kalbit ; Paul Nimrod B. Firaza ; Rufino T. Agudera

Philippine Journal of Urology.2017;27(2):138-143.

This case report discusses penile strangulation caused by a ball bearing of a fidget spinner in a 9 year - old child. Initial examination revealed a 2 cm x 2 cm metallic ball bearing encircling the base of the penis with gross edema of the distal penile shaft and erythematous penile skin. To release the bearing, a modified string method was used. After removal, skin erosion was treated with debridement and applied with hydrocolloid dressing. Analysis and cross referencing of the case with literature suggest that successful extraction of a constricting object and treatment of penile strangulation, due to the varied nature, causes and effects of penile strangulation, greatly depends on immediate diagnosis and treatment. This spares one from immediate and long term complications, or necrosis with subsequent auto-amputation.

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Exploring the clinicopathological characteristics of testicular cancer: A study at the Southern Philippines Medical Center

Bryan B. Cagampang ; Jay-r R. Enojo

Philippine Journal of Urology.2024;34(2):51-59.

OBJECTIVE

To investigate the clinicopathologic profile of testicular cancer at the Southern Philippines Medical Center (SPMC) in Davao City from January 2017 to December 2022.

METHODS

This is a retrospective study that analyzed data from a cohort of 33 patients using a combination of descriptive statistics and chi-square tests.

RESULTS

The study revealed a mean patient age of 35 years, with the majority (82%) falling between 19 and 59 years. Cryptorchidism was associated with 9% of cases, and most tumors (55%) were located on the right side, with sizes between 3 and 10 cm (58%). The predominant symptom was a painless testicular mass (100%), underscoring the importance of self-examination. Pathologic stage distribution indicates a predominance of advanced stages, notably Stage IIIC at 24%. Germ cell tumors constitute 91% (52% seminoma, 39% non-seminoma), with no significant correlation between tumor stage at diagnosis and number of risk factors identified or body mass index (BMI). Symptom duration trends towards significance in association with advanced stages.

CONCLUSION

The study contributes to a comprehensive understanding of testicular cancer in the Philippines, aligning with global trends. It emphasizes the crucial role of early detection through selfexamination and timely consultation. The prevalence of advanced stages highlights the imperative for heightened awareness and intervention.

Human ; Testicular Neoplasms ; Epidemiology ; Germ Cell Tumor ; Neoplasms, Germ Cell And Embryonal

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