OBJECTIVE: Prostate cancer is the most common cancer in men and localized prostate adenocarcinoma has multiple treatment options. In this study, the objective was to review the outcome of patients that were treated with HDR brachytherapy as monotherapy in all prostate adenocarcinoma patients at the St Luke's Medical Center.

MATERIALS AND METHODS: Thirty three (33) patients who underwent HDR prostate brachytherapy as monotherapy for prostate adenocarcinoma in a single institution for the past 5 years received 38 Gy in 4 fractions. The charts of these patients were reviewed to determine biochemical control using the Phoenix criteria and ASTRO definition, and toxicity.

RESULTS: Patients showed good biochemical control, with 92.16% meeting the target PSA value of 2 ng/mL or less and a 96.51% without consecutive rise of PSA post brachytherapy. There was also minimal toxicity, with no report of gastrointestinal toxicity and 9.1% rate of temporary genitourinary toxicity.

CONCLUSION: Good biochemical control of prostate adenocarcinoma was achieved with the use of HDR brachytherapy as monotherapy, with a minimal toxicity profile.

Human ; Male ; Aged ; Middle Aged ; Brachytherapy ; Adenocarcinoma ; Prostate

OBJECTIVE: This study aimed to determine the association between Lower Urinary Tract Symptoms (LUTS) and premature ejaculation and define its prevalence and factors associated among Filipino males during the Annual National Digital Rectal Exam (DRE) day.

METHODOLOGY: A descriptive cross sectional study was done in all male participants during the Annual National DRE day conducted at the Institute of Urology, St. Luke's Medical Center-Quezon City. All subjects were assessed by urologists for the presence of LUTS using the International Prostate Symptom Score (IPSS), and the Premature Ejaculation Diagnostic Tool (PEDT). The IPSS was categorized into total score (IPSS sum), storage symptoms (FUN - frequency, urgency, nocturia) and voiding symptoms (WISR - weak stream, intermittency, straining and residual urine). Ultrasound was also performed to obtain prostate size. The relationship between age, demographics, prostate size, IPSS scores, storage symptom score, voiding symptom score, and PEDT scores were analyzed using one way ANOVA. The statistical significance was set at P< 0.05.

RESULTS: A total of 101 male participants were included in the study. Participants' age ranged from 36 to 86, with a mean age of 61 ±. The mean IPSS was 5.79 (±6.59 SD). The most common symptom is nocturia with prevalence of 32.7%. The prevalence of PE is 26.7% and 16.8% has probable PE. There are no associations between PE and age, LUTS, storage and voiding symptoms, prostate size and co-morbid illnesses such as hypertension and diabetes showing p values of 0.291, 0.226, 0.600, 0.108, 0.908, 0.954 and 0.833 respectively. However PE was associated with weak stream (P= 0.015) and educational attainment (P=0.008).

CONCLUSION: Filipino men are becoming more concern about their health. LUTS are commonly seen in men in increasing age. PE is a very common male sexual dysfunction so there is a need for identification of such patients (17). Although, no correlation has been made between age, LUTS and PE in this study, however in further correlational analysis, educational status seems to have an impact in the self-reporting PE which may be due to higher awareness of participants with higher education. It is recommended that clinicians always utilize the screening questions for PE to give the appropriate treatment, since patients are often unwilling to volunteer their symptoms on PE (4.17). Our study also showed significant correlation with PE and weak stream, without association to prostate size. relating to a possible neurologic physiologic pathway rather than anatomic etiology of PE. Further study is recommended.

Human ; Male ; Aged 80 and over ; Aged ; Middle Aged ; Adult ; Ejaculation ; Premature Ejaculation ; Sexual Dysfunction, Physiological ; Lower Urinary Tract Symptoms

OBJECTIVE: To investigate the efficacy of terpene compound drug (pinene, camphene, borneol, anethole, fenchone and cineol in olive oil) in facilitating spontaneous passage of ureteral calculi

METHODS: Systematic literature search of the MEDLINE, EMBASE, OVID, Science Direct, Proquest, Google scholar, Cochrane Library databases and rference lists of related literature was done without language restriction. Trials on ureterolithiasis medical expulsive therapy (MET) that compare terpene compound drug versus placebo/control group or alpha-blockers were identified. Articles retrieved were critically appraised by two independent reviewers according to Cochrane Collaboration recommendations. Data from included studies were extracted for calculation of risk ratio (RR) and 95% confidence interval (CI). Effect estimates were pooled using Mantel-Haenszel method with random effect model. Inter-study heterogeneity and publication bias were assessed. The PRISMA guidelines for meta-analysis reporting were followed.

RESULTS: Five trials (total of 344 subjects) of adequate methodological quality were included. Pooled effect estimates from homogenous studies showed that compared to placebo/ control group, patients treated with terpene compound drug had significantly higher ureteral calculi expulsion rate (pooled RR: 1.34; 95% CI 1.12, 1.61). Analysis of studies that compare terpene compound drug with alpha-blockers showed no significant difference (pooled RR: 0.79; 95% CI 0.59, 1.06), although significant inter-study heterogeneity was noted. Only minor gastrointestinal adverse effect was reported on terpene compound drug use.

CONCLUSIONS: The results suggest that terpene compound drug as MET is effective in promoting passage of ureterolithiasis. High quality large-scale RCTs comparing alpha-blockers and terpene compound drug are warranted to make a more definitive conclusion.

Human ; Male ; Female ; TERPENES-adverse effects,therapy,TREATMENT OUTCOME ; UROLOGIC DISEASES ; URETERAL DISEASES ; Ureteral Calculi

OBJECTIVE: This study aimed to evaluate the clinical utility of power Doppler ultrasonography (PDUS) in the detection of prostate cancer and determine its predictive ability compared to digital rectal examination, serum PSA levels and gray-scale transrectal ultrasonography, using biopsy as the reference standard.

MATERIALS AND METHODS: This is a prospective cross-sectional study of 100 consecutive patients, who underwent prostate needle biopsies at the National Kidney and Transplant Institute. All patients were seen at the Out-patient Department, suspected of having prostate cancer because of abnormally high serum PSA levels (>4 ng/ml) and/or abnormal digital rectal examination. Patients previously diagnosed with prostate cancer were excluded in the study. All patients underwent gry-scale TRUS before power Doppler imaging of the prostate using the Siemens Sonoline Elegra high resolution digital ultrasound with a 6.5 MHz endocavitary probe. After power Doppler imaging, a systematic 12-core and lesion-directed TRUS-guided biopsy of the prostate was performed.

RESULTS: A total of 100 patients (mean age 65, SD 7, range 41-83) were included in this study. Prostate needle biopsy confirmed 37 prostate cancer cases. Of the 37 patients diagnosed with prostate cancer, 18 had an abnormal DRE, 26 had abnormal TRUS findings, and 14 had positive power Doppler flow. PDUS has a positive predictive value of 66.7% and a specificity of 88.9%. Logistic regression analysis with the odds ratio computed at 95% C.I. showed that the probability of having prostate cancer when DRE is positive, PSA is elevated, hypoechoic lesion is present on Gray-scale TRUS and hypervascularity of the peripheral zone is present on PDUS are significantly higher than if all of these tests were negative with PDUS in combination with DRE showing the highest predictive ability for prostate cancer.

CONCLUSION: Power Doppler imaging increases the specificity and positive predictive value of Gray-scale transrectal ultrasound in prostate cancer detection. The addition of PDUS to the screening tool of digital rectal exam increases the probability of the patient having cancer when both tests are positive, thus increasing its predictive power.

Prostate Cancer ; Power Doppler Ultrasonography ; Gray-scale Ultrasonography