OBJECTIVE: Transrectal ultrasound-guided prostate biopsy (TRUSPBx) is the recommended method for the histopathologic confirmation of prostate cancer. However, the overall cancer detection rate is low; hence, patients are potentially exposed to multiple biopsies and their attendant morbidity. Multiparametric MRI of the prostate followed by MRI-Ultrasound fusion-guided prostate biopsy (FBx) is an emerging diagnostic pathway that has been established and recommended in men with a persistently elevated PSA despite a previous negative biopsy. However, evidence regarding its value in the biopsy-naïve setting is scarce. The objective is to compare the diagnostic accuracy of MRI fusion-guided prostate biopsy against TRUSPBx in biopsy-naïve men. METHODS: This is a retrospective cohort study involving biopsy-naïve men with a PSA of 3 to 20 ng/ml. Primary outcomes of the study include overall cancer detection rate (CDR) and detection of clinically-significant prostate cancer (csPCa). Subgroup analyses were performed based on PSA level and prostate volume. Independent t-test, Mann Whitney U test and Chi square test were used in the statistical analysis. RESULTS: A total of 185 biopsy-naïve men with a PSA level of 3 – 20 ng/mL were included in the study. Median pre-biopsy PSA level was 7.07 ng/mL (5.06 – 11.0) and 9.02 ng/mL (5.8 – 13.8) in the FBx arm and TRUS-guided biopsy arm, respectively. Ninety-nine (n=99; 53%) underwent MP-MRI of the prostate followed by MRI fusion-guided prostate biopsy and eighty-six (n=86; 46%) underwent the standard TRUS-guided prostate biopsy. Compared to TRUSPBx, FBx significantly detected more prostate cancer (CDR: 68% vs 30%, p<0.0001) and csPCa (46% vs 22%, p=0.001). The diagnostic yield of FBx was distinctly superior in the subgroup of men with a PSA of 4 – 10 ng/mL (CDR: 64% vs 7%, p<0.0001; csPCa: 43% vs 2%, p<0.0001) and a prostate volume of <40grams (CDR: 82% vs 36%, p<0.0001; csPCa: 53% vs 21%, p=0.006). CONCLUSION Compared to the current standard, the diagnostic yield of MRI fusion-guided prostate biopsy is significantly better in biopsy-naïve men. FBx detected more men with prostate cancer, with a higher proportion of men having clinically-significant disease. This advantage is strongly evident in men with a PSA level of 4 – 10 ng/mL and an average prostate volume of 40 grams. Hence, Multiparametric MRI of the prostate followed by MRI fusion-guided prostate biopsy is an effective first-line diagnostic modality for prostate cancer in men presenting with elevated PSA levels.
Male ; Image-Guided Biopsy ; Prostatic Neoplasms

BACKGROUND: The low prevalence of human papillomavirus (HPV) DNA and mRNA in biopsy samples of Filipinos with head and neck squamous cell carcinoma (HNSCC) has been reported previously. Here, the HPV serologic profiles of HNSCC cases were analyzed and associated with lifestyle and sexual practices. METHODS: Serum samples were collected between May 2012 and September 2013 from HNSCC patients (n = 22) in the northwest region of the Philippines, and age- and sex-matched clinically healthy controls. Antibodies to capsid and early oncoproteins of HPV16, 18, 31, 33, 45, 52, 58, 6, and 11 were analyzed using multiplex serology. RESULTS: Most of the cases were males with tumors of the oral cavity or larynx. Two of the cases tested positive for at least one of the early oncoproteins (E6, E7, E1, and/or E2) of HPV16, and 11 did not display reactivity to any HPV early or late oncoproteins. Of the controls, four tested positive for at least one of the HPV16 early oncoproteins, and 10 were non-reactive to all HPV types. Titers to HPV16 E6 or E7 of the seropositive cases and controls were considerably lower than those typically observed in economically developed countries. CONCLUSIONS: The low HPV titers seen here are consistent with the results of molecular analyses for this population. Hence, the seropositivity of some of the HNSCC cases is likely an indication of prior exposure to the virus and not the presence of HPV-driven tumors.
Antibodies ; Biopsy ; Capsid ; Carcinoma, Squamous Cell ; Developed Countries ; DNA ; Epithelial Cells ; Head ; Humans ; Larynx ; Life Style ; Male ; Mouth ; Neck ; Oncogene Proteins ; Philippines ; Prevalence ; RNA, Messenger

This is a correlation validation study wherein the English version of the International Index of Erectile Function-5 (IIEF-5) was adapted into Filipino. Many of the sex-related terms in the questionnaire do not have a direct translation in Filipino which made adaptation difficult. In the pretest, there was no difficulty with comprehension and readability of the Filipino version. Subjects judged it as equivalent to the English IIEF-5. There was a high positive correlation with the English version (r=0.93). After modification by a Review Panel, the final instrument underwent validation in a study which included 64 heterosexual, sexually active male aged 40 years old and above. The mean age of the subjects was 54.7. Content validity was determined by 2 urologists. The translated tool was found to be reliable (coefficient of stability=0.92) and could discriminate subjects with or without ED (validity coefficient=0.95). This study did not document treatment responsiveness and specificity. The questionnaire, however, can be used to screen patients with ED. Prevalence among the sample population was determined and found to be 45.3%.

Human ; Male ; Middle Aged (a Person 45-64 Years Of Age) ; Adult (a Person 19-44 Years Of Age) ; Erectile Dysfunction ; Philippines ; Male

Objectives: This study aimed to determine the effectiveness of sildenafil citrate on the erectile dysfunction of and satisfaction on sexual performance of married male Filipinos 30-50 years old. It likewise aimed to determine the effect of sildenafil citrate on the onset of erection, ejaculation latency period, detumescence time, refractory period, grade on penile erection and finally on the patient and wife's overall treatment satisfaction. Methods: The study is a placebo, double-blind, crossover clinical study to determine the effectiveness of sildenafil citrate on erectile dysfunction and satisfaction on sex\jal performance among mid-adult married, male, Filipinos conducted in July to October 2006 and included healthy, married, male Filipinos working in or near a tertiary hospital and those seen at OPD Urology Clinic who fall under the age of 30 to 50 years. A sildenafil citrate or matching placebo dose was 50 mg. Effectiveness was assessed by the scores of IIEF-5, mean scores of minutes of onset of erection, ejaculation latency period, detumescence time and penile hardness. Results: Patients upon taking sildenafil, had shorter latency period, duration of erection and detumescence in both first and second occurrences than when they took the placebo. The mean grade of penile hardness is significantly higher when taken the sildenafil (3.5) compared to when they took the placebo (2.9) (p
Erectile Dysfunction