Purpose: Postmicturition dribbling (PMD) is a common but underrecognized lower urinary tract symptom (LUTS). This study evaluated the clinical and urodynamic characteristics of PMD in men with medication-refractory LUTS. Methods: From 2008 to 2010, 150 male patients underwent questionnaire assessment, urodynamic study (UDS), and transrectal ultrasound of the prostate (TRUSP). PMD was defined as a Likert score ≥3. Results: PMD was reported by 47% of patients and was significantly associated with higher International Prostate Symptom Score (IPSS) scores, particularly LUTS such as urgency, incomplete emptying, and weak stream. PMD also adversely affected quality of life, especially motivation, sexual function, and psychological well-being. Among the UDS and TRUSP parameters, only poor bladder compliance was significantly associated with PMD (4% vs. 17%, P=0.016), corresponding to a 4-fold higher risk. Conclusions PMD was prevalent and clinically meaningful in men with LUTS and was strongly associated with core LUTS and reduced bladder compliance. Because PMD is not included in the IPSS, it may be underrecognized in routine clinical evaluation, underscoring the need for broader symptom assessment.

Purpose: Active surveillance (AS) is one of the management options for patients with low-risk and select intermediate-risk prostate cancer (PC). However, factors predicting disease reclassification and conversion to active treatment from a large population of pure Asian cohorts regarding AS are less evaluated. This study investigated the intermediate-term outcomes of patients with localized PC undergoing AS. Materials and Methods: This cohort study enrolled consecutive men with localized non-high-risk PC diagnosed in Taiwan between June 2012 and Jan 2023. The study endpoints were disease reclassification (either pathological or radiographic progression) and conversion to active treatment. The factors predicting endpoints were evaluated using the Cox proportional hazards model. Results: A total of 405 patients (median age: 67.2 years) were consecutively enrolled and followed up with a median of 64.6 months. Based on the National Comprehensive Cancer Network (NCCN) risk grouping, 70 (17.3%), 164 (40.5%), 140 (34.6%), and 31 (7.7%) patients were classified as very low-risk, low-risk, favorable-intermediate risk, and unfavorable intermediate-risk PC, respectively. The 5-year reclassification rates were 24.8%, 27.0%, 18.6%, and 25.3%, respectively. The 5-year conversion rates were 20.4%, 28.8%, 43.6%, and 37.8%, respectively. A prostate-specific antigen density (PSAD) of ≥0.15 ng/mL2 predicted reclassification (hazard ratio [HR] 1.84, 95% confidence interval [CI] 1.17–2.88) and conversion (HR 1.56, 95% CI 1.05–2.31). A maximal percentage of cancer in positive cores (MPCPC) of ≥15% predicted conversion (15% to <50%: HR 1.41, 95% CI 0.91–2.18; ≥50%: HR 1.97, 95% CI 1.1453–3.40) compared with that of <15%. A Gleason grade group (GGG) of 3 tumor also predicted conversion (HR 2.69, 95% CI 1.06–6.79; GGG 3 vs 1). One patient developed metastasis, but none died of PC during the study period (2,141 person-years). Conclusions AS is a viable option for Taiwanese men with non-high-risk PC, in terms of reclassification and conversion. High PSAD predicted reclassification, whereas high PSAD, MPCPC, and GGG predicted conversion.