COMPARATIVE ANALYSIS OF PROSTATE VOLUME MEASUREMENT USING TRANSABDOMINAL ULTRASOUND, TRANSRECTAL ULTRASOUND, AND MRI: A RETROSPECTIVE OBSERVATIONAL STUDY Introduction: Prostate volume (PV) measurement is crucial for managing prostate conditions, including benign prostatic hyperplasia (BPH). Its range can be measured using different imaging modalities like transabdominal ultrasound (TAUS), transrectal ultrasound (TRUS), and magnetic resonance imaging (MRI) of the prostate, which were compared in this study. Methods: A single tertiary centre retrospective observational analysis was conducted on PV measurements obtained through TAUS, TRUS, and MRI prostate from the same patients prior to biopsy. The mean of PV from each imaging modality was analysed using the Analysis of Variance (ANOVA) and a Tukey post hoc test, with p < 0.05 was considered statistically significant. Results: Only 311 out of 718 patients who underwent TRUS biopsy from January 2018 until December 2022 were eligible for this study based on the inclusion criteria. The median age and PSA were 71 years old and 7.5 ng/mL, respectively. No significant difference was found across the means of the imaging modality and PV measurement among the imaging modalities (F = 0.713, p = 0.49). The Tukey post hoc test also revealed no significant difference between each modality, namely TAUS-TRUS (p = 0.45), MRI-TRUS (p = 0.79), and TAUS-MRI (p = 0.85). Conclusion: This study demonstrated no statistically significant relationship in prostate volume measurements from the three different imaging modalities, namely TAUS, TRUS, and MRI.

Purpose: To investigate the effect of androgen deprivation therapy (ADT) on health-related quality of life (HRQOL) in Asian men with all stages of prostate cancer. Materials and Methods: READT (real-life evaluation of the effect of ADT in prostate cancer patients in Asia) was a multi-center, prospective observational study involving six sites across four Asian populations. We enrolled eligible prostate cancer patients, who opted for ADT alone or in combination without prior neoadjuvant or adjuvant ADT within 12 months. The EuroQoL-5 dimensions, 5 level scale (EQ-5D-5L) utility index scores and visual analog scale (VAS) were evaluated at baseline, month 6 and month 12. Results: A total of 504 patients were recruited into READT between September 2016 and May 2020 with 52.9% diagnosed with metastatic prostate cancer. The EQ-5D-5L was evaluable in 442/504 (87.7%) of patients. Overall baseline EQ-5D-5L utility index score was 0.924 (interquartile range [IQR] 0.876–1.000). We observed a statistically significant difference in baseline EQ-5D-5L utility index score among different populations with a median EQ-5D-5L utility index score of 1 for Taiwan & Hong Kong, 0.897 for China and 0.838 for Malaysia. Similar trend was observed throughout multiple treatment time-points. Stage IV prostate cancer were significantly associated with a lower baseline EQ-5D-5L utility index score compared to stage I–III prostate cancer, producing a median disutility value of -0.080. Participants had a high median VAS (80, IQR 70–90), indicating good overall health on average during ADT initiation. Conclusions The study highlights the differences in health state utility index scores among various Asian prostate cancer patients receiving ADT at real-world setting. Our findings will be informative and useful in cost-effectiveness evaluation and policy decision making.

Introduction: This study aimed to determine the views and practices of healthcare providers and barriers they encountered when implementing the national health screening program for men in a public primary care setting in Malaysia. Methods: An online survey was conducted among healthcare providers across public health clinics in Malaysia. All family medicine specialists, medical officers, nurses and assistant medical officers involved in the screening program for adult men were invited to answer a 51-item questionnaire via email or WhatsApp. The questionnaire comprised five sections: participants’ socio-demographic information, current screening practices, barriers and facilitators to using the screening tool, and views on the content and format of the screening tool. Results: A total of 231 healthcare providers from 129 health clinics participated in this survey. Among them, 37.44% perceived the implementation of the screening program as a “top-down decision.” Although 37.44% found the screening tool for adult men “useful,” some felt that it was “time consuming” to fill out (38.2%) and “lengthy” (28.3%). In addition, ‘adult men refuse to answer’ (24.1%) was cited as the most common patient-related barrier. Conclusions: This study provided useful insights into the challenges encountered by the public healthcare providers when implementing a national screening program for men. The screening tool for adult men should be revised to make it more user-friendly. Further studies should explore the reasons why men were reluctant to participate in health screenings, thus enhancing the implementation of screening programs in primary care.

Background: Background: Urinary incontinence is a common problem among older women. The objective of this study was to determine the prevalence of urinary incontinence among older women aged 55 years and over in the Klang valley, the most densely populated urban area in Malaysia, and to determine any potential ethnic differences. Methods: This study used cross-sectional data from the Malaysian Elders Longitudinal Research (MELoR) study. A total of 863 participants were included, with a mean age of 67.97 ± 7.50 (S.D.). They were selected by simple random sampling from the electoral rolls of three parliamentary constituencies. Results: The prevalence of urinary incontinence was 30.8%. Mixed urinary incontinence (UI) was present in 44.7%, stress UI in 39.1% and urge UI in 16.2%. Ethnic Malays (38%) were more likely than ethnic Indians (32.3%) and Chinese (29.7%) to have UI. Ethnic Malays were also more likely to have stress UI and Indians were more likely to have urge UI . Conclusion The prevalence of UI in this study was comparable to other Asian and worldwide studies. The significant association between ethnicity and UI, however, has not been reported in any previous studies. Further studies should identify factors which may determine these ethnic differences in UI.
Urinary Incontinence ; Aged ; Lower Urinary Tract Symptoms ; Ethnicity

In recent years, prolonged ketamine abuse has been reported to cause urinary tract damage. However, there is little information on the pathological effects of ketamine from oral administration. We aimed to study the effects of oral ketamine on the urinary tract and the reversibility of these changes after cessation of ketamine intake. Methods: Rats were fed with illicit (a concoction of street ketamine) ketamine in doses of 100 (N=12), or 300 mg/kg (N=12) for four weeks. Half of the rats were sacrificed after the 4-week feeding for necropsy. The remaining rats were taken off ketamine for 8 weeks to allow for any potential recovery of pathological changes before being sacrificed for necropsy. Histopathological examination was performed on the kidney and urinary bladder. Results: Submucosal bladder inflammation was seen in 67% of the rats fed with 300 mg/kg illicit ketamine. No bladder inflammation was observed in the control and 100 mg/kg illicit ketamine groups. Renal changes, such as interstitial nephritis and papillary necrosis, were observed in rats given illicit ketamine. After ketamine cessation, no inflammation was observed in the bladder of all rats. However, renal inflammation remained in 60% of the rats given illicit ketamine. No dose-effect relationship was established between oral ketamine and changes in the kidneys. Conclusion: Oral ketamine caused pathological changes in the urinary tract, similar to that described in exposure to parenteral ketamine. The changes in the urinary bladder were reversible after short-term exposure.