This present study was undertaken to validate the English version of the General Health Questionnaire (GHQ-12) in urological patients. Validity and reliability were studied in patients with lower urinary tract symptoms (LUTS) and patients without LUTS. Reliability was evaluated using the test-retest method and internal consistency was assessed using Cronbach's alpha. Sensitivity to change was expressed as the effect size in the pre-intervention versus postintervention score in additional patients with benign prostatic hyperplasia (BPH) who underwent transurethral resection of the prostate (TURP). Internal consistency was excellent. A high degree of internal consistency was observed for each of the 12 items with Cronbach's alpha value of 0.37-0.79, while total scores was 0.79 in the population study. Test-retest correlation coefficient for the 12 items score were highly significant. Intraclass correlation coefficient was high (0.35-0.79). It showed a high degree of sensitivity and specificity to the effects of treatment. A high degree of significant level between baseline and post-treatment scores were observed across all 12 items in the treatment cohort but not in the control group. The GHQ-12 is suitable, reliable, valid and sensitive to clinical change in urological disorders.

The objective of this study was to validate the Malay version of the International Index of Erectile Function (IIEF-15) in patients with lower urinary tract symptoms. Reliability and validity was assessed by using the test -retest while Cronbach's alpha was used to assess internal consistency. Effect size was evaluated to assess the sensitivity to change in the pre-transurethral resection of the prostate (TURP) vs post-TURP. Internal consistency was excellent. A high degree of internal consistency was observed for each of the 15 items and five domains (Cronbach's alpha value ¼ 0.56 and higher and 0.74 and higher, respectively). Test -retest correlation coefficient for the 15 items and domains scores showed no significant changes. Intraclass correlation coefficient for 15 items and domains were high (ICC ¼ 0.59 and above). It can be concluded that the Mal-IIEF-15 is suitable, reliable, valid and sensitive to clinical change in the Malaysian population.

Twelve resections of prostate and 1 extensive bladder tumour were performed in patients on long-term anticoagulation without withdrawal of warfarin therapy. The mean preoperative prothrombin index was 2.3. Four patients required blood transfusion. There were no major complications. The effects of surgery and infusion of fresh frozen plasma (FFP) on the level of anticoagulation were monitored. FFP reduced the prothrombin index by 0.25/unit. Transurethral resection can be carried out safely by an experienced urologist on patients anticoagulated with warfarin, reducing the risk of serious thromboembolic complications associated with withdrawal of anticoagulation.

PurposeProstate cancer is a bimodal disease with aggressive and indolent forms. Current prostate-specific-antigen testing and digital rectal examination screening provide ambiguous results leading to both under-and over-treatment. Accurate, consistent diagnosis is crucial to risk-stratify patients and facilitate clinical decision making as to treatment versus active surveillance. Diagnosis is currently achieved by needle biopsy, a painful procedure. Thus, there is a clinical need for a minimally-invasive test to determine prostate cancer aggressiveness. A blood sample to predict Gleason score, which is known to reflect aggressiveness of the cancer, could serve as such a test.Materials and MethodsBlood mRNA was isolated from North American and Malaysian prostate cancer patients/controls. Microarray analysis was conducted utilizing the Affymetrix U133 plus 2·0 platform. Expression profiles from 255 patients/controls generated 85 candidate biomarkers. Following quantitative real-time PCR (qRT-PCR) analysis, ten disease-associated biomarkers remained for paired statistical analysis and normalization.ResultsMicroarray analysis was conducted to identify 85 genes differentially expressed between aggressive prostate cancer (Gleason score ≥8) and controls. Expression of these genes was qRT-PCR verified. Statistical analysis yielded a final seven-gene panel evaluated as six gene-ratio duplexes. This molecular signature predicted as aggressive (ie, Gleason score ≥8) 55% of G6 samples, 49% of G7(3+4), 79% of G7(4+3) and 83% of G8-10, while rejecting 98% of controls.ConclusionIn this study, we have developed a novel, blood-based biomarker panel which can be used as the basis of a simple blood test to identify men with aggressive prostate cancer and thereby reduce the overdiagnosis and overtreatment that currently results from diagnosis using PSA alone. We discuss possible clinical uses of the panel to identify men more likely to benefit from biopsy and immediate therapy versus those more suited to an “active surveillance” strategy.

Objective To validate the English version of the International Prostate Symptom Score (IPSS) in patients with and without urinary symptoms in a Malaysian population. Patients and methods Validity and reliability were assessed in patients with lower urinary tract symptoms (LUTS) and in patients with no LUTS. Reliability was evaluated using the test-retest method and internal consistency using Cronbach's a. Sensitivity to change was expressed as the effect size in the score before and after intervention in additional patients with LUTS who underwent transurethral resection of the prostate (TURP). Results Internal consistency was excellent; there was a high degree of internal consistency for each of the seven domains and for the total score (Cronbach's a o0.60 and o 0.79, respectively) in the populations studied. The test-retest correlation coef®cient for the seven domain scores was highly signi®cant. The intraclass correlation coef®cient was high (o0.59). There was a high level of sensitivity and speci®city for the effects of treatment, with a very signi®cant change between the seven scores domains in the treated group but not in the control group. Conclusions The IPSS is suitable, reliable, valid and sensitive to clinical change in the Malaysian population.