Objectives:To evaluate the diagnostic performance of preoperative multiparametric magnetic resonance imaging (mp-MRI) as a predictor of extracapsular extension (ECE) and unfavorable Gleason score (GS) in patients with intermediate and high-risk prostate cancer (PCa).Materials and Methods:Patients with clinically localized PCa who underwent radical prostatectomy (RP) and had preoperative mp-MRI between May-2011 and December-2013. Mp-MRI was evaluated according to the European Society of Urogenital Radiology MRI prostate guidelines by two different readers. Histopathological RP results were the standard reference.Results:79 patients were included; mean age was 61 and median preoperative prostate-specific antigen (PSA) 7.0. On MRI, 28% patients had ECE evidenced in the mp-MRI, 5% seminal vesicle invasion (SVI) and 4% lymph node involvement (LNI). At RP, 39.2% had ECE, 26.6% SVI and 12.8% LNI. Sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of mp-MRI for ECE were 54.9%, 90.9%, 76%, 81% and 74.1% respectively; for SVI values were 19.1%, 100%, 77.3%, 100% and 76.1% respectively and for LNI 20%, 98.4%, 86.7%, 66.7% and 88.7%.Conclusions:Major surgical decisions are made with digital rectal exam (DRE) and ultrasound studies before the use of Mp-MRI. This imaging study contributes to rule out gross extraprostatic extension (ECE, SVI, LNI) without competing with pathological studies. The specificity and NPV are reasonable to decide surgical approach. A highly experienced radiology team is needed to provide accurate estimations of tumor extension and aggressiveness.

No abstract

Prevalence of lower urinary tract symptoms and overactive bladder in men and women over 18 years old: The Colombian overactive bladder and lower urinary tract symptoms (COBaLT) study Aims: To estimate the prevalence of LUTS and overactive bladder (OAB) in the Colombian population. Methods: A cross-sectional, population-based study was conducted in men and women ≥18 years using directed interviews and self-administered questionnaires in five main cities in Colombia. A sample size of 1054 subjects was estimated (prevalence of LUTS/OAB 15%, CI 95%, statistical power 80%, precision 3%). We used a multi-stage probabilistic sampling technique to randomly select individuals in the community, stratified by socioeconomic status, gender, and age. We used the 2002 ICS and 2010 IUGA/ICS definitions as well as validated questionnaires in Spanish. Descriptive statistics were employed. Results: A total of 1060 participants were included. Mean age was 42 (range 18-89) years. The prevalence of at least one LUTS was 84%, while overactive bladder was reported by 31.8% participants. Among individuals with at least one LUTS, 13.2% would feel "mostly unsatisfied," "unhappy," or "terrible" to spend the rest of their lives with their current urinary condition. Nocturia was the most prevalent LUTS (55.3%), followed by urgency (46.4%) and frequency (45.8%). Urge, stress, and mixed urinary incontinence were reported by 15.3%, 8.6%, and 7% of participants, respectively. Conclusions: LUTS are highly prevalent in the Colombian population and severely affect quality of life. This is the first study conducted in Colombia and Latin America focused on evaluating LUTS in men and women of all age groups of interest using a multi-stage probabilistic sampling technique. These results may have a significant influence on health decision-making and assessment of future therapies. K E Y W O R D Slower urinary tract symptoms, mixed urinary incontinence, overactive bladder, prevalence, quality of life, urinary incontinence Alan Wein led the peer-review process as the Associate Editor responsible for the paper. 200 |

Aim: To determine the prevalence of nocturia and associated risk factors in the Colombian population aged ≥18 years old. Methods: This is a cross-sectional population-based study conducted in 1060 participants in Colombia. Nocturia was assessed with the Spanish version of the ICIQ-OAB, using the ICS terminology. Descriptive statistics were used to evaluate nocturia prevalence. Logistic regression analysis was carried out to determine the association of nocturia with predefined variables. Results: The prevalence of nocturia was 55.9% and it was more common in women than men (53.96% vs. 46.04%; p = .004). At least three episodes of nocturia were observed in 20.37% of the participants who had a severe alteration in their quality of life (p < .01). The bivariate model showed an association between nocturia and obesity (odds ratio [OR], 1.69; 90% confidence interval [CI]: 1.22-2.34), diabetes mellitus (OR, 2.99; 90% CI: 1.86-4.83), high blood pressure (OR, 2.04; 90% CI: 1.52-2.72), cardiovascular disease (OR, 1.75; 90% CI: 1.08-2.83), depression (OR, 1.89; 90% CI: 1.23-2.89), obstructive sleep apnea (OR, 1.70; 90% CI: 1.17-2.46), and childhood enuresis (OR, 1.45; 90% CI: 1.04-2.02). The multivariate model showed an association with obesity (OR, 2.0; 95% CI: 1.14-3.51) in women, as well as age ≥ 65 years (OR, 3.18; 95% CI: 1.26-8.02) and erectile dysfunction (OR, 3.44; 95% CI: 1.21-9.72) in men. Childhood enuresis was significantly associated with nocturia in both genders (OR, 1.61; 95% CI: 1.09-2.40 in women and OR, 1.66; 95% CI: 1.09-2.52 in men). Conclusion: There is a significant prevalence of nocturia in our population and a clear association with impaired quality of life. We consider important to inquire about history of childhood enuresis to define the risk of presenting nocturia in adulthood. Nocturia was associated with multiple comorbidities. Obesity and erectile dysfunction play an important role as modifiable risk factor.

Aims: Photovaporization of the prostate (PVP) with GreenLight Laser is a surgical treatment for lower urinary tract symptoms. It is considered safe in elderly patients with comorbidities, however, the evidence is inconclusive. The objective of this study is to evaluate the efficacy and safety outcomes of PVP according to the American Society of Anesthesiologists Physical Status (ASAPS). Methods: A cohort of 675 patients who underwent PVP between 2012 and 2018 was evaluated. Patients were classified according to their ASAPS as low (I and II) and high risk (III and IV). Surgical characteristics and improvement of symptoms and Quality of Life (QoL) were evaluated.Results: The median age of high-risk group was higher than low-risk group. The high-risk group had more history of anticoagulation, antiaggregation, urinary catheterization, urinary retention and urethral stricture. Longer times of hospitalization ] vs 21.8 hours , P = .008) and catheterization .57] vs 17.67 hours [IQR = 14.76-22.5], P = .004) were found in the high-risk group. Conversion and bleeding control were not different between groups. In the follow-up