Purpose: The main purpose of this study is to (1) identify the continual diversity between conventional fixed field intensity modulation radiotherapy (IMRT) and RapidArc (RA) for high-risk prostate cancer; and (2) determine potential benefits and drawbacks of using for this type of treatment. Methods: A cohort of 20 prostate cases including prostate, seminal vesicles and pelvic lymph nodes was selected for this study. The primary planning target volume (PTVP) and boost planning target volume (PTVB) were contoured. The total prescription dose was 75.6 Gy (45 Gy to PTVP and an additional 21.6 Gy to PTVB). Two plans were generated for each PTV: multiple 7-fields for IMRT and two arcs for RA. Results: A Sigma index (IMRT: 2.75 ± 0.581; RA: 2.8 ± 0.738) for PTVP and (IMRT: 2.0 ± 0.484; RA: 2.1 ± 0.464) for PTVB indicated similar dose homogeneity inside the PTV. Conformity index (IMRT: 0.96 ± 0.047; RA: 0.95 ± 0.059) for PTVP and (IMRT: 0.97 ± 0.015; RA: 0.96 ± 0.014) for PTVB was comparable for both the techniques. IMRT offered lower mean dose to organ at risks (OARs) compared to RA plans. Normal tissue integral dose in IMRT plan resulted 0.87% lower than RA plans. All the plans displayed significant increase (2.50 times for PTVP and 1.72 for PTBB) in the average number of necessary monitor units (MUs) with IMRT beam. Treatment delivery time of RA was 2-6 minutes shorter than IMRT treatment. Conclusion: For PTV including pelvic lymph nodes, seminal vesicles and prostate, IMRT offered a greater degree of OARs sparing. For PTV including seminal vesicles and prostate, RA with two arcs provided comparable plan with IMRT. RA also improved the treatment efficiency due to smaller number of MUs required.

AIMS AND OBJECTIVESTo correlate Intravesical Prostatic Protrusion (IVPP) with International Prostate Symptoms Score (IPSS), Quality of Life Index (QOL), Uroflowmetry, Post Void Urine (PVR) and Pressure Flow Study (PFS) and to assess whether the presence and increasing grades of Intravesical prostatic protrusion are directly correlated with the severity of Bladder outlet obstruction due to Benign prostatic hypertrophy. MATERIALS AND METHODSNon-randomized prospective cohort study, conducted in Department of Urology, Govt. Stanley Hospital, from June 2012 to June 2015, on a sample of 100 patients with IVPP. IVPP was correlated with IPSS, Quality of life index, Uroflowmetry, Effects of drug therapy, Response to surgical therapy. Response of patients with Intravesical prostatic protrusion of same grade to surgical therapy and drug therapy are compared to decide which modality of management is best. RESULTSThe incidence of IVPP in patients presenting with LUTS due to BPH is 1 in 5. Majority present with grade 2 IVPP. The increasing grades of IVPP are significantly directly correlated with IPSS score, Q-max and Post void residual. Statistical analysis showed IVPP to correlate significantly with BOO. TURP showed a very good and significant mean decrease of IPSS and Q-max, whereas those who had medical treatment showed only a mean decrease of 2 in IPSS score and 1 in Q-max. CONCLUSIONThe increasing grades of IVPP are significantly directly correlated with IPSS score max and Post void residual. IVPP have a very good positive and negative predictive value and also a good accuracy rate in comparison with all other parameters in predicting the BOO. The surgical intervention statistically proved to be superior to medical treatment in IVPP patients. KEYWORDSIVPP, Prostate, Urology. HOW TO CITE THIS ARTICLE:Rajaraman T, Balaji AR, Vetrichandar S, et al. Effect of intravesical prostatic protrusion (IVPP) on lower urinary tract function and management.