ABSTRACT
BACKGROUND@#Prostate cancer is the most common malignant tumor among adult men worldwide andthe second most common cause of cancer death. Gleason grading system is a powerful predictor in theprognosis and treatment outcome of prostate carcinoma.@*OBJECTIVE@#This retrospective study aims to evaluate the accuracy of transrectal ultrasound (TRUS)-guided biopsy of the prostate compared to radical prostatectomy specimen in predicting thepathological grading of prostate adenocarcinoma using the Gleason scores between specimens.@*METHODS@#This is a review of 69 patients who underwent radical prostatectomy due to prostate cancerin 2010-2015. The Gleason scores of the transrectal ultrasound biopsies were compared with thesurgical specimen.@*RESULTS@#The biopsy Gleason scores obtained from the TRUS biopsy and the radical prostatectomyspecimens were similar in 79.7% of the cases. In patients with moderately differentiated tumors onbiopsy (Gleason score of 5 to 7), the concordance rate was 83% with upgrading after surgery in 16%of the cases. In poorly-differentiated tumors on biopsy (Gleason score of 8 to 10), 74% revealed thesame score on histopathological examination after radical prostatectomy, while 25% of the caseswere given lower Gleason scores after operation. Overall, 20.3% cases were discrepant by 1 or moreGleason scores after radical prostatectomy. There was a good histopathological correlation betweenTRUS biopsy and prostatectomy specimen {AUC =0.787(p=0.001)}.@*CONCLUSION@#The overall accuracy of Gleason score on transrectal ultrasound-guided biopsies inpredicting prostatectomy specimen grade is favorable. It plays a significant role in clinical decisionmaking of patients with prostate carcinoma.
ABSTRACT
Electrical stimulators as a substitute to lower urinary tract function are relatively expensive and not available locally. A local prototype electrical stimulator was used in the spinal shock phase of cats to determine its effectivity based on adequate bladder evacuation, return of detrusor activity and complications. Spinal shock was surgically induced in eighteen male domestic cats, then they were randomly assigned to intermittent catheterization and electrical stimulation. Electrical stimulation of the spinal sacral roots resulted in earlier urination. Residual urine volume determined by catheterization revealed that adequate bladder evacuation was achieved. Moreover urinary tract integrity was maintained in the cats undergoing electrical stimulationThese findings showed that the local prototype electrical stimulator is effective.
Subject(s)
Cats , Urinary BladderABSTRACT
Accurate preoperative evaluation of the inferior vena cava and renal vein for uroflourecent in patients with renal malignancy is important in planning a successful surgical approach. The presence of venous extension may alter anesthetic and transfusion requirements as well as the addition of a vascular surgeon to the operative team. Traditionally, venacavography has been considered as the most reliable method of identifying tumor thrombus; although doppler ultrasound has been proposed as a non-invasive alternative. We have compared these two procedures in a limited study of five (5) subjects with renal malignancy who subsequently underwent nephrectomy. Venacavography was able to correctly identify thrombus extension in all cases (2 true positives and 3 true negatives). Sensitivity, specificity, accuracy, and positive and negative predictive values were 100%. Doppler ultrasound on the other hand had a false positive and no false negative. Sensitivity 66%, specificity 66%, accuracy 80%, positive predictive value 66%, and negative predictive value 100%.