ABSTRACT
@#Adenocarcinoma represents 0.5 to 2% of all malignant tumors of the bladder, and the mucinous subtype is extremely rare as a primary vesical lesion. This is the case of a 50-year-old male who presented with dysuria with occasional hematuria, underwent cystoscopy, transurethral resection of the bladder tumor, with the subsequent diagnosis of Mucinous adenocarcinoma of the bladder. He then completed neoadjuvant chemotherapy but eventually underwent cystoprostatectomy, urethrotomy with extended bilateral pelvic lymph node dissection due to tumor progression.
ABSTRACT
OBJECTIVE@#To provide an overview on the impact of healthcare disruption by the COVID-19 pandemic to urology training programs in the Philippines.@*METHODS@#A survey questionnaire was used in collaboration with the study done by Rosen, et al. last May 2020. Telephone survey of the study population was done determining the status of resident staffing, workload, health/wellness, and didactics. Numerical and categorical data were analyzed and descriptive statistics are provided.@*RESULTS@#All the observations on resident time in the workplace, including assignment to teams (81%), redeployment responses (55-97%), and remote clinical work (65%) were significant. Fifty one percent of residents have decreased research load. Eighty one percent have didactics in small groups. Fifty-five percent have 1 to 2 Video-based learning/conferences per week (p=0.007) followed by those with 3-4 with 98% (p=0.120) and those with >5 with only 6% (p=0.729). For Resident health and wellness, 87% of the residents were exposed to COVID-positive patients, but only 8% of residents were COVID positive (p=0.591). Lastly, 59% of the participants do not have access to wellness programs.@*CONCLUSION@#Data from respondents revealed significant changes in the different aspects of the present study. Urology residents spent more time away from their specialties, and have been re-deployed to COVID-19 floors. Ambulatory services, conferences, educational lectures have mostly shifted to virtual platforms. Resident concerns for COVID-19 exposure have been addressed properly; however, wellness programs have not been widely available for residents. As a first national survey, the present study may give significant insights on program changes and may be used as preliminary data for future studies.
Subject(s)
PhilippinesABSTRACT
@#Adenocarcinoma represents 0.5 to 2% of all malignant tumors of the bladder, and the mucinous subtype is extremely rare as a primary vesical lesion. The patient is a case of a 50-year-old male who initially presented with dysuria with occasional hematuria. A CT scan was done and showed bladder new growth. Cystoscopy Transurethral Resection of the bladder tumor was done revealing mucinous adenocarcinoma of the bladder. He then completed neoadjuvant chemotherapy with Pacitaxel and Cisplatin for 4 cycles, however repeat CT scan with contrast post chemotherapy showed progression of the adenocarcinoma. Due to the possibility of a primary lesion in the gastrointestinal tract, colonoscopy was performed revealing sessile serrated adenoma, as were tumor markers CA 19-9, CA 125, alpha-fetoprotein, and CEA, all of which without any abnormal results. He eventually underwent cystoprostatectomy and urethrectomy with extended bilateral pelvic lymph node dissection. The margins and lymph nodes were negative for tumor invasion. Adenocarcinoma is diagnosed mainly on histopathology and with the help of Immunohistochemistry (IHC). Once the diagnosis is confirmed, the radical surgery should be advised which could improve survival and disease progression.