Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 14 de 14
Filter
4.
Int. braz. j. urol ; 45(4): 775-781, July-Aug. 2019. tab, graf
Article in English | LILACS | ID: biblio-1019893

ABSTRACT

ABSTRACT Purpose To identify how the most frequently used parameters in daily clinical practice diagnosing bladder outlet obstruction (BOO) due to benign prostate hyperplasia (BPH) correlate to each other. Materials and methods The study included 452 patients with lower urinary tract symptoms (LUTS) of the UNICAMP urology outpatient clinic of LUTS. Inclusion criteria: patients with BOO due to BPH who agreed to participate in the study. Exclusion criteria: patients with urinary tract infection, neurological diseases that compromised the lower urinary tract, prior prostatic surgery, radiotherapy or urethral stenosis. Patient assessment: history, international prostate symptoms score (IPSS), nocturnal quality of life score (NQoL) questionnaires, physical and digital rectal examination (DRE), PSA, transabdominal ultrasound with intravesical prostate protrusion (IPP), post-mictional residue and free uroflowmetry. Results There was no strong Spearman correlation among the studied variables. The only moderate correlations occurred between IPSS and NQoL (p <0001; c=0.56) and between IPP and prostate volume (p <0001; c=0.57). Weak correlations between IPP and post-mictional residue (p <0001; c=0.31) and free uroflowmetry (p <0001; c=-0.26); and between IPSS and free uroflowmetry (p <0001, c=-0.21) were observed. Conclusion In this study, we found moderate, weak, very weak and absent correlation among the various parameters used in the diagnosis and management of BOO due to BPH. As the value of these tools is variable, the creation of a logical and objective algorithm was not possible and the treatment is based on the interpretation of clinical symptoms.


Subject(s)
Humans , Male , Adult , Aged , Aged, 80 and over , Prostatic Hyperplasia/diagnosis , Urinary Bladder Neck Obstruction/diagnosis , Lower Urinary Tract Symptoms/diagnosis , Organ Size , Prostate/pathology , Prostatic Hyperplasia/physiopathology , Prostatic Hyperplasia/pathology , Quality of Life , Reference Standards , Urination/physiology , Urodynamics/physiology , Urinary Bladder Neck Obstruction/physiopathology , Urinary Bladder Neck Obstruction/pathology , Surveys and Questionnaires , Regression Analysis , Ultrasonography/methods , Statistics, Nonparametric , Digital Rectal Examination , Lower Urinary Tract Symptoms/physiopathology , Lower Urinary Tract Symptoms/pathology , Middle Aged
6.
Int. braz. j. urol ; 43(6): 1129-1135, Nov.-Dec. 2017. tab
Article in English | LILACS | ID: biblio-892915

ABSTRACT

ABSTRACT Objective: To evaluate the overactive bladder (OAB) diagnosis using OAB-V8 and ICIQOAB questionnaires in women with different schooling and cultural levels. Materials and Methods: Three hundred and eighty six healthy women answered a clinical questionnaire filling out information about schooling, demographic and gynecological data. The OAB-V8 and ICIQ-OAB questionnaires were used to evaluate OAB diagnosis and symptoms; and the QS-F questionnaire, to determine the sexual function. All questionnaires were validated in Portuguese. Results: The mean age was 37.3 years-old. Regarding to schooling level, 23.1% had concluded primary education; 65.8%, secondary school; and 11.1% had higher education. Considering the OAB-V8 (score ≥8), 51.8% of evaluated women had OAB diagnosis. There was a positive linear correlation between the OAB-V8 and ICIQ-OAB questionnaires in its sections "a" (r=0.812, p<0.001) and "b" (r=759, p<0.001). There was a positive linear correlation between age and the amount of time used to answer the OAB-V8, ICIQ-OAB and QS-F questionnaires (p<0.001). The ICIQ-OAB was the hardest to answer for all schooling levels when compared to the other questionnaires. Women who had concluded primary and secondary education significantly demanded more help to answer all questionnaires than those with higher education (p<0.05). Furthermore, women with higher education took significantly less time answering all questionnaires when compared to their less educated counterparts (primary and secondary schooling), since they were quicker to answer each individual question. Conclusion: Educational level and ageing had an impact on women response using different questionnaires for OAB and sexual function evaluations.


Subject(s)
Humans , Female , Adult , Social Class , Educational Status , Urinary Bladder, Overactive/diagnosis , Surveys and Questionnaires
7.
Int. braz. j. urol ; 42(5): 1028-1032, Sept.-Oct. 2016. graf
Article in English | LILACS | ID: lil-796899

ABSTRACT

ABSTRACT Report case (s) relevant aspects: Man, 27 years old, complaining of acute testicular pain by 2 hours in the remaining left testicle. Denies fever, lower urinary tract symptoms such as dysuria, urinary frequency, concommitant or prior urethral discharge to the painful condition. He underwent right orchiectomy 13 years ago by testicular torsion. He is a chronic user of cocaine for 15 years and during the last three days the drug use was continuous and intense. Proposed premise substantiating case (s) description: Initial diagnostic hypothesis: Syndromic: Acute Scrotum Syndrome (SEA) Main Etiologic (testicular torsion) Secondary Etiologic (acute orchiepididymitis) Briefly delineates what might it add? Lines of research That Could be Addressed: In this challenging clinical case we presented an alternative and new etiologic diangosis for the acute scrotum which the main etiologic factor remains testicular torsion. This new diangosis is acute testicular ischemia as a complication of cocaine abuse.


Subject(s)
Humans , Male , Adult , Scrotum/blood supply , Testicular Diseases/etiology , Testis/blood supply , Cocaine-Related Disorders/complications , Acute Pain/etiology , Ischemia/etiology , Scrotum/pathology , Spermatic Cord Torsion/pathology , Testicular Diseases/pathology , Testis/pathology , Vasoconstrictor Agents/poisoning , Cocaine/poisoning , Diagnosis, Differential , Ischemia/pathology
8.
Int. braz. j. urol ; 41(2): 344-352, Mar-Apr/2015. tab, graf
Article in English | LILACS | ID: lil-748291

ABSTRACT

Purpose To compare dietary, lifestyle, clinical, anthropometric, genetic and prostatic features of Brazilian Indians and non-Indians (Amazon). Methods 315 men, 228 Indians and 89 non-Indians, ≥40 years old were submitted to digital rectal examination, serum prostate specific antigen (PSA), testosterone, TP53 and GSTP1 genotyping, anthropometric, lifestyle, dietary, personal and familial medical history. Prostatic symptoms were evaluated with the International Prostate Symptom Score (IPSS). Results Macuxis and Yanomamis represented 43.6% and 14.5% of Indians respectively who spontaneously referred no prostate symptoms. Mean IPSS was 7, range 3-19, with only 15% of moderate symptoms (score 8-19); Mean age was 54.7 years, waist circumference 86.6 cm, BMI 23.9 kg/m2. Yanomamis presented both lower BMI (21.4 versus 24.8 and 23.3, p=0,001) and prostate volume than Macuxis and “other ethnic groups” (15 versus 20, p=0.001). Testosterone (414 versus 502 and 512, p=0.207) and PSA (0.48 versus 0.6 and 0.41, p=0.349) were similar with progressive PSA increase with aging. Val/Val correlated with lower PSA (p=0.0361). Indians compared to control population presented: - TP53 super representation of Arg/Arg haplotype, 74.5% versus 42.5%, p<0.0001. -GSTP1 Ile/Ile 35.3% versus 60.9%; Ile/Val 45.9% versus 28.7%; Val/Val 18.8% versus 10.3%; p=0.0003. Conclusions Observed specific dietary, lifestyle, anthropometric and genetic profile for TP53 and GSTP1 may contribute to Brazilian Indian population prostate good health. .


Subject(s)
Adult , Aged , Aged, 80 and over , Humans , Male , Middle Aged , Anthropometry , Indians, South American/statistics & numerical data , Prostate/anatomy & histology , Prostatic Diseases/ethnology , Prostatic Diseases/genetics , Age Factors , Brazil , Digital Rectal Examination , Feeding Behavior/ethnology , Glutathione S-Transferase pi/genetics , Life Style/ethnology , Organ Size , Polymorphism, Genetic , Prostate-Specific Antigen/blood , Risk Factors , Statistics, Nonparametric , /genetics
9.
Int. braz. j. urol ; 39(6): 779-792, Nov-Dec/2013. tab, graf
Article in English | LILACS | ID: lil-699128

ABSTRACT

Purpose To analyze controversial clinicopathologic predictors of biochemical recurrence after surgery: age, race, tumor extent on surgical specimen, tumor extent on needle biopsy, Gleason score 3 + 4 vs 4 + 3, and amount of extent of extraprostatic extension and positive surgical margins. Materials and Methods The needle biopsies and the correspondent surgical specimens were analyzed from 400 patients. Time to recurrence was analyzed with the Kaplan-Meier curves and risk of shorter time to recurrence using Cox univariate and multivariate analysis. Results Except for age, race, maximum percentage of cancer per core, and number of cores with cancer, all other variables studied were significantly predictive of time to biochemical recurrence using the Kaplan-Meier curves. In univariate analysis, except for focal extraprostatic extension, age, race, focal positive surgical margins, and maximum extent and percentage of cancer per core, all other variables were significantly predictive of shorter time to recurrence. On multivariate analysis, diffuse positive surgical margins and preoperative PSA were independent predictors. Conclusions Young patients and non-whites were not significantly associated with time to biochemical recurrence. The time consuming tumor extent evaluation in surgical specimens seems not to add additional information to other well established predictive findings. The higher predictive value of Gleason score 4 + 3 = 7 vs 3 + 4 = 7 discloses the importance of grade 4 as the predominant pattern. Extent and not simply presence or absent of extraprostatic extension should be informed. Most tumor extent evaluations on needle biopsies are predictive of time to biochemical recurrence, however, maximum percentage of cancer in all cores was the strongest predictor. .


Subject(s)
Adult , Aged , Humans , Male , Middle Aged , Neoplasm Recurrence, Local/pathology , Prostate/pathology , Prostatectomy/methods , Prostatic Neoplasms/pathology , Prostatic Neoplasms/surgery , Age Factors , Biopsy, Needle , Brazil , Kaplan-Meier Estimate , Neoplasm Grading , Neoplasm Recurrence, Local/blood , Predictive Value of Tests , Prognosis , Prostate-Specific Antigen/blood , Prostatic Neoplasms/blood , Reference Values , Retrospective Studies , Time Factors
10.
Int. braz. j. urol ; 39(3): 320-327, May/June/2013. tab, graf
Article in English | LILACS | ID: lil-680089

ABSTRACT

Objective There is evidence that reactive stroma in different cancers may regulate tumor progression. The aim of this study is to establish any possible relation of reactive stroma grading on needle prostatic biopsies to biochemical recurrence. Materials and Methods The study group comprised 266 biopsies from consecutive patients submitted to radical prostatectomy. Reactive stroma was defined as stroma surrounding neoplastic tissue and graded as 0 (absent), 1 (slight), 2 (moderate), and 3 (intense) according to tumor stroma area relative to total tumor area. Results From the total of 266 needle prostatic biopsies, 143 (53.8%), 55 (20.7%), 54 (20.3%), and 14 (5.3%) showed grades 0, 1, 2, and 3, respectively. Increasing reactive stroma grade was significantly associated with clinical stage T2, higher preoperative PSA, higher biopsy and radical prostatectomy Gleason score, more extensive tumors in radical prostatectomy, and pathologic stage > T2. Only grade 3 was significantly associated with time and risk to biochemical recurrence. On multivariate analysis only preoperative PSA and 2 methods of biopsy tumor extent evaluation were independent predictors. Conclusion Increasing reactive stroma grade on biopsies is significantly associated with several clinicopathologic adverse findings, however, only grade 3 predicts time and risk to biochemical recurrence following radical prostatectomy on univariate but not on multivariate analysis. We have not been able to show that reactive stroma grade 3 on biopsies is an independent predictor of biochemical recurrence beyond that of preoperative PSA and other pathologic findings on biopsy. .


Subject(s)
Aged , Humans , Male , Middle Aged , Adenocarcinoma/pathology , Neoplasm Recurrence, Local/pathology , Prostate/pathology , Prostatectomy/methods , Prostatic Neoplasms/pathology , Stromal Cells/pathology , Biomarkers, Tumor/analysis , Biopsy, Fine-Needle/methods , Disease Progression , Neoplasm Grading , Predictive Value of Tests , Prostate-Specific Antigen/blood , Risk Factors , Survival Analysis , Time Factors , Treatment Outcome
11.
Int. braz. j. urol ; 39(3): 328-334, May/June/2013. tab
Article in English | LILACS | ID: lil-680090

ABSTRACT

Purpose Little is known about the effects of literacy levels on prostate cancer screening. This study evaluates the association between literacy, compliance with screening, and biopsy findings in a large Brazilian screening study. Materials and Methods We analyzed 17,571 men screened for PCa with digital rectal examination (DRE) and total and free prostate-specific antigen (PSA) from January 2004 to December 2007. Of those, 17,558 men had information regarding literate status. Full urological evaluation in a specialized cancer center was recommended in the case of: a) suspicious DRE, b) PSA > 4.0 ng/mL, or c) PSA 2.5-3.9 ng/mL and free/total PSA (f/tPSA) ratio < 15%. Transrectal ultrasound guided prostate biopsy (14 cores) was performed upon confirmation of these findings after the patient's consent. Patients' compliance with screening recommendations and biopsy results were evaluated according to literacy levels. Results an abnormal PSA, a suspicious DRE, or both were present in 73.2%, 19.7%, and 7.1% of those men who underwent biopsy, respectively. PCa was diagnosed in 652 men (3.7%). Previous PSAs or DREs were less common among illiterate men (p < 0.0001). Additionally, illiterate men were less prone to attend to further evaluations due to an abnormal PSA or DRE (p < 0.0001). PSA levels > 10 mg/mL (p = 0.03), clinical stage > T2a (p = 0.005), and biopsy Gleason > 7 (p = 0.02) were more common among illiterate men. Conclusions In a screened population, literacy levels were associated with prior PCa evaluations and with compliance with screening protocols. Illiterate men were at higher risk of being diagnosed with more advanced and aggressive PCa. .


Subject(s)
Aged , Aged, 80 and over , Humans , Male , Middle Aged , Health Literacy , Mass Screening/methods , Prostatic Neoplasms/diagnosis , Biopsy , Brazil , Digital Rectal Examination , Educational Status , Neoplasm Grading , Predictive Value of Tests , Prostate-Specific Antigen/blood , Prostatic Neoplasms/pathology , Risk Factors
12.
Int. braz. j. urol ; 38(2): 175-184, Mar.-Apr. 2012. ilus, tab
Article in English | LILACS | ID: lil-623331

ABSTRACT

PURPOSE: The amount of extraprostatic extension and positive surgical margin correlates in most studies with biochemical recurrence following radical prostatectomy. We studied the influence of focal and diffuse extraprostatic extension and positive surgical margins on biochemical progression using a simple method for quantification. MATERIALS AND METHODS: A total of 360 prostates were step-sectioned and totally processed from 175 patients with stage T1c and 185 patients with clinical stage T2 submitted to radical retropubic prostatectomy. Extraprostatic extension was stratified into 2 groups: present up to 1 quadrant and/or section from the bladder neck or apex (Group 1, focal) and in more than 1 quadrant or section (Group 2, diffuse); and, positive surgical margin present up to 2 quadrants and/or sections (Group 1, focal) and in more than 2 quadrants or sections (Group 2, diffuse). The Kaplan-Meier product-limit analysis was used for the time to biochemical recurrence, and an univariate and multivariate Cox stepwise logistic regression model to identify significant predictors. RESULTS: Extraprostatic extension was found in 129/360 (35.8%) patients, 39/129 (30.2%) in Group 1 and 90/129 (69.8%) in Group 2. In univariate analysis but not in multivariate analysis, patients showing diffuse extraprostatic extension (Group 2) had a significant higher risk to develop biochemical recurrence in a shorter time. Positive surgical margin was present in 160/360 (44.4%) patients, 81/160 (50.6%) patients in Group 1 and 79/160 (49.4%) patients in Group 2. Patients with diffuse positive surgical margins (Group 2) had a significant higher risk in both univariate and multivariate analyses. Diffuse positive surgical margin was the strongest predictor on both analyses and an independent predictor on multivariate analysis. CONCLUSION: Diffuse extraprostatic extension in univariate analysis and positive surgical margins on both univariate and multivariate analyses are significant predictors of shorter time to biochemical progression following radical prostatectomy.


Subject(s)
Aged , Humans , Male , Middle Aged , Neoplasm Recurrence, Local , Prostate-Specific Antigen/blood , Prostatectomy/methods , Prostatic Neoplasms/pathology , Prostatic Neoplasms/surgery , Kaplan-Meier Estimate , Neoplasm Invasiveness , Neoplasm, Residual , Organ Size , Prostate/pathology , Prostatic Neoplasms/blood , Retrospective Studies , Seminal Vesicles/pathology
13.
Int. braz. j. urol ; 34(6): 725-733, Nov.-Dec. 2008. tab
Article in English | LILACS | ID: lil-505653

ABSTRACT

INTRODUCTION: In the case of clinically negative inguinal regions in penile cancer, the treatments proposed might vary from careful observation to radical dissection for all patients. We evaluated the effectiveness of the sentinel lymph node biopsy using lymphoscintigraphy in patients with penile cancer and at least one negative inguinal region. MATERIALS AND METHODS: In 18 patients, biopsy of the sentinel lymph node from the 32 negative inguinal regions and modified radical lymphadenectomy in these regions regardless of the biopsy results was performed. Clinical staging, pathological results of the sentinel and the other lymph nodes removed during lymphadenectomy, tumor behavior, local and inguinal recurrence and specific disease mortality were accessed. RESULTS: The mean age of the study sample was 57.7 years (44 - 81 years) and the sentinel lymph node presented 0 percent false negative 66 percent sensitivity, and 79.3 percent specificity when compared with the modified inguinal lymphadenectomy as the gold standard treatment. CONCLUSION: Sentinel lymph node biopsy is a feasible method of assessing the presence of regional metastasis in patients with penile cancer and clinically negative inguinal regions. However, the optimal lymphoscintigraphy technique is still in evolution and requires further optimization at high volume centers.


Subject(s)
Adult , Aged , Aged, 80 and over , Humans , Male , Middle Aged , Lymph Node Excision/methods , Penile Neoplasms/pathology , Penis/pathology , Sentinel Lymph Node Biopsy/methods , Lymph Nodes/pathology , Lymph Nodes , Lymph Nodes/surgery , Neoplasm Staging , Prospective Studies , Penile Neoplasms/surgery , Penis/surgery , Sensitivity and Specificity
14.
Int. braz. j. urol ; 34(5): 627-637, Sept.-Oct. 2008. ilus, graf, tab
Article in English | LILACS | ID: lil-500399

ABSTRACT

OBJECTIVE: Pressure-flow study is the gold standard for diagnosis of bladder outlet obstruction (BOO). A prospective study was carried out to compare urodynamic evaluation and measurement of intravesical protrusion of the prostate for diagnosing BOO. MATERIALS AND METHODS: Patients presenting with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia and suspected BOO were prospectively evaluated through conventional urodynamics and classified according to the bladder outlet obstruction index (BOOI). They also underwent abdominal ultrasound measurement of the intravesical prostatic protrusion (IPP) and prostatic volume. The IPP was classified into three stages: grade I under 5 mm; grade II, between 5 and 10 mm; and grade III over 10 mm. RESULTS: Forty-two patients, mean age 64.8 ± 8.5 years were enrolled. Transabdominal ultrasound determined a mean prostatic volume of 45 ± 3.2 mL. Achieved IPP's values were the following: grade I - 12 (28.5 percent), grade II - 5 - (12 percent) and grade III - 25 (59.5 percent). The results of prostate volume differed significantly between obstructed and non-obstructed men (p = 0.033) and for IPP among obstructed, inconclusive and non-obstructed men (p = 0.016). For IPP, the area under ROC curve was 0.758 (95 percent confidence interval - 0.601 to 0.876), and the cutoff point to indicate BOO was 5 mm with 95 percent sensitivity (75.1 - 99.2) and 50 percent specificity (28.2 - 71.8). CONCLUSION: IPP and prostatic volume measured through abdominal ultrasound are noninvasive and accessible methods that significantly correlate to urinary BOO, and are useful in the diagnosis of male urinary obstructive problems.


Subject(s)
Aged , Humans , Male , Middle Aged , Prostatic Hyperplasia , Urinary Bladder Neck Obstruction/diagnosis , Predictive Value of Tests , Prospective Studies , Prostatic Hyperplasia/complications , Sensitivity and Specificity , Urodynamics , Urinary Bladder Neck Obstruction/etiology , Urinary Bladder Neck Obstruction
SELECTION OF CITATIONS
SEARCH DETAIL