Reliability and validity of the National Institutes of Health Chronic Prostatitis Symptom Index questionnaire in the Turkish Population

Background/aim: To develop the first Turkish version of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH- CPSI) questionnaire and to investigate its validity and reliability in men with chronic prostatitis/chronic pelvic pain syndrome (CP/ CPPS) and healthy controls. Material and methods: A total of 204 patients, 116 CP/CPPS and a control group which consisted of 88 healthy individuals were included in this prospective study. The NIH-CPSI form was first translated into Turkish and later on back into English. Using the Turkish version of the NIH CPSI, 40 patients completed the same questionnaires twice at 2-week intervals for test-retest concordance. To evaluate internal consistency and test-retest reliability, Cronbach's alpha value, and the Spearman correlation test were utilized respectively. Results: Our findings demonstrated statistically significant differences in NIH-CPSI scores between the patients and control groups (P <0.001). Cronbach's alpha coefficient value of NIH-CPSI was 0.864. Reliability of test-retest was 0.909 (P <0.001). Additionally, the Spearman correlation test showed that the results obtained using the Turkish NIH-CPSI were significantly correlated. Conclusion: The first Turkish version of the NIH-CPSI was found to be a reliable and valid instrument for Turkish patients with chronic prostatitis in both clinical and research settings.

Prostate volume effect on Gleason score upgrading in active surveillance appropriate patients.

INTRODUCTION: Gleason Score (GS) upgrading rates in the literature are reported to be around 33-45%. The relationship between prostate volume and GS upgrading should be defined, aiming to reduce upgrading rates in patients with low risk groups who are eligible for active surveillance (AS) or minimally invasive treatment, by varying biopsy cores, or lengths of cores according to prostate volumes. In this regard, the aim of our study was to establish the relationship between prostate volume and GS upgrading. MATERIALS AND METHODS: We retrospectively analyzed the medical records of 78 patients, who were appropriate for AS between 2011-2016 at our hospital. Inclusion criteria were patient age under 65 years, PSA level under 10 ng/ml, GS (3 + 3) or (3 + 4), and 3 or less positive cores, clinical stages ≤ T2. GS increase in radical prostatectomy specimen was considered as 'upgrading' and in addition, score reported by biopsy as 3 + 4 but in surgical specimen as 4 + 3 were also considered as 'upgrading'. The effect of prostate volume on Gleason grade upgrading was examined by calculating upgrading rates separately for patients with prostate volume 30 ml or less, those with 30 to 60 ml, and those over 60 ml. RESULTS: As a result of the analysis of the data, upgrading was seen in 35 (44.8%) of 78 patients included in the study. In the cohort mean prostate volume was 49.8 (± 26.3) ml. Twenty-two patients (28.2%) had prostate volume 30 ml or less, 34 (43.6%) 30 to 60 ml, and 22 (28.2%) 60 ml or more. The patients were divided into two groups as those with and without GS upgrading. Between the groups prostate volume and prostate volume range (0-30/31-60/> 60) were not significantly different (p value > 0.05). CONCLUSIONS: Gleason grade upgrading causes patients to be classified in a lower risk group than they actually are, and may lead to inappropriate treatment. This condition has a direct effect on the decision of active surveillance. Therefore, it is important to define the factors that can predict GS upgrading in active surveillance appropriate patients. In this study, we found that prostate volume has no significant effect on upgrading in active surveillance appropriate patients.

The role of anticholinergic therapy based on the upoint system in the treatment of chronic prostatitis.

OBJECTIVE: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common problem and severely impairs the quality of life (QoL). We aimed to investigate the effects of different treatment options on voiding symptoms and QoL in patients with urinary phenotype according to the UPOINT system. Matherial and methods: Ninety-six patients with NIH category II,III CP/CPPS were included in the study prospectively. After the diagnosis, the questionnaires including NIH Chronic prostatitis Symptom Index (NIH-CPSI), International Prostate Symptom Score (IPSS), Overactive Bladder Screening Questionnaire (OAB-V8), and Beck depression inventory were filled by the patients. The patients with urinary phenotype were treated by alpha-blocker, antimuscarinic or both therapy modalities (combined) considering the specific therapy recommendations by UPOINT. The questionnaires applied on the first visit were reapplied after one month and treatment success was evaluated. RESULTS: Seventy-three patients were included in 'Urinary phenotype' group (76%) and 23 were included in 'other phenotypes' (24%) group of the patients according to the UPOINT classification. Significant improvements of symptoms were observed with the all treatment modalities when the NIH-CPSI, IPSS and OAB-V8 scores were compared before and after treatment in the 'Urinary phenotype' group. Significant differences in the percentage of change in values were obtained in the anticholinergic group for pain subdomain of NIH-CPSI and IPSS scores. CONCLUSION: U-POINT clasification is useful for deciding on the treatment modality in CP/CPSS patients. We showed anticholinergic therapy might be effective option. Addition to the symptomatic recovery, there is need more further studies about effectivity cholinergic system in the prostate tissue.

Reliability and validity of the Bladder and Bowel Dysfunction Questionnaireamong Turkish children

Background/aim: We developed a Turkish version of the Bladder and Bowel Dysfunction Questionnaire (BBDQ) and evaluated its psychometric properties among Turkish pediatric patients.Materials and methods: The BBDQ was translated into Turkish and then it was back-translated into English. A total of 193 patients were asked to complete the Turkish version of the BBDQ as well as the Dysfunctional Voiding and Incontinence Scoring System (DVISS). In addition, 39 children completed the same questionnaires twice at 2-week intervals for test/retest evaluation.Results: Cronbach's alpha coefficient of the BBDQ was 0.727. Reliability of the test/retest was 0.759 (P < 0.001). Area under the curve of the receiver operating characteristic plot was 0.765. There were statistically significant differences in BBDQ scores between the controls and patients (P < 0.001). Analysis demonstrated moderate convergent validity against the DVISS (r: 0.78, r2: 0.601, P < 0.0001).Conclusion: The Turkish version of the BBDQ is a reliable and valid instrument for Turkish pediatric patients with bladder and bowel dysfunction in clinical and research settings.

Bladder cancer and polymorphisms of DNA repair genes (XRCC1, XRCC3, XPD, XPG, APE1, hOGG1).

Carcinogenic molecules from cigarettes are known to cause DNA damage to bladder epithelial cells, but such damage can be corrected by some DNA repair mechanisms such as base and nucleotide excision repair, double-strand repair and mismatch repair. Various gene products play a role in these DNA repair systems. The aim of this study was to investigate six of these genes (XRCC1, XRCC3, XPD, XPG, APE1, hOGG1) each of which has a separate role in these repair mechanisms. The study was performed on 83 bladder cancer patients and 45 healthy controls. The genes were amplified by polymerase chain reaction (PCR) and restriction fragment polymorphism determinations were used to elucidate the specific changes in the gene region. There was no difference in smoking status between patient and control groups. It was found that there was a statistical significance in XRCC3 T carriers between patient and control groups and so there was a 4.87-fold protective role by the XRCC3 T allele against bladder cancer. The AA genotype and A allele carriers of the APE gene were more frequent in the transitional epithelial carcinoma group than in the adenocarcinoma group. The genotype distribution for the APE gene was determined to be significantly different between local and invasive cases; G allele carriers for this gene were significantly higher in invasive cancer types.