A prospective observational study to evaluate the role of restaging transurethral resection of bladder tumour in patients with non-muscle invasive bladder cancer

Background: Transurethral resection of bladder tumour (TURBT) is the primary treatment modality for Non-muscle invasive bladder cancer (NMIBC). Restaging transurethral resection of bladder tumour (RETURBT) is indicated to reduce risk of residual disease and correct staging errors after primary TURBT. The aim of the study is to evaluate the risk of residual tumour and upstaging in NMIBC after TURBT and to investigate the risk factors for the same.Methods: A prospective observational study was carried out over 4 years and 87 patients were included in the study. Patients with NMIBC underwent RETURBT after 2-6 weeks of primary TURBT. The incidence of residual tumour and upstaging in RETUBRT was correlated with various histopathological and morphological parameters in primary TURBT.Results: Out of 87 patients, who underwent RETURBT, residual disease was present in 51 patients (58.6%) and upstaging occurred in 22 patients (25.2%).On univariate analysis, T1 stage (p=0.01), high grade (p=0.01), Carcinoma in situ(CIS) (p=0.01) and multifocality (p=0.05) were predictive for residual disease in RETURBT. High grade (p=0.01), CIS (p=0.01) and absence of detrusor muscle in specimen (p=0.03) were risk factors for upstaging in RETURBT.Conclusions: NMIBC have high incidence of residual disease and upstaging after primary TURBT. T1 stage, high tumour grade, CIS, and multifocality are risk factors for residual disease after primary TURBT. High tumour grade, CIS and absence of detrusor muscle are strongly associated with upstaging during RETURBT

Comparison of Visual Prostate Symptom Score and International Prostate Symptom Score in the evaluation of men with benign prostatic hyperplasia: A prospective study from an Indian population

Background: Lower urinary tract symptoms (LUTSs) due to benign prostatic hyperplasia (BPH) are common conditions in middle-age or older men. The International Prostate Symptom Score (IPSS) is a useful and validated questionnaire to evaluate LUTS secondary to BPH. Van der Walt et al have developed an alternative questionnaire named the Visual Prostate Symptom Score (VPSS) questionnaire. This study aimed to evaluate the relationship between the VPSS and IPSS in the evaluation of men with LUTSs due to BPH in an Indian population. Materials and methods: This was a prospectively designed study conducted at Sri Sathya Sai Institute of Higher Medical Sciences, Prashanthigram (Anantapur, Andhra Pradesh, India). A total of 121 patients who presented to the urology outpatient department with LUTS due to BPH were enrolled in the study. Patients were followed up at 1-month and 3-month intervals. All patients were given both questionnaires. The correlation test was used to assess the correlation between two symptom scores and various parameters. Observations with a P value < 0.05 were considered statistically significant. Results: There was a statistically significant difference in the number of patients requiring assistance to fill the questionnaires according to their education level. There was a positive correlation between IPSS total score and VPSS total score (r = 0.7235; P < 0.0001), VPSS total score and VPSS quality of life (Qol; r = 0.70753; p < 0.0001), IPSS total versus IPSS Qol (r = 0.65583; P < 0.0001), and IPSS Qol versus VPSS Qol (r = 0.84093; P < 0.0001). A negative correlation was observed between total VPSS with Qmax, total IPSS with Qmax, IPSS total versus Qavg (r = −0.479; P < 0.0001), and VPSS total versus Qavg (r = −0.5; P < 0.0001). All VPSS questions showed statistically significant correlation with the corresponding IPSS questions. Conclusion: There is a statistically significant correlation between the VPSS and IPSS and it can be completed by a greater number of patients without assistance