Case Report: High-grade anterior prostate cancer previously undetected by transrectal biopsy, diagnosed with MRI-US fusion transperineal robotic prostate biopsy [version 1; peer review: 2 approved]

Seventy percent of anterior prostate cancer cases are diagnosed during rebiopsy. MRI-US fusion transperineal robotic prostate biopsy is an emerging diagnostic method and might be an effective one in diagnosing prostate cancers in difficult sites such as the anterior zone. We report a case of a high grade anterior prostate cancer previously undetected by transrectal biopsy, diagnosed with MRI-US fusion transperineal robotic prostate biopsy. This case report suggests that MRI-US fusion transperineal robotic prostate biopsy might be valuable in diagnosing prostate cancer especially in difficult sites – the anterior region in this case – and might be an imperative diagnostic method in suspicious cases with prior negative biopsy

Prevalence of Urinary Incontinence, Risk Factors and Its Impact: Multivariate Analysis from Indonesian Nationwide Survey

Aim: to describe the profile of urinary infection (UI) and to analyze its risk factors and impacts. Methods: subjects were enrolled consecutively from pediatric, urology, obstetrics & gynecology, and geriatric outpatient clinics at six teaching hospitals in various regions of Indonesia. Those with urinary tract infection and diabetes mellitus were excluded. The UI questionnaire was adapted from the 3 Incontinence Questions (3IQ). Written informed consent was obtained prior to the interview. Results: about 2765 completed questionnaires were obtained. The overall UI prevalence was 13.0%, which consisted of prevalence of stress UI (4.0%), urgency UI/wet OAB (4.1%), dry OAB (1.6%), mixed UI (1.6%), overflow UI (0.4%), enuresis (0.4%), other UI (0.7%). The prevalence of UI was significantly higher (p0.05) between male and female subjects. Enuresis and urgency UI/wet OAB were the most common UI in pediatric population. The prevalence was 2.3% and 2.1% respectively. Urgency UI and stress UI were the two most common type in adult and geriatric population. Both have an equal prevalence of 4.6%. The multivariate analysis showed that the prevalence of UI increased with LUTS (PR 4.22, 95%CI 2.98-5.97), chronic cough (PR 2.08, 95% CI 1.32-3.28), and fecal incontinence (PR 1.85, 95% CI 1.03-3.32). We found that UI impaired family life (25.3%), sexual relationship (13.6%), and job/school performance (23.7%). Frequent toilet use and reducing fluid intake were the two most common behavior changes. Conclusion: the prevalence of UI in Indonesia is nearly similar to other Asian countries. It increases with age and is not affected by gender. LUTS, chronic cough, and fecal incontinence may have significant effects on the prevalence. UI seems to impact daily life and behavior. Key words: urinary incontinence, daily life, LUTS, prevalence, age