Positive Predictive Values in Diagnosis of Incidental Prostate Cancer

Özet

Objective: Although the incidence of incidental prostate cancer (IPCa) decreases in recent years; for patients who performed by transurethral resection of the prostate (TURP) due to bladder outlet obstruction with or without prostatism symptoms (BPH), it is still can be seen. This article purposes to answer two questions a) for urologist, which clinical parameters including obesity and smoking have positive predictive value. b) for pathologists; which materials are wholly sampled for reducing the cancer ?Methods: We evaluated 1315 cases who were performed by TURP due to bladder outlet obstruction with or without prostatism symptoms the years 2006-2015. The ages of the patients, smoking, body mass index (BMI), digital rectal examination (DRE) findings, preoperative prostate specific antigen (PSA) levels, uroflow values, total prostate volume determined by suprapubic ultrasound and Gleason score were recorded. We analyzed the relationship between these parameters and IPCa. These situation compared with benign prostate tissue materials.Results: Totally 31 cases (2.35%) were found in the IPCa. While the cases of 24 were pT1a, 7 cases were pT1b. Age, body mass index, PSA, peak current speed and mean flow rate parameters respectively 8.887, 5.668, 9.660, 4.814 and 3.716 times as an incidental effect in detecting prostate cancer has been concluded.Conclusion: Older patient age, over the 25 kg/m2 of BMI, over the 4 ng/dl of PSA levels, the peak flow rate less than 10 ml/sec and the mean flow rate less than 5 ml/sec might be independent risk factors for detecting IPCa. More external validation is needed for confirming our results.Key words: Incidental prostate cancer, clinic parameters, diagnosis

Abstract

Objective: While there are suggestions for oral hydration times after general anesthesia, there is no published study with regard to sedation. The aim of this prospective study was to determine a safe time for oral intake after pediatric sedation and its association with nausea and vomiting after discharge.Methods: A total of 180 children (aged 1 month to 13 years) sedated for magnetic resonance imaging were randomly assigned into three groups. All patients fasted for 6 hours and were allowed to take clear fluids until 2 hours before sedation with thiopental (3 mg/kg). After the patients were transported to the recovery room, we allowed the patients to drink as much clear fluids as they wanted prior to discharge in group I, 1 hour after the patients met the discharge criteria for group II, and 2 hours after the patients met the discharge criteria for group III. All patients were assessed for vomiting in the recovery room until 1 hour after their first oral hydration. The parents were then telephoned the next day and questioned regarding nausea/vomiting and any unanticipated hospital admission.Results: There were no statistically significant intergroup differences with respect to age, sex, weight, or the ASA status. There was no nausea and vomiting in either the recovery or post discharge period in any group. In the telephone questionnaire, no hospital admissions were reported.Conclusion: Oral hydration just before discharge is safe, and fasting children after discharge for a period of time is unnecessary for patients sedated with thiopental.Key words: Sedation, oral intake, postoperative nausea and vomiting