This study evaluates the efficiency of the transrectal and transperineal approaches for prostate biopsy in terms of detecting significant cancer, and compares the safety between these two approaches.

Background: eHealth can help replicate the benefits of conventional surgical prehabilitation programs and overcome organizational constraints related to human resources and health care–related costs. Objective: We aimed to assess the impact of an optimized perioperative program using a personalized mobile app designed for preparation and recovery after radical prostatectomy (RP). Methods: We report on a series of 122 consecutive robot-assisted RP before and after the implementation of the betty.care app (cohort A: standard of care, n=60; cohort B: optimized program, n=62). The primary end point was continence recovery, defined as “0 or 1 safety pad per day” at 6 weeks after surgery. Secondary end points were length of stay, same-day discharge, complications, readmissions, and number of days alive and out of hospital within 30 days from surgery. Results: Both cohorts were comparable in terms of age, prostate-specific antigen, prostate volume, and disease aggressiveness. Intraoperative parameters (lymph node dissection, operative time, and bilateral nerve-sparing surgery) were comparable in both groups, except for blood loss, which was significantly higher in cohort B (182 vs 125 cc; P=.008). The 6-week continence rate was improved in cohort B in both univariable and multivariable analyses (92% vs 75%; P=.01). There were trends favoring cohort B for all secondary end points with a minimal 30% benefit compared with cohort A. Grade 2 or more complications occurred less frequently in cohort B (13% vs 3.2%; P=.042). Same-day discharge and readmission rates were 35% and 53% (P=.043), and 3.3% and 1.6% (P=.54) in cohorts A and B, respectively. Mean length of stay was reduced by 0.2 days in cohort B (0.58 vs 0.78 days; P=.10). The main limitation was the absence of randomization. Conclusions: The implementation of a mobile app that provides a holistic approach to the perioperative period, integrating prehabilitation, rehabilitation, and remote monitoring, could lead to the improvement of important functional outcomes after RP and could replicate an on-site prehabilitation program. Multicenter validation is needed.

The aim of this study is to evaluate a new user-friendly scoring system, namely the BETTY score, that aims to predict 30-day patient outcomes after surgery. In this first description, we rely on a population of prostate cancer patients undergoing robot-assisted radical prostatectomy. The BETTY score includes the patient’s American Society of Anesthesiologists score, the body mass index, and intraoperative data, including operative time, estimated blood loss, any major intraoperative complications, hemodynamic, and/or respiratory instability. There is an inverse relationship between the score and severity. Three clusters assessing the risk of postoperative events were defined: low, intermediate, and high risk of postoperative events. A total of 297 patients was included. The median length of hospital stay was 1 day (IQR1-2). Unplanned visits, readmissions, any complications, and serious complications occurred in 17.2%, 11.8%, 28.3%, and 5% of cases, respectively. We found a statistically significant correlation between the BETTY score and all endpoints analyzed (all p ≤ 0.01). A total of 275, 20, and 2 patients were classified as low-, intermediate-, and high-risk according to the BETTY scoring system, respectively. Compared with low-risk patients, patients at intermediate-risk were associated with worse outcomes for all endpoints analyzed (all p ≤ 0.04). Future studies, in various surgical subspecialties, are ongoing to confirm the usefulness of this easy-to-use score in routine.

There are conflicting data with regards to the link between diet and the prostate cancer. The purpose of this study was to assess the association of dietary factors with incidence, prevalence and mortality rates of prostate cancer worldwide. We conducted an ecological study including 170 countries, whose data on incidence, prevalence and mortality rates of prostate cancer, dietary factors, and potentially confounding factors were available and collected in May 2020. Univariable and multivariable linear regression analyses were used. Consumption of nuts and seeds was inversely associated with incidence, prevalence and mortality rates of prostate cancer (β −0.7, P < 0.001; β −2.1, P < 0.001; β −0.1, P = 0.02; respectively). Intake of alcohol was associated with increased incidence, prevalence and mortality rates of prostate cancer (β 1.8, P < 0.001; β 4.5, P < 0.001; β 0.4, P < 0.001; respectively). Consumption of processed meats was also associated with increased incidence and prevalence rates of prostate cancer (β 0.6, P = 0.003; β 2.8, P = 0.001; respectively). These data suggest that consumption of nuts and seeds have a protective effect against prostate carcinogenesis, progression, and metastasis, while alcohol and processed meat increase these risks.

The Bladder Cancer Index (BCI) is a validated questionnaire for health-related quality of life in patients with bladder cancer (BC). To translate the original BCI into an Arabic validated version. For translation and validation, we proceeded in 5 steps: (1) Authorization of translation by the authors of the original BCI. (2) Translation from English to Arabic. (3) Submission of the translated version into Arabic to a committee of readers. (4) Backward translation to ensure there was no discrepancy between the two versions during the reverse translation. (5) Qualitative linguistic validation of the document obtained from seven patients having BC. Translation was authorized in February 2015. The reading committee that evaluated the clarity of the text admitted the version with minor revisions. The questionnaire was finally tested on seven patients with bladder tumor treated in the department of urology B at Ibn Sina Teaching Hospital. They all responded to the questionnaire without understanding nor filling difficulty. Therefore, no major changes were made following this qualitative assessment. This Arabic version of BCI questionnaire will enable researchers from Arab countries to use a measurement tool validated and recognized internationally to assess QOL in patients with BC.