Background: Early diagnosis of recurrent prostate cancer is a cornerstone for further adequate therapy planning. Therefore, clinical practice and research still focuses on diagnostic tools that can detect prostate cancer in early recurrence when it is undetectable in conventional diagnostic imaging. ¹⁸F-PSMA-1007 PET/CT is a novel method to evaluate patients with biochemical recurrent PCa. The aim of this review was to evaluate the role of ¹⁸F-PSMA-1007 PET/CT in prostate cancer local recurrence, lymph node metastases and bone metastases detection. Methods: Original studies, reviews and five meta-analyses were included in this article. A total of 70 studies were retrieved, 31 were included in the study. Results: All patients described in the studies underwent ¹⁸F-PSMA-1007 PET/CT. The administered ¹⁸F-PSMA-1007 individual dose ranged from 159 ± 31 MBq to 363.93 ± 69.40 MBq. Results showed that ¹⁸F-PSMA-1007 PET/CT demonstrates a good detection rate in recurrent prostate cancer. Conclusions: ¹⁸F-PSMA-1007 PET/CT appears to achieve reliable performance in detecting recurrent prostate cancer. The high detection rate of ¹⁸F-PSMA-1007 PET/CT in recurrent prostate cancer was confirmed, especially in local recurrence and small lymph nodes with non-specific characteristics on conventional diagnostic imaging methods. However, several authors emphasize some limitations for this tracer—for example, non-specific uptake in bone lesions that can mimic bone metastases.

Introduction: The aim of the study was to analyse the correlation of subjective complaints and urethral pressure profilometry (UPP) data in women with different types of urinary incontinence (UI): stress UI (SUI), urgency UI (UUI), and mixed UI (MixUI). Methods: A study group of 405 women with complaints about UI were surveyed (UDI-6; ICIQ-UI) to determine the subjectively dominant type of UI, and UPP was performed for all these women. The variables analysed by UPP were the maximum urethral closure pressure at rest (MUCPrest), maximum urethral closure pressure at cough stress (MUCPstress), functional urethral length at rest (FULrest), functional urethral length during cough stress (FULstress) test and pressure transmission ratio (PTR). The statistical variation between different groups of UI patients was calculated for all the analysed variables. Results: The value of PTR was statistically and significantly higher in the group of patients with isolated UUI, compared to the SUI and MixUI groups. The MUCPrest and MUCPstress values were consistently lower in women with isolated SUI, compared to isolated UUI. The FULrest and FULstress values showed no statistically significant difference between the groups with different types of UI. Conclusions: The PTR value is a result of UPP test that helps in distinguishing objectively between UUI, SUI, and MixUI. The PTR value can be used to characterise the hypermobility of urethra. The MUCPrest and MUCPstress values are consistently lower in women with isolated SUI, compared to those with isolated UUI. MUCP can be used as an objective criterion for differentiation of these 2 groups of patients.

This study aimed to assess the efficacy and safety of ODX, a novel, cytotoxic, bone-targeting drug candidate, in castration-resistant prostate cancer bone metastatic disease. Patients with progressive disease were randomised to ten cycles of ODX, intravenous infusion Q2W (3, 6, and 9 mg/kg, respectively). The primary objective was to assess the relative change from baseline in bone alkaline phosphatase (B-ALP) and serum-aminoterminal-propeptide of Type I procollagen (S-P1NP) at 12 weeks. The inclusion criteria selected were broad, and a double-blind design was used to ensure objective recruitment of patients for the assessment of efficacy. None of the patients received bone-protecting agents during the ODX treatment period. Fifty-five 21,20 and 14) patients were randomised to ODX (3, 6 and 9 mg/kg), respectively. The lower number of patients in arm 3 was due to too low a recruitment rate towards the end of the study. The median treatment time were 14, 13 and 14 weeks, respectively. The decrease in B-ALP at 12 weeks in study arms 3, 6 and 9 mg/kg was seen in 6/15 (40%), 8/12 (67%) and 5/12 (42%) patients, respectively, whereas the corresponding numbers for P1NP were 8/15 (53%), 8/12 (67%), and 4/12 (33%), respectively. The median decrease in B-ALP and P1NP at 12 weeks for study arms 3, 6 and 9 mg/kg were 37%, 14% and 43%, respectively, and 51%, 40% and 64%, respectively. The decrease in serum C-terminal telopeptide at 12 weeks was seen in the vast majority of patients and in about one-third of patients in bone scan index. ODX was well tolerated, and no drug-related serious adverse events occurred. There were no significant differences between study arms regarding efficacy and safety. ODX was well tolerated and demonstrated inhibitory effects on markers related to the vicious cycle in bone at all three doses. The reduction in metastatic burden, assessed with bone scan index, supports this finding. Studies with continued ODX treatment until disease progression are being planned (ClinicalTrials.gov Identifier: NCT02825628).

Background: Prostate cancer is one of the most prevalent cancers in the male population. To determine the aggressiveness of suspected lesions precisely, predictive models are increasingly being developed using quantitative MRI measurements, and particularly the ADC value. This study aimed to determine whether ADC values could be used to establish the aggressiveness of prostate cancer. Methods: A retrospective single-center study included 398 patients with prostate cancer who underwent a multiparametric MRI prior to radical prostatectomy. DWI ADC values were measured (µm²/s) using b values of 50 and 1000. The dominant lesion best visualized on MRI was analyzed. The ADC values of the index lesion and reference tissue were compared to tumor aggressivity according to the Gleason grade groups based on radical prostatectomy results. Statistical analysis was performed using the Mann–Whitney U test, Kruskal–Wallis H test, Spearman’s rank correlation, and ROC curves. Results: A very strong negative correlation (rs = −0.846, p < 0.001) between ADC and GS was found. ROC analysis revealed an AUC of 0.958 and an ADC threshold value of 758 µm²/s in clinically significant prostate cancer diagnoses using the absolute ADC value, with no advantage of using the ADC ratio over the absolute ADC value being identified. Conclusion: DWI ADC values and the calculated ADC ratio have a significant inverse correlation with GS. The findings indicate a strong capability in determining prostate cancer aggressiveness, as well as the possibility of assisting with assigning PI-RADS categories using ADC as quantitative metrics.

Objective: To analyze the association between patient history profile, conventional urodynamic variables, and specific types of urinary incontinence (UI) in order to establish the role of urodynamic in differentiating various types of UI in women. Material and methods: This cross-sectional study enrolled 547 women with UI. All patients were divided into three groups according to the UI type based on questionnaires: stress UI (SUI), mixed UI (MixUI), and urgent UI (UUI). Patient history taking, physical examination, and conventional urodynamics were performed. The association between patient profile characteristics, urodynamic data, and type of UI were assessed using one-way analysis of variance and chi-square tests. Results: Significant correlations were observed between the age, body mass index (BMI), cystocele, menopausal status, and most urodynamic data in at least one UI group (p<0.05). Age differed among all three groups (p<0.001), with SUI group consisting the youngest patients. BMI was higher in the MixUI group (p=0.001). The maximum cystometric capacity differed among all three groups (p<0.001), with the highest in the SUI. The maximum flow rate was higher in the SUI group than that in the UUI group (p<0.001). Residual urine, opening detrusor pressure, and pressure transmission ratio were significantly higher in the UUI group. Detrusor overactivity and menopause were less frequently observed in the SUI group. The least pronounced urodynamic SUI was found in the UUI group. Spearman correlation for cystocele was negative in the SUI and positive in the UUI group. Conclusion: Conventional urodynamics give additional information to correctly diagnose specific types of UI in women. Cite this article as: Pilsetniece Z, Vjaters E. The role of conventional urodynamic in diagnosing specific types of urinary incontinence in women. Turk J Urol 2020; 46(2): 134-9.