UROFAIR Virtual 2020

UROFAIR Virtual 2020 Abstracts C-10133 Glansectomywith Split SkinGraft Coverage as anAlternative toMutilating Penile Surgeries Mon Mon Oo (1) (1) Khoo Teck Puat Hospital Introduction and Objectives: Penile squamous cell carcinoma accounts for ~0.4% of cancers among local males. Due to its aggressiveness, most patients undergo partial or total penectomy as treatment, resulting in significant impact on the psychology and sexual function of patients. We aim to highlight an alternative surgical approach of glansectomy with split skin graft (SSG) coverage for suitablemalignant lesions of the glans. Literature review revealed that organ-preserving surgeries has compatible oncological outcomes as non- organ-sparing surgeries while preserving function. Methods: A42-year-old Chinesemale with no past medical history, presented with a 4 cmwarty lesion involving the prepuce and the glans. He underwent an incisional biopsy with circumcision. The lesion was histologically proven to be well-differentiated squamous cell carcinoma (SCC). He then opted to undergo glansectomy with SSG coverage. The glans was dissected off the corporal bodies and urethra was divided sharply. Specimen was then removed and urethra spatulated. 10 x 5 cm SSG with thickness 16/1000 of inch was harvested from the thigh and anastomosed to the urethra and the penile shaft skin circumferentially. SSG was then quilted to corporal bodies. Results: Final histology reported pT2 Grade 1 SCC with negative margins of 3 mm. At 3 months post-operation, both the penile wound and SSG donor site have healed well without recurrence. Both urinary and sexual functions are preserved. Patient is satisfied with the cosmesis and the functional status. Conclusions: In selected patients with carcinoma confined to the glans, glansectomy with SSG coverage is a feasible method that can give good functional and psychological outcomes. The Uro-Oncology Multi-Disciplinary Team (MDT) Clinic – Clinical and Patient Reported Outcomes from Implementing a New Model of Care Raj Tiwari (1) (1) Sengkang General Hospital Introduction and Objectives: We present our experience of a Uro-Oncology Multi-Disciplinary (MDT) Clinic in a single urology unit evaluating the access to multidisciplinary care, potential benefits to clinic resource utilisation and to patients receiving such care. Methods: All consecutive patients attending the MDT clinic between December 2018 to December 2019 were included. The MDT clinic is a one stop clinic comprising joint consultations with urologists, medical oncologists, radiation oncologists and nurses. Time efficiency was calculated assuming 1 clinic visit required 15 minutes consult time, and 60 minutes travel time. Patient satisfaction surveys were administered, and comprised three standardized questions scored from 1 (very unsatisfied) to 5 (very satisfied) assessing adequacy of medical advise given, and whether the MDT clinic potentially saved total consult time and facilitated subsequent treatment. Results: Of 51 consecutive patients who attended, the mean age was 69 years (range 35-88). There were a majority of males (86.2%) and Chinese (80.4%) patients. There were 33 patients (64.7%) living within a 5 kilometers radius from the hospital. The casemix included prostate cancer (57%), urothelial cancer (22%), renal cancer (12%) and others (9%). The median time from MDT to therapy initiation was 8 days. When the MDT model was compared to a traditional tumour board (multivisit) model mean time savings were 16 minutes consult time and 64 minutes travel time per patient respectively. The patient survey showed a mean score of 4 (satisfied) across all 3 domains. Conclusions: The MDT clinic improves access to early therapy, enhances clinic efficiency, is time-saving and associated with high patient satisfaction scores. C-10136 C-10134 Relationship Between Age and Metabolic Syndrome with Prevalence of Lower Urinary Tract Syndrome (LUTS) in Beaneno Village, Sasitamean District, Malaka Regency, East Nusa Tenggara, Indonesia In 2019 Gede Agung Widya Iswara (1) (1) Kaputu Public Health Center Introduction and Objectives: Lower Urinary Tract Symptoms (LUTS) was a syndrome that characterized with obstructive, iritative and post voiding symptoms. Several study have predicted the prevalence of LUTS will be increase from 45,2% in 2008 to 45,8% in 2018. In Indonesia there are limited study about prevalence rate of LUTS and the relationship between LUTS and risk factors of LUTS. The purpose of this study was to determine the relationship of age, body mass index (BMI), abdominal circumference, blood glucose, cholesterol, and blood pressure with the incidence of LUTS. Methods: This study use cross-sectional analytic design which involving all male respondents with aged over 40 years old in beaneno village. This study use international prostate symptom score (IPSS) questionnaire for LUTS, identification cards for the demographic, height and weight measurements for BMI, abdominal circumference, blood glucose and total cholesterol test, and blood pressure to get metabolic syndrome data Results: The mean age of respondents was 57,79 ± 12,36 years oldand the prevalence of LUTS was 72,1%. By using chi-square test, the p values from age (p = 0,004), BMI (p = 0,025), AC (p = 0,445), Blood Glucose (p = 0,271), Cholesterol (p = 0,680) and blood pressure (p = 0,292). Conclusions: The result from this study obtained a correlation between age and BMI with the incidence of LUTS. Robotic Guided Transperineal Prostate Biopsy vs. TRUS biopsy: Complications and Cancer Detection Rate Jingzeng Du (1) (1) Singapore General Hospital Introduction and Objectives: Transperineal prostate biopsy has been reported to have less septic complications and higher cancer detection rate. In this study we present our series comparing complications and cancer detection rate between robotic guided transperineal prostate biopsy (RTPB) and transrectal prostate (TRUS) biopsy to guide clinical case selection. Methods: Patients who underwent RTPB for suspected prostate cancer at the Singapore General Hospital (SGH) between September 2006 and February 2016 were retrospectively analyzed. Then, complication rate was evaluated using the modified Clavien classification system. Consecutive patients who underwent TRUS biopsy in SGH between March 2012 to Dec 2013 were also analyzed for comparison. Results: Total 950 patients were included in RTPB group. After excluding patients with inadequate data total 865 patients were included. Total of 731 patients were included in TRUS biopsy group after excluding cases with missing data. 1. Complication rate: Sepsis complication rate was significantly lower in RTPB group compare to TRUS biopsy group (0.1% vs. 2.2%, P < 0.05). TRUS biopsy group had significantly higher Clavien Grade 3 and 4 complications compare to RTPB group (9.4% vs. 0; P < 0.05). 2. Cancer detection rate: a) for biopsy naive patients MRI targeted biopsy had higher cancer detection rate compare to template RTPB and TRUS biopsy (78.6% vs. 43.6% vs. 34.0% P < 0.05) b) for previous negative biopsy patients similar results revealed, cancer detection rate were 45.3% 27.5% 20.4% P < 0.05 Conclusions: RTPB have lower high-grade complications especially septic complication. MRI targeted biopsy have higher cancer detection rate compare to TRUS and template RTPB C-10128 15