Translation and validation of the Portuguese version of the International Consultation on Incontinence Questionnaire (ICIQ) Bladder Diary.

INTRODUCTION AND HYPOTHESIS: The International Consultation on Incontinence Questionnaire (ICIQ) Bladder Diary (BD) is a standardized and validated diary, developed in the English language, designed to assess lower urinary tract symptoms (LUTS) in men and women. This study reports the translation, cross-cultural adaptation and validation process of this diary to the Portuguese language. METHODS: After translation and back-translation of the ICIQ-BD to Portuguese, 140 urologic patients were asked to fill in this 3-day diary as well as the Overactive Bladder questionnaire Short Form (OABqSF) and a questionnaire evaluating the difficulties in filling out the ICIQ-BD. A subset of 60 patients filled out a second diary with/without LUTS treatment in between (30 patients in each group). In addition, content validity, internal consistency, criterion and construct validity were tested. RESULTS: The Portuguese version of the ICIQ-BD showed adequate internal consistency (Cronbach's alpha of 0.78), and patients reported few difficulties in filling out this tool, answering most commonly 1 on a 1-6 scale of difficulty. Excellent test-retest reliability and responsiveness of the diary were observed when comparing the first diary to a second completed 2-6 weeks later. Criterion validity was also confirmed, given the good correlation with the OABqSF (Pearson's 0.386-0.447). Finally, construct validity was established through statistically significant concordance between data obtained in the BD with generally accepted theories. CONCLUSION: The present version of the ICIQ-BD is the first bladder diary successfully validated in the Portuguese language. It is a suitable and standardized tool for scientific research and diagnostic assessment of LUTS in adult men and women.

Prostate Ewing Sarcoma/PNET: A case of long survival in a highly aggressive malignancy.

Prostate Ewing sarcoma/peripheral primitive neuroectodermal tumor (ES/PNET) is extremely rare. Currently, a multimodal approach is recommended, although there is no standard treatment. Nevertheless, this tumor has a very poor prognosis, with the longest reported survival of 24 months. We present a case of locally advanced prostate ES/PNET in a 29-year-old male who was treated with a multimodal approach. The patient is alive and disease free, with a seven year follow-up, with very good quality of life. This exceptionally long survival may be the result of the very aggressive multimodal treatment chosen and described herein.

The Impact of Sacral Neuromodulation on Sexual Dysfunction.

BACKGROUND/AIMS: Sacral neuromodulation (SNM) is a well-established treatment in several urinary and bowel dysfunctions, nevertheless its role on sexual dysfunction remains unclear. We evaluate the impact of SNM on sexual function and its association with age at SNM, functional diagnosis and post-void residual urine (PVR) before SNM. METHODS: Patients who had SNM were retrospectively analyzed. Sexual function was assessed before and after treatment with the International Index of Erectile Function (IIEF-5) for men and the Female Sexual Function Index (FSFI) for women. IIEF-5 and FSFI were also associated with age at SNM, functional diagnosis, and PVR. RESULTS: Fifteen females and 9 males, with a median age of 41 years (26-72 years), median follow-up 20.7 months (2-53 months) were enrolled. IIEF-5 improved in 4 patients (p = 0.06), and FSFI total score in 5 (p = 0.2). There was significant association between functional diagnosis and FSFI total score (p = 0.05), and FSFI specific domains of arousal (p = 0.03), lubrication (p = 0.04), and satisfaction (p = 0.03), with significant improvement showed in patients with detrusor overactivity with impaired contractility. CONCLUSION: Although gains observed in IIEF-5 and FSFI were modest, our preliminary results show that SNM may have favorable impact on sexual function.

Late urethral erosion of transobturator suburethral mesh (Obtape): a minimally invasive management under local anaesthesia.

The placement of transobturator sub-urethral synthetic tapes, although with a high success rate of achieving continence, carries the risk of tape erosion to adjacent structures. While vaginal erosion occurs more frequently, urethral erosion has also been reported, usually in the immediate or early postoperative period. We present two different cases of urethral erosion with the Obtape sling, the first one diagnosed 1 year after surgery and the second one, a very late complication, occurring 4 years after the placement of the sling. Although transvaginal urethrotomy with tape resection has been the most popular approach described in the literature, we describe a minimally invasive trans-urethral approach for the management of this complication under local anaesthesia. We also present some "tricks of the trade" on retrieving the tape trans-urethrally while maximizing the length of tape removed.