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Article ; Online: Prostate-specific Antigen Density as a Proxy for Predicting Prostate Cancer Severity: Is There Any Difference between Systematic and Targeted Biopsy?

Arafa, Mostafa A / Farhat, Karim Hamda / Rabah, Danny M / Khan, Farrukh K / Mokhtar, Alaa / Al-Taweel, Waleed

Saudi journal of medicine & medical sciences

2023 Volume 11, Issue 4, Page(s) 299–304

Abstract: Background: Prostate cancer screening with prostate-specific antigen (PSA) can result in unnecessary biopsies and overdiagnosis. Alternately, PSA density (PSAD) calculation may help support biopsy decisions; however, evidence of its usefulness is not ... ...

Abstract	Background: Prostate cancer screening with prostate-specific antigen (PSA) can result in unnecessary biopsies and overdiagnosis. Alternately, PSA density (PSAD) calculation may help support biopsy decisions; however, evidence of its usefulness is not concrete. Objective: To evaluate the predictive value of PSAD for clinically significant prostate cancer detection by systematic and MRI-targeted biopsies. Methods: This prospective study was conducted at two tertiary hospitals in Riyadh, Saudi Arabia, between December 2018 and November 2021. Patients suspected of prostate cancer were subjected to multi-parametric MRI, and for those with positive findings, systematic and targeted biopsies were performed. Clinically non-significant and significant prostate cancer cases were classified based on histopathology-defined ISUP grade or Gleason score. The PSAD was measured using the prostate volume determined by the MRI and categorized into ≤0.15, 0.16-0.20, and >0.20 ng/ml Results: Systematic and targeted biopsies were carried out for 284 patients. The discriminant ability of PSAD is higher in MRI-targeted biopsy compared with systematic biopsy (AUC: 0.77 vs. 0.73). The highest sensitivity (97%) and specificity (87%) were detected at 0.07 ng/ml Conclusion: PSAD has good discriminant power for predicting clinically significant prostate cancer. A cutoff of 0.07 ng/ml
Language	English
Publishing date	2023-10-06
Publishing country	India
Document type	Journal Article
ZDB-ID	2734896-9
ISSN	2321-4856 ; 2321-4856
ISSN (online)	2321-4856
ISSN	2321-4856
DOI	10.4103/sjmms.sjmms_49_23
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Development and internal validation of a nomogram predicting significant prostate cancer: Is it clinically applicable in low prevalent prostate cancer countries? A multicenter study.

Arafa, Mostafa A / Farhat, Karim H / Khan, Farrukh K / Rabah, Danny M / Elmorshedy, Hala / Mokhtar, Alaa / Al-Taweel, Waleed

The Prostate

2023 Volume 84, Issue 1, Page(s) 56–63

Abstract: Background: Accurately identifying aggressive prostate tumors and studying them as a separate outcome are urgently needed. Nomogram is a predictive tool using an algorithm, it has been widely applied in clinical practice to predict prognosis. We aimed ... ...

Abstract	Background: Accurately identifying aggressive prostate tumors and studying them as a separate outcome are urgently needed. Nomogram is a predictive tool using an algorithm, it has been widely applied in clinical practice to predict prognosis. We aimed to develop and internally validate a nomogram predicting clinically significant prostate cancer (csPCa). Methods: Data were retrieved from the records of the two main hospitals in Riyadh, during the period 2019-2022. Significant variables associated with csPCa cases were used to develop and internally validate a novel nomogram, utilizing the C index, and calibration curves. Decision curve analysis (DCA) was used to assess its clinical utility. Results: Prostate imaging reporting and data system (PI-RADS), smaller prostate volume, and prostate-specific antigen (PSA) > 10 ng/mL were significantly associated with the risk csPCa, respectively. The model developed by the nomogram showed an excellent accuracy for csPCa discrimination, as indicated by area under the curve (0.83), and calibration curves. DCA showed that our model was superior and surpassed all other models with a larger net benefit for various threshold probabilities. Based on our model, at a probability threshold of 30%, biopsying patients is the equivalent of a strategy that led to an absolute 5% reduction in the number of biopsies without missing any csPCa. Conclusion: The developed nomogram consisting of PI-RAD, total PSA, and prostate volume showed a robust predictive capacity for csPCa before prostate biopsy that may be valuable for clinical judgment to prevent needless biopsy. Yet, the small percentage (5%) of yielded unnecessary biopsies that could be saved by using such a model, cast an important question on its merit and clinical applicability.
MeSH term(s)	Male ; Humans ; Prostatic Neoplasms/diagnosis ; Prostatic Neoplasms/epidemiology ; Prostatic Neoplasms/pathology ; Prostate-Specific Antigen/analysis ; Nomograms ; Magnetic Resonance Imaging/methods ; Biopsy ; Retrospective Studies
Chemical Substances	Prostate-Specific Antigen (EC 3.4.21.77)
Language	English
Publishing date	2023-09-27
Publishing country	United States
Document type	Multicenter Study ; Journal Article
ZDB-ID	604707-5
ISSN	1097-0045 ; 0270-4137
ISSN (online)	1097-0045
ISSN	0270-4137
DOI	10.1002/pros.24625
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Article: Outcome of anastomotic posterior urethroplasty with various ancillary maneuvers for post-traumatic urethral injury. Does prior urethral manipulation affect the outcome of urethroplasty?

Mehmood, Shahbaz / Alsulaiman, Omer Abdulaziz / Al Taweel, Waleed Mohammad

Urology annals

2018 Volume 10, Issue 2, Page(s) 175–180

Abstract: Purpose: We present our success rate and complications of delayed anastomotic urethroplasty (DAU) in patients with post-traumatic posterior urethral injury.: Materials and methods: This was a retrospective study of patients aged ≥17 years that ... ...

Abstract	Purpose: We present our success rate and complications of delayed anastomotic urethroplasty (DAU) in patients with post-traumatic posterior urethral injury. Materials and methods: This was a retrospective study of patients aged ≥17 years that underwent DAU for post-traumatic posterior urethral injury during 2010-2014. Stricture length was measured by ascending and descending urethrogram. Success of procedure was considered when the patient was free of stricture-ralated obstruction and needed no further intervention. Primary group includes patients who underwent first time delayed urethroplasty while secondary group included patients who had some sort of urethral manipulation in local hospital. Results were analyzed using unpaired Results: Of the 80 male patients, 73 (91.25%) patients underwent primary DAU while 7 (8.75%) patients had secondary DAU. Median age, stricture length, and follow-up were 27.0 ± 12.7, 1.6 ± 0.9, and 3.2 ± 0.9, respectively. Overall, success rate was 83.75% while success rate in primary group was 89.04% and secondary group was only 28.57% ( Conclusion: DAU has durable success rate with less morbidity. Ancillary elaborated maneuvers are frequently needed in patients with complex and elongated post-traumatic posterior urethral defect with successful outcome.
Language	English
Publishing date	2018-04-30
Publishing country	India
Document type	Journal Article
ISSN	0974-7796
ISSN	0974-7796
DOI	10.4103/UA.UA_168_17
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Article: Neurogenic bladder in spinal cord injury patients.

Taweel, Waleed Al / Seyam, Raouf

Research and reports in urology

2015 Volume 7, Page(s) 85–99

Abstract: Neurogenic bladder dysfunction due to spinal cord injury poses a significant threat to the well-being of patients. Incontinence, renal impairment, urinary tract infection, stones, and poor quality of life are some complications of this condition. The ... ...

Abstract	Neurogenic bladder dysfunction due to spinal cord injury poses a significant threat to the well-being of patients. Incontinence, renal impairment, urinary tract infection, stones, and poor quality of life are some complications of this condition. The majority of patients will require management to ensure low pressure reservoir function of the bladder, complete emptying, and dryness. Management typically begins with anticholinergic medications and clean intermittent catheterization. Patients who fail this treatment because of inefficacy or intolerability are candidates for a spectrum of more invasive procedures. Endoscopic managements to relieve the bladder outlet resistance include sphincterotomy, botulinum toxin injection, and stent insertion. In contrast, patients with incompetent sphincters are candidates for transobturator tape insertion, sling surgery, or artificial sphincter implantation. Coordinated bladder emptying is possible with neuromodulation in selected patients. Bladder augmentation, usually with an intestinal segment, and urinary diversion are the last resort. Tissue engineering is promising in experimental settings; however, its role in clinical bladder management is still evolving. In this review, we summarize the current literature pertaining to the pathology and management of neurogenic bladder dysfunction in patients with spinal cord injury.
Language	English
Publishing date	2015-06-10
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2649530-2
ISSN	2253-2447
ISSN	2253-2447
DOI	10.2147/RRU.S29644
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Article: Visual Internal Urethrotomy for Adult Male Urethral Stricture Has Poor Long-Term Results.

Al Taweel, Waleed / Seyam, Raouf

Advances in urology

2015 Volume 2015, Page(s) 656459

Abstract: Objective. To determine the long-term stricture-free rate after visual internal urethrotomy following initial and follow-up urethrotomies. Methods. The records of all male patients who underwent direct visual internal urethrotomy for urethral stricture ... ...

Abstract	Objective. To determine the long-term stricture-free rate after visual internal urethrotomy following initial and follow-up urethrotomies. Methods. The records of all male patients who underwent direct visual internal urethrotomy for urethral stricture disease in our hospital between July 2004 and May 2012 were reviewed. The Kaplan-Meier method was used to analyze stricture-free probability after the first, second, third, fourth, and fifth urethrotomies. Results. A total of 301 patients were included. The overall stricture-free rate at the 36-month follow-up was 8.3% with a median time to recurrence of 10 months (95% CI of 9.5 to 10.5, range: 2-36). The stricture-free rate after one urethrotomy was 12.1% with a median time to recurrence of eight months (95% CI of 7.1-8.9). After the second urethrotomy, the stricture-free rate was 7.9% with a median time to recurrence of 10 months (95% CI of 9.3 to 10.6). After the third to fifth procedures, the stricture-free rate was 0%. There was no significant difference in the stricture-free rate between single and multiple procedures. Conclusion. The long-term stricture-free rate of visual internal urethrotomy is modest even after a single procedure.
Language	English
Publishing date	2015-10-01
Publishing country	Egypt
Document type	Journal Article
ZDB-ID	2397564-7
ISSN	1687-6377 ; 1687-6369
ISSN (online)	1687-6377
ISSN	1687-6369
DOI	10.1155/2015/656459
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Article ; Online: Transperineal versus transrectal multi-parametric magnetic resonance imaging fusion targeted prostate biopsy.

Rabah, Danny / Al-Taweel, Waleed / Khan, Farrukh / Arafa, Mostafa / Mehmood, Shahbaz / Mokhtar, Alaa / Farhat, Karim

Saudi medical journal

2021 Volume 42, Issue 6, Page(s) 649–654

Abstract: Objectives: To compare transperineal biopsies (TPBx) with transrectal ultrasound-guided biopsy (TRUSBx) in order to provide evidence, making clinicians able to select the appropriate biopsy approach under different conditions.: Methods: A comparative ...

Abstract	Objectives: To compare transperineal biopsies (TPBx) with transrectal ultrasound-guided biopsy (TRUSBx) in order to provide evidence, making clinicians able to select the appropriate biopsy approach under different conditions. Methods: A comparative prospective study, conducted in King Khalid University Hospital (KKUH) and King Faisal Specialist Hospital and Research Centre (KFSH&RC), Riyadh, Kingdom of Saudi Arabia, between March 2019 and February 2020. All patients with raised prostate-specific antigen or atypical digital rectal examination findings were subjected to multi-parametric magnetic resonance imaging (MRI). Those with positive findings were referred to targeted fusion- guided biopsy either TPBx or TRUSBx, randomly. Complication rate, cancer detection rate, and procedure time were recorded. Results: Transperineal biopsies and TRUSBx had an equivalent complication rate. However, both case detection rate and clinically significant cancer detection rate were significantly higher in TPBx versus TRUSBx (45.1% versus 29.1%, Conclusion: No difference in complication rate was detected between the 2 procedures; however, TPBx was more effective for cancer detection in general and clinically significant cancer detection in particular.
MeSH term(s)	Humans ; Image-Guided Biopsy ; Magnetic Resonance Imaging ; Male ; Prospective Studies ; Prostatic Neoplasms/diagnostic imaging ; Ultrasonography, Interventional
Language	English
Publishing date	2021-05-28
Publishing country	Saudi Arabia
Document type	Journal Article
ZDB-ID	392302-2
ISSN	1658-3175 ; 0379-5284
ISSN (online)	1658-3175
ISSN	0379-5284
DOI	10.15537/smj.2021.42.6.20200771
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Article ; Online: Systemic complications of the bidirectional intraoperative chemotherapy with intravenous ifosfamide and hyperthermic intraperitoneal chemotherapy (HIPEC) using cisplatin plus doxorubicin.

Hakeam, Hakeam / Ayman, Azzam / Waleed, Al Taweel / Amen, Tarek

Pleura and peritoneum

2019 Volume 4, Issue 4, Page(s) 20190025

Abstract: Background: Ifosfamide has recently used as the intravenous component of bidirectional intraoperative chemotherapy (BDIC) with hyperthermic intraperitoneal chemotherapy (HIPEC) using cisplatin plus doxorubicin. Little is known about the systemic ... ...

Abstract	Background: Ifosfamide has recently used as the intravenous component of bidirectional intraoperative chemotherapy (BDIC) with hyperthermic intraperitoneal chemotherapy (HIPEC) using cisplatin plus doxorubicin. Little is known about the systemic toxicities of this BDIC regimen. Therefore, this study aimed to assess the toxicities of this treatment. Methods: A prospective, cohort study, of patients who underwent the BDIC using intravenous ifosfamide 1,300 mg/m Results: A total of 18 patients were enrolled in the study. Grade 1 leukopenia developed in 11.1% of the patients, with 5.5% developed neutropenia. Thrombocytopenia developed in 61.1% of patients; it was grade 1 or 2 in most patients, but grade 3 in 1 (5.5%) patient. All patients developed erythrocytopenia after BDIC. Leukopenia, neutropenia, and thrombocytopenia resolved without treatment in all patients. Nephrotoxicity developed in 33.3% of the patients. One patient progressed to the End-stage kidney disease classification. No patient developed haemorrhagic cystitis. Conclusions: Intravenous ifosfamide combined with HIPEC using cisplatin plus doxorubicin yielded low rates of mild leukopenia. Mild thrombocytopenia was frequent, but severe suppression of platelets was uncommon. Nephrotoxicity developed in one-third of the patients, and haemorrhagic cystitis was absent.
Language	English
Publishing date	2019-11-06
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2861909-2
ISSN	2364-768X ; 2364-7671
ISSN (online)	2364-768X
ISSN	2364-7671
DOI	10.1515/pp-2019-0025
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Article: The effect of spinal cord-injury level on the outcome of neurogenic bladder treatment using OnabotulinumtoxinA.

Al Taweel, Waleed / Alzyoud, Khalil Mohammed

Urology annals

2015 Volume 7, Issue 3, Page(s) 320–324

Abstract: Aim: The aim was to report the effectiveness and safety OnabotulinumtoxinA (Botox, Allergan, Inc., Irvine, CA, USA) intradetrusor injections in spinal cord-injured (SCI) patients with refractory neurogenic detrusor overactivity. And to assess the result ...

Abstract	Aim: The aim was to report the effectiveness and safety OnabotulinumtoxinA (Botox, Allergan, Inc., Irvine, CA, USA) intradetrusor injections in spinal cord-injured (SCI) patients with refractory neurogenic detrusor overactivity. And to assess the result based on SCI level. Materials and methods: We reviewed the chart of 103 patients with neurogenic bladder secondary to SCI at the rehab center who received OnabotulinumtoxinA in our Neurourology Department for treatment of lower urinary tract symptoms between January 2007 and December 2013. All patients had a clinical examination, urinalysis, and an urodynamic study at baseline and 3 months after treatment as well as a visual analogue scale (VAS; range scale: 0-10) and a bladder diary checked for 3 days. 300 IU of OnabotulinumtoxinA, detrusor muscle injections were performed in 30 sites under cystoscopic guidance. Outcome measures included frequency of urge urinary incontinence collected by bladder diaries; changes in urodynamic parameters such as maximum cystometric bladder capacity, reflex volume, maximum detrusor pressure; side-effects; antimuscarinic drug consumption and quality of life (QOL) measured with VAS. Results: The study includes 32 female and 71 male with a mean patient age of 29 years (range: 18-56 year). The effect of Botox injection on bladder function was observed within 1-2 week after treatment. The urodynamic parameters were improved significantly after treatment compared with baseline values. There were significant reductions in the frequencies of incontinence episodes after treatment as seen in the voiding diary. A significant improvement in patient satisfaction was found after treatment which was expressed on the VAS assessment, with an improvement of the mean of 3 points. Patients with thoracic and lumbar injury have better result compare to cervical injury patients. The earliest recurrence of clinical symptoms was at 10 weeks. Overall, the mean duration of symptomatic improvement was 8 (2.5-21) months. Conclusion: Intradetrusor onabotulinumtoxinA injections are an effective and well-tolerated treatment for neurogenic overactive bladder that will increase patient satisfaction and improve QOL with persisted clinical efficacy for more than 8 months.
Language	English
Publishing date	2015-06-30
Publishing country	India
Document type	Journal Article
ISSN	0974-7796
ISSN	0974-7796
DOI	10.4103/0974-7796.152013
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Article ; Online: Neurogenic bladder evaluation and management after spinal cord injury: Current practice among urologists working in Saudi Arabia.

Al Taweel, Waleed / Alkhayal, Abdullah

Urology annals

2010 Volume 3, Issue 1, Page(s) 24–28

Abstract: Aim: The aim of this study is to determine the current trends in the management and surveillance of the NB population secondary to spinal cord injury (SCI) or myelomeningocele by certified urologist working in Saudi Arabia and to compare it to the ... ...

Abstract	Aim: The aim of this study is to determine the current trends in the management and surveillance of the NB population secondary to spinal cord injury (SCI) or myelomeningocele by certified urologist working in Saudi Arabia and to compare it to the current guidelines. Materials and methods: A cross-sectional study was conducted using a 12-points questionnaire distributed to urologists working in Saudi Arabia and registered at the Saudi medical association. The assessment and follow-up of upper and lower urinary tract function in neurogenic bladder patients, their optimal frequency and management of related infections were the topics of inquiry. Results: Of the 272 urologists surveyed, 105 responded, yielding a response rate of 38%. Eighty-nine percent of respondents said that ultrasound was their diagnostic tool of choice for upper tract evaluation. Sixty-one percent of respondents said that they would follow their patients with a multichannel urodynamic study. Forty percent of urologists stated that they would treat asymptomatic bacteriuria. Clean intermittent catheterization (CIC) was the most common modality chosen for the management of neurogenic bladder in patients with emptying difficulties. Conclusion: This study confirms that most urologists in Saudi Arabia involved with neurogenic bladder management. However, more than one third of the urologists do not have urodynamic machine and only two of the reporting practitioners has a videourodynamic machine. The results emphasize the need for clear guidelines in this field of urology in Saudi Arabia. Highly specialized rehabilitation centers for neurogenic bladder secondary to SCI are required for optimal care and urologist teaching.
Language	English
Publishing date	2010-11-01
Publishing country	India
Document type	Journal Article
ZDB-ID	2557851-0
ISSN	0974-7834 ; 0974-7834
ISSN (online)	0974-7834
ISSN	0974-7834
DOI	10.4103/0974-7796.75872
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Article ; Online: Transobturator tape for female stress incontinence: follow-up after 24 months.

Taweel, Waleed Al / Rabah, Danny M

Canadian Urological Association journal = Journal de l'Association des urologues du Canada

2010 Volume 4, Issue 1, Page(s) 33–36

Abstract: Objective: The objective of this paper is to evaluate the effectiveness of transobturator vaginal tape (TOT) in the treatment of female stress urinary incontinence (SUI) and to analyze functional results and quality of life after 24 months follow-up.: ...

Abstract	Objective: The objective of this paper is to evaluate the effectiveness of transobturator vaginal tape (TOT) in the treatment of female stress urinary incontinence (SUI) and to analyze functional results and quality of life after 24 months follow-up. Methods: The study included all women with SUI who underwent a TOT procedure in which the sling passes from the obturator foramen from the outside to the inside, under general or regional anesthesia from December 2004 to January 2006. All study patients must have had a minimal follow-up of 24 months. The patients were prospectively evaluated, and the following factors were assessed: number of pads used per day, physical examination including pelvic examination, urinalysis, urogenital distress inventory (UDI-6), analog global satisfaction scale (GSS), pad weight test, and urodynamic studies including filling cystometry and Valsalva leak point pressure (VLPP) test. Results: Fifty-two consecutive patients who fulfilled the inclusion criteria underwent TOT procedure by 1 surgeon. The mean age was 50 +/-9 (range 37-72) and minimal follow-up was 24 months (range 24-30 months). Two patients were lost to follow-up after 12 months and 3 patients did not come for the 24-month evaluation. The mean operative time was 18 minutes +/-4 (range 15-31), with an average amount of bleeding 57 cc +/-22cc. Our results demonstrate a 92% cure or improvement rate after 12 months, and an 85% after 24 months. Conclusion: The transobturator approach from outside to inside is a very effective treatment of SUI with low morbidity. However, longer follow-up in larger populations should assess the long-term reliability of this procedure.
Language	English
Publishing date	2010-01-15
Publishing country	Canada
Document type	Journal Article
ISSN	1920-1214
ISSN (online)	1920-1214
DOI	10.5489/cuaj.08118
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