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  1. Wan Mokhter WM, Duan X, Yang J, Mohamed Daud MA
    PLoS One, 2025;20(2):e0313557.
    PMID: 39937772 DOI: 10.1371/journal.pone.0313557
    BACKGROUND: To investigate the risk factors for urethral stricture (US) in patients with benign prostatic hyperplasia (BPH) after transurethral resection of the prostate (TURP) and to construct a nomogram model with predictive features.

    METHODS: Clinical data of 400 patients with BPH who underwent TURP between June 2020 and June 2023 at Chengdu University Hospital were retrospectively collected. The data were divided into US group and no US group. Univariate and multivariate logistic regression analyses were performed sequentially to identify independent risk factors associated with US. Based on the results of the multivariate analysis, a nomogram model predicting the risk of US was constructed. We assessed the discriminatory power and calibration of the models using the C index, ROC curves, and calibration plots. In addition, we performed a decision curve analysis to validate the clinical utility of the model.

    RESULTS: Data from a total of 400 patients were included in this study, and 35 (8.75%) were diagnosed with US. The results of univariate and multivariate analyses indicated that the following five factors age, prostate size, Preoperative indwelling catheter, Preoperative urethral dilation, Postoperative indwelling catheter time were independent influences on the risk of US. Nomogram model of US was constructed using these independent influences. The area under the curve (AUC) of the subject's operating characteristic was 0.916 (95% CI: 0.868-0.959), and after internal validation, the corrected C-index remained at 0.916. This further validates the accuracy and reliability of the predictive model. Calibration plots and decision curve analyses demonstrated the good clinical value of the column-line diagram model.

    CONCLUSIONS: The nomogram model we constructed can have some guidance in clinical work.

  2. Othman MF, Zakaria AD, Yahya MM, Md Hashim MN, Wan Mokhter WM, Wan Zain WZ, et al.
    Malays J Med Sci, 2023 Oct;30(5):106-115.
    PMID: 37928791 DOI: 10.21315/mjms2023.30.5.9
    BACKGROUND: Polyethylene glycol (PEG) solution is widely used as a colonoscopic bowel cleaning agent, although some patients are intolerant due to the need for ingesting large solution volumes and unpleasant taste. A low-volume solution may enhance patient tolerability and compliance in bowel preparation. Accordingly, this study compared the effectiveness of two difference PEG volumes for bowel preparation before colonoscopy in terms of bowel cleanliness, completeness of colonoscopy, patient tolerability and colonoscopy duration.

    METHODS: Using a prospective randomised controlled single-blinded study design, 164 patients scheduled for colonoscopy were allocated to two groups (n = 82 patients in each) to receive either the conventional PEG volume (3 L, control group) or the low volume (2 L, intervention group). The Boston Bowel Preparation Scale (BBPS), a validated scale for assessing bowel cleanliness during colonoscopy, was used to score bowel cleanliness in three colon segments. Secondarily, colonoscopy completeness, tolerability to drinking PEG and the duration of colonoscopy were compared between the groups.

    RESULTS: There were no statistically significant differences between the two intervention groups in terms of bowel cleanliness (P = 0.119), colonoscopy completion (P = 0.535), tolerability (P = 0.190) or the amount of sedation/analgesia required (midazolam, P = 0.162; pethidine, P = 0.708). Only the duration of colonoscopy differed between the two groups (longer duration in the control group, P = 0.039).

    CONCLUSION: Low-volume (2 L) PEG is as effective as the standard 3 L solution in bowel cleaning before colonoscopy; however, the superiority of either solution could not be established.

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