Cases Of Prostatitis Research Articles

Acupuncture as a Treatment Choice for Persistent Chronic Bacterial Prostatitis-Related Symptoms

Background and Aim: In several chronic bacterial prostatitis (CBP) cases, symptoms persist despite bacterial eradication. Since acupuncture has been shown to ameliorate the symptoms of chronic prostatitis/chronic pelvic pain syndrome, it may be an effective treatment option for clinically untreated CBP cases. In order to investigate the above hypothesis, we performed a pilot study. Methods: Patients with persistent CBP-related symptoms and confirmed bacterial eradication were randomly allocated to acupuncture or conventional medical treatment. Symptom burden was assessed at baseline, weeks 4 and 12. Eight patients received 30-min sessions of acupuncture twice weekly for 1 month (Group 1), ten patients received lornoxicam 8 mg orally once daily for 1 month (Group 2), eight patients received Serenoa repens (SR) 320 mg twice daily for 1 month (Group 3), and nine patients received pregabalin 25 mg twice daily for 1 month (Group 4). The primary outcome is the proportion of responders at week 4 with significant change from baseline in the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) total score and International Prostate Symptom Score (IPSS) at week 4. Secondary outcomes included ratings of clinical pain (visual analog scale) and quality of life at week 12. Results: At week 4, no statistically significant differences in the mean decrease of NIH-CPSI and IPSS total scores from baseline among groups were noted. After 12 weeks, none of the participants experienced complete resolution of pain. Differences in the mean pain and quality of life levels were statistically insignificant. Conclusion: Acupuncture is an effective treatment option for persistent CBP-related pain however is inferior to conventional medical treatment in reducing CBP-related lower urinary tract symptoms. For this reason, it may be offered in combination with medical therapy in patients with combined symptoms.

Fungal prostatitis due to endemic mycoses and Cryptococcus: A multicenter case series.

Fungal prostatitis is exceedingly rare with mostly case reports. Electronic medical records at three medical centers were searched for cases of fungal prostatitis due to endemic mycoses and Cryptococcus over the preceding 10 years. Seven cases were identified from 105 600 prostate biopsies within the Southern California Permanente Medical Group for an incidence of 0.0066%. An additional eight cases were identified from two other health care systems. Excluding four patients without available clinical data, 11 patients were reviewed, most of whom underwent biopsy due to elevated prostate-specific antigen. Four were asymptomatic and the remainder had nonspecific signs or symptoms. All biopsies revealed granulomatous inflammation and fungal organisms. Seven patients had coccidioidomycosis, three patients had cryptococcosis (confirmed in two cases and suspected by organism morphology in the other), and one patient had likely histoplasmosis based on organism morphology. Prolonged antifungal treatment was standard; outcomes were favorable. Fungal prostatitis due to endemic mycoses and Cryptococcus is uncommon and associated with favorable outcomes but generally involves prolonged therapy.

Prostatic Artery Embolization Is Safe and Effective for Medically Recalcitrant Radiation-Induced Prostatitis

PurposeChronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) represents 90% of all chronic prostatitis cases and may occur after radiation therapy (RT) for localized prostate cancer. Medical therapy is effective in approximately 50% of cases, with no therapy demonstrating consistent efficacy in refractory cases. Prostatic artery embolization (PAE) is effective in men with lower urinary tract symptoms and benign prostatic hyperplasia. We report clinical improvement after PAE in a case series of men with CP/CPPS after RT. Methods and MaterialsNine men (median age 72 years; range, 61-83 years) with CP/CPPS after RT for prostate cancer underwent PAE. Baseline International Prostate Symptom Score was recorded in 5 patients (median 23; range, 4-26), Chronic Prostatitis Symptom Index score in 6 patients (median 22.5; range, 6-34), and quality of life (QoL) score in 8 patients (median 5; range, 2-6). Median baseline prostate volume was 49 cm3 (range, 22-123 cm3). Patients were followed up at 6 and 12 weeks with QoL, International Prostate Symptom Score, and/or Chronic Prostatitis Symptom Index score and magnetic resonance imaging. ResultsTechnical success (ie, bilateral embolization) was achieved in 78% (n = 7) of patients with the other 2 patients having undergone unilateral embolization with no major complications. Clinical success was seen in 89% (n = 8) of patients and QoL improved in 78% (n = 7) during the follow-up period. ConclusionCP/CPPS after RT for localized prostate cancer is a highly morbid condition, with medical therapy successful in only 50% of cases. PAE may be a successful therapy for medically recalcitrant CP/CPPS, and further studies are necessary to understand the best patient selection and scenario for PAE in the setting of CP/CPPS.

Acute prostatitis after prostate biopsy under ciprofloxacin prophylaxis with or without ornidazole and pre-biopsy enema: analysis of 3.479 prostate biopsy cases.

ABSTRACTObjectives:To investigate the characteristics of cases of NIH category I acute prostatitis developed after transrectal prostate biopsy and clarifiy the risk factors and preventive factors.Materials and Methods:We retrospectively reviewed the medical records of 3.479 cases of transrectal ultrasound-guided needle biopsies performed with different prophylactic antibiotherapy regimens at two different institutions between January 2011 and February 2016. The patients of Group I have received ciprofl oxacin (n=1.523, 500mg twice daily) and the patients of Group II have received ciprofl oxacin plus ornidazole (n=1.956, 500mg twice daily) and cleansing enema combination as prophylactic antibiotherapy. The incidence, clinical features and other related microbiological and clinical data, were evaluated.Results:Mean age was 62.38±7.30 (47-75), and the mean prostate volume was 43.17±15.20 (21-100) mL. Of the 3.479 patients, 39 (1.1%) developed acute prostatitis after the prostate biopsy procedure. Of the 39 cases of acute prostatitis, 28/3.042 occurred after the first biopsy and 11/437 occurred after repeat biopsy (p=0.038). In Group I, 22 of 1.523 (1.4%) patients developed acute prostatitis. In Group II, 17 of 1.959 (0.8%) patients developed acute prostatitis. There was no statistical difference between the two groups according to acute prostatitis rates (X2=2.56, P=0.11). Further, hypertension or DM were not related to the development of acute prostatitis (P=0.76, X2=0.096 and P=0.83, X2=0.046, respectively).Conclusions:Repeat biopsy seems to increase the risk of acute prostatitis, while the use of antibiotics effective for anaerobic pathogens seems not to be essential yet.

Chronic prostatic infection: Microbiological findings in two Mediterranean populations.

Despite accumulated knowledge, several microbiological aspects of chronic bacterial prostatitis (CBP) remain uncertain. The aim of our study was to determine microbiological characteristics on our CBP population. The material of this retrospective study consisted in bacterial isolates from urine and/or prostatic secretions or sperm cultures (total ejaculate) obtained from individuals with prostatitis symptoms and from patients with febrile relapses of CBP visiting our department, from 03/2009 to 03/2015. Retrospective data from an Italian single-center database (years 2009-2015) were also collected for a tentative comparison of pathogen prevalence between chronic bacterial prostatitis cases assessed in Greece and Italy. A total of 389 bacterial isolates obtained from eligible Greek patients constituted the material of the study. While E coli was the most frequent individual pathogen, Gram-positive species were overly more frequent than Gram-negative. Besides the high frequency of E. coli and E. faecalis isolates the most remarkable similarity between Greek and Italian databases was the wide array of different Gram-positive and Gram-negative species isolated from CBP patients. In Greece, the incidence of CBP is possibly higher than that reported in international surveys. Similarities between Greek and Italian databases suggest geographical trends in CBP epidemiology.

Use of prostate systematic and targeted biopsy on the basis of multiparametric MRI in biopsy-naive patients (MRI-FIRST): a prospective, multicentre, paired diagnostic study

Whether multiparametric MRI improves the detection of clinically significant prostate cancer and avoids the need for systematic biopsy in biopsy-naive patients remains controversial. We aimed to investigate whether using this approach before biopsy would improve detection of clinically significant prostate cancer in biopsy-naive patients. In this prospective, multicentre, paired diagnostic study, done at 16 centres in France, we enrolled patients aged 18-75 years with prostate-specific antigen concentrations of 20 ng/mL or less, and with stage T2c or lower prostate cancer. Eligible patients had been referred for prostate multiparametric MRI before a first set of prostate biopsies, with a planned interval of less than 3 months between MRI and biopsies. An operator masked to multiparametric MRI results did a systematic biopsy by obtaining 12 systematic cores and up to two cores targeting hypoechoic lesions. In the same patient, another operator targeted up to two lesions seen on MRI with a Likert score of 3 or higher (three cores per lesion) using targeted biopsy based on multiparametric MRI findings. Patients with negative multiparametric MRI (Likert score ≤2) had systematic biopsy only. The primary outcome was the detection of clinically significant prostate cancer of International Society of Urological Pathology grade group 2 or higher (csPCa-A), analysed in all patients who received both systematic and targeted biopsies and whose results from both were available for pathological central review, including patients who had protocol deviations. This study is registered with ClinicalTrials.gov, number NCT02485379, and is closed to new participants. Between July 15, 2015, and Aug 11, 2016, we enrolled 275 patients. 24 (9%) were excluded from the analysis. 53 (21%) of 251 analysed patients had negative (Likert ≤2) multiparametric MRI. csPCa-A was detected in 94 (37%) of 251 patients. 13 (14%) of these 94 patients were diagnosed by systematic biopsy only, 19 (20%) by targeted biopsy only, and 62 (66%) by both techniques. Detection of csPCa-A by systematic biopsy (29·9%, 95% CI 24·3-36·0) and targeted biopsy (32·3%, 26·5-38·4) did not differ significantly (p=0·38). csPCa-A would have been missed in 5·2% (95% CI 2·8-8·7) of patients had systematic biopsy not been done, and in 7·6% (4·6-11·6) of patients had targeted biopsy not been done. Four grade 3 post-biopsy adverse events were reported (3 cases of prostatitis, and 1 case of urinary retention with haematuria). There was no difference between systematic biopsy and targeted biopsy in the detection of ISUP grade group 2 or higher prostate cancer; however, this detection was improved by combining both techniques and both techniques showed substantial added value. Thus, obtaining a multiparametric MRI before biopsy in biopsy-naive patients can improve the detection of clinically significant prostate cancer but does not seem to avoid the need for systematic biopsy. French National Cancer Institute.

Prognostic and Clinic-Pathological Significances of SCF and COX-2 Expression in Inflammatory and Malignant Prostatic Lesions.

The initiation of prostatic malignancy has been linked to chronic inflammation. Stem cell factor (SCF) is an inflammatory cytokine that is specific to the c-KIT receptor which is type III receptor tyrosine kinase (RTK). Cyclooxygenases (COXs) are the main enzymes which are responsible for prostaglandins production from arachidonic acid. COX2 is an enzyme which is produced under different pathological conditions. The aim of our study; is to investigate the clinicopathological and the prognostic significance of SCF and COX-2 expression in prostatic adenocarcinoma (PC), chronic prostatitis and nodular prostatic hyperplasia (NPH) in a trial to clarify the role of inflammation as a risk factor for prostatic carcinogenesis and cancer progression. SCF and COX-2 tissue protein expression were evaluated in 50 cases of PC, 20 cases of chronic prostatitis and 10 cases of NPH using immunohistochemistry, patients were followed up for 5years. The relationship between their levels of expressions, clinicopathological, and prognostic criteria were studied. SCF expression in PC was positively correlated with advanced patient age (p = <0.001), high level of PSA (p = 0.010), higher Gleason score (p = 0.011). COX-2 expression in PC was positively correlated with advanced patient age (p = <0.001), high level of PSA (p = 0.016), advanced D'Amico risk group (p = 0.038). High levels of expression of both SCF& COX-2 are associated with higher incidence of tumor relapse, worse disease overall survival and free survival (p < 0.001). SCF and COX-2 are associated with PC progression and associated with poor prognosis in PC patients.

Tubercular Prostatitis: A rare case of Genitourinary Tuberculosis

Genitourinary tuberculosis is the second most common type of extra-pulmonary tuberculosis after tubercular lymphadenitis. Tuberculosis of the prostate is a relatively rare condition and most cases are diagnosed on histology following prostatectomy or prostatic biopsy. Probably several cases of tubercular prostatitis remain undiagnosed. Therefore it requires a high index of suspicion. Here we report a rare case of tubercular prostatitis in a 49 years old man who presented with features of lower urinary tract symptoms. Journal of Nobel Medical College Volume 7, Number 1, Issue 12, January-June 2018, Page: 65-67

Phage Therapy in Prostatitis: Recent Prospects.

Prostatitis has various etiology including bacterial infection and dysregulated immunity; some of its forms remain a serious therapeutic challenge. Inflammation occurs in all forms of this disorder and is proposed to predispose to the development of prostate cancer (PC). There are reports that phage therapy is effective in chronic bacterial prostatitis. Recent findings suggest that phages not only eliminate bacteria, but also mediate immunomodulating (for example, anti-inflammatory) functions. The immunomodulating effects of phages could be beneficial in treating all forms of prostatitis and play some role in the prevention of the development of PC. As the etiological factors contributing to the majority of prostatitis cases remains largely unknown, and management options are often likewise limited, phage therapy merits further research as an attractive therapeutic option given its immunomodulating effects irrespective of the underlying causative factor(s).

Prognostic significance of prostate specific antigen in comparison with histological grade of prostatic adenocarcinoma: A Hospital based study.

Background : Prostate gland disease causes significant morbidity in elderly males. Our objective of the study was to evaluate the histopathological spectrum of prostatic lesions in correlation with prostate specific antigen and compare the prostate specific antigen with histological grade of prostatic adenocarcinoma. Methods: The present retrospective study was carried in the department of pathology, Narayana Medical College & Hospital, Nellore, and Andhra Pradesh, India from January 2015 to December 2015. 119 Prostatic biopsy specimens were analyzed histopathologically for diagnosis of types of prostatic lesion and correlated with serum PSA level. Prostatic adeno carcinomas were graded according to Gleason histological grading. Gleason’s grading of tumors was correlated with serum PSA levels Result: Out of 119 patients, 95 cases had benign prostatic hyperplasia, 17 cases had prostatic adenocarcinoma, 7 cases had prostatitis. In our study, the maximum number of BPH cases (51.58%) showed PSA levels 10ng/ml. 5 cases (71.43%) of prostatitis showed PSA levels of 4-10ng/ml.Maximum cases of grade 2 and grade 3 prostatic adenocarcinoma had PSA range of 20-49 .99ng/ml. Conclusion : Benign prostatic hyperplasia is the most commonly diagnosed prostatic lesions. Investigation like serum PSA level detection can aid in the diagnosis, but accurate diagnosis of non-neoplastic and neoplastic lesions of prostate can be made by histopathological study of prostate biopsy. There is a positive relation was seen between higher levels of PSA and Gleason histopathological grade.

Granulomatous prostatitis: clinical and histomorphologic survey of the disease in a tertiary care hospital.

BackgroundGranulomatous prostatitis is an uncommon entity that is diagnosed incidentally on histopathology and is broadly classified as nonspecific, specific, postsurgical (post-transurethral resection), or secondary to other rare systemic granulomatous diseases. Only very few studies are available in the literature that describe the clinical and histomorphological spectrum of the disease.MethodsA retrospective analysis of histopathological records of 1,181 prostatic specimens received in the pathology department was done over a period of 13 years (January 2003 to January 2016). All histologically proven cases of granulomatous prostatitis were retrieved, and relevant clinical data were collected from patients’ records. Epstein and Hutchins classification was used to categorize these cases.ResultsTwenty-two cases of granulomatous prostatitis were identified, accounting for an incidence of 1.86%. Among these, nonspecific granulomatous prostatitis (n = 10) was the most common followed by tubercular prostatitis (n = 5), posttransurethral resection of the prostate (n = 3), allergic (n = 2), and xanthogranulomatous prostatitis (n = 2). The age range of these patients was between 41 and 75 years, with the majority of patients in their 7th decade. Serum prostate-specific antigen levels ranged between 0.88 ng/mL and 19.22 ng/mL. Hard and fixed nodules were observed on digital rectal examination in 14 cases. Transrectal ultrasound revealed hypoechoic shadows in five cases.ConclusionDespite present-day advances in imaging modalities and serological investigations, it is virtually impossible to identify granulomatous prostatitis clinically. Histopathology remains the gold standard in diagnosing the disease. However, assigning an etiologic cause to the wide spectrum of granulomas in granulomatous prostatitis requires a pathologist’s expertise and proper clinical correlation for appropriate patient management.

Association of anti-sperm antibodies with chronic prostatitis: A systematic review and meta-analysis

Chronic prostatitis is a risk factor for impaired male fertility potential, and anti-sperm antibodies (ASAs) cause the autoimmune disease immune infertility, which has a negative effect on semen parameters. Current studies have investigated the ASA-positive relationship between chronic prostatitis versus normal controls, but have shown inconsistent results. Hence, we systematic searched the PubMed, EMBASE, Science Direct/Elsevier, Medline, and the Cochrane Library up to October 2015 for case-control studies that involved the ASA-positive relationship between chronic prostatitis patients versus normal controls. The meta-analysis was performed with Review Manager and Stata software. After literature search, six studies were identified, including 721 cases of chronic prostatitis and 160 normal controls. Our results illustrated a significant correlation of the ASA-positive relationship between chronic prostatitis patients versus normal controls. The combined odds ratio of the ASA-positive rate in chronic prostatitis patients and normal controls was 3.26 (1.86–5.71). There was also a significant correlation of the ASA-positive relationship between National Institutes of Health (NIH) III versus normal controls, and the combined OR was 2.46 (1.10–5.51). However, there was no significant correlation of the ASA-positive relationship between National Institutes of Health (NIH) II versus normal controls. The present study illustrates that the positive rate of ASAs in chronic prostatitis patients was significantly higher than in the control group, suggesting that chronic prostatitis has a negative effect on male reproductive function. However, studies with larger samples are needed to better illuminate the correlation between ASAs and chronic prostatitis.

An observational study of the use of beclomethasone dipropionate suppositories in the treatment of lower urinary tract inflammation in men.

BackgroundNonbacterial prostatitis, together with chronic pelvic pain syndrome, accounts for 90–95 % of prostatitis cases. Anti-inflammatory medications are commonly used to reduce storage/inflammatory symptoms that can deteriorate quality of life. The purpose of this study was to observe the efficacy and safety of beclomethasone dipropionate rectal suppositories (Topster®) in inflammations of the lower urinary tract in men.MethodsPatients underwent diagnostic and therapeutic protocols according to current evidence-based practice. Efficacy assessments: voiding parameters, perineal pain, International Prostate Symptom Score (IPSS), digital rectal examination (DRE). Adverse events and patient compliance were recorded throughout the study.ResultsOne hundred eighty patients were enrolled, mean age 52 ± 14.97. Most frequent diagnosis: nonbacterial prostatitis (85 %). All patients completed visits 1 and 2. All patients were treated with beclomethasone dipropionate (BDP) suppositories, 136/180 also with Serenoa repens (SR) extract. Antibiotics were rarely required.162/180 patients presented clinically significant improvements and terminated treatment.Mean change vs. baseline in voiding frequency: −3.55 ± 2.70 n/day in patients taking only BDP and −3.68 ± 2.81 n/day in those taking both BDP and SR (P<.0001 in both groups). Uroflowmetry improved significantly; change from baseline 3.26 ± 5.35 ml/s in BDP only group and 5.61 ± 7.32 ml/s in BDP + SR group (P = 0.0002 for BDP, P<.0001 for BDP + SR). Urine stream normal in 35 % of patients at visit 1 and 57.22 % of patients at visit 2. Mean change in perineal pain, on 0–10 VAS, −0.66 ± 2.24 for BDP only group (P = 0.0699) and −1.37 ± 2.40 for BDP + SR group (P<.0001). IPSS increased at visit 2. No adverse events were reported.For all parameters, none of the comparisons between groups was found to be statistically significant.ConclusionThis study confirmed the drug’s good safety profile. We also observed an improvement in the main storage symptoms and clinical findings associated with lower urinary tract inflammation in patients treated with beclomethasone dipropionate suppositories.

The status of sperm immobilizing-antibody (SI-Ab) detected in infertile females (therapy and pathogenic mechanisms)

Chronic prostatitis is a risk factor for impaired male fertility potential, and anti-sperm antibodies (ASAs) cause the autoimmune disease immune infertility, which has a negative effect on semen parameters. Current studies have investigated the ASA-positive relationship between chronic prostatitis versus normal controls, but have shown inconsistent results. Hence, we systematic searched the PubMed, EMBASE, Science Direct/Elsevier, Medline, and the Cochrane Library up to October 2015 for case-control studies that involved the ASA-positive relationship between chronic prostatitis patients versus normal controls. The meta-analysis was performed with Review Manager and Stata software. After literature search, six studies were identified, including 721 cases of chronic prostatitis and 160 normal controls. Our results illustrated a significant correlation of the ASA-positive relationship between chronic prostatitis patients versus normal controls. The combined odds ratio of the ASA-positive rate in chronic prostatitis patients and normal controls was 3.26 (1.86–5.71). There was also a significant correlation of the ASA-positive relationship between National Institutes of Health (NIH) III versus normal controls, and the combined OR was 2.46 (1.10–5.51). However, there was no significant correlation of the ASA-positive relationship between National Institutes of Health (NIH) II versus normal controls. The present study illustrates that the positive rate of ASAs in chronic prostatitis patients was significantly higher than in the control group, suggesting that chronic prostatitis has a negative effect on male reproductive function. However, studies with larger samples are needed to better illuminate the correlation between ASAs and chronic prostatitis.

MP26-11 IS PRE-OPERATIVE URINE CULTURE SUFFICIENT TO PREDICT SEPTIC COMPLICATIONS OF PERCUTANEOUS NEPHROLITHOTOMY?

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Kidney & Bladder II1 Apr 2016MP26-11 IS PRE-OPERATIVE URINE CULTURE SUFFICIENT TO PREDICT SEPTIC COMPLICATIONS OF PERCUTANEOUS NEPHROLITHOTOMY? Marouene Chakroun, Walid Kerkeni, Abderrazak Bouzouita, Haroun Ayed, Mohamed Cherif, Amine Derouiche, Mohamed Riadh Ben Slama, and Mohamed Chebil Marouene ChakrounMarouene Chakroun More articles by this author , Walid KerkeniWalid Kerkeni More articles by this author , Abderrazak BouzouitaAbderrazak Bouzouita More articles by this author , Haroun AyedHaroun Ayed More articles by this author , Mohamed CherifMohamed Cherif More articles by this author , Amine DerouicheAmine Derouiche More articles by this author , Mohamed Riadh Ben SlamaMohamed Riadh Ben Slama More articles by this author , and Mohamed ChebilMohamed Chebil More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2948AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Preoperative urine culture is essential before urologic surgery; its positivity may be associated with a high risk of postoperative complications. Our objective was to evaluate the incidence and the severity of septic complications after percutaneous nephrolithotomy (PNL), and determinate whether preoperative urine culture was predictive of these complications. METHODS We retrospectively analyzed data of 277 patients who had undergone PNL between 2009 and 2014. Septic complications occurred after surgical procedure were reported and then classified according to severity using the Clavien-Dindo classification. Univariate analysis was used to assess the impact pre-operative urine culture on the occurrence of septic complications. RESULTS The median age was 46 years (9 – 80). %). The median size of the stone was 30.69 mm (10-70). The average operative time was 167.38 mn (75-300). Complications occurred in 139 patients (55.37%), septic ones in 69 patients (24.9%), including 6 cases of retroperitoneal phlegmon (2.16%), one case of renal abscess (0.36%), 3 cases of pyelonephritis (1.08%), and 4 cases of prostatitis (1.44%). Fever with no etiology has been reported in 56 cases, it was considered as a septic complication. According to severity, grade 4 complications have been reported in 3 patients (1.08%), with recovery after resuscitation. Preoperative urine culture was positive in 17 patients (6.13%); all had peri-operative antibiotherapy adapted to the antibiogram. Seven of these patients (41.17%) had septic complications. In univariate analysis, preoperative urine culture was not predictive of septic complications (OR=1.27; p = 0.242). CONCLUSIONS Pre-operative urine culture was not sufficient to predict septic complications after PNL. Most patients who presented with septic complications post-operatively had negative preoperative urine culture. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e358 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Marouene Chakroun More articles by this author Walid Kerkeni More articles by this author Abderrazak Bouzouita More articles by this author Haroun Ayed More articles by this author Mohamed Cherif More articles by this author Amine Derouiche More articles by this author Mohamed Riadh Ben Slama More articles by this author Mohamed Chebil More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Clinicopathological Overview of Granulomatous Prostatitis: An Appraisal.

Granulomatous prostatitis is a rare inflammatory condition of the prostate. Granulomatous prostatitis is important because, it mimics prostatic carcinoma clinically and hence the diagnosis can be made only by histopathological examination. To study the histomorphological features and to know the prevalence of granulomatous prostatitis. Histopathological records of 1,203 prostatic specimens received in the Department of the Pathology over a period of five years (June 2009 - June 2014). Seventeen cases of histopathologically, diagnosed granulomatous prostatitis were retrieved and reterospective data was collected from the patient's records. Out of 17 cases of granulomatous prostatitis, we encountered 9 cases of non-specific granulomatous prostatitis, 5 cases of xanthogranulomatous prostatitis and 3 cases of specific tubercular prostatitis. The common age ranged from 51-75 years (mean 63 years) with mean PSA level of 15.8ng/ml. Six patients showed focal hypoechoic areas on TRUS and 11 cases revealed hard and fixed nodule on DRE. Non-specific granulomatous prostatitis is the most common type of granulomatous prostatitis. There is no specific pattern of clinical, biochemical and ultrasound findings that allows the diagnosis of granulomatous prostatitis or differentiates it from prostatic carcinoma. Hence, histomorphological diagnosis is the gold standard in differentiating various prostatic lesions.

Non-steroid antiinflammatory drugs in therapy of chronic abacterial prostatitis/syndrome of chronic pelvic pain

The inflammatory chronic abacterial prostatis/chronic pelvic pain syndrome accounts for 60-65% of all cases of chronic prostatitis. The etiology of the chronic abacterial prostatis/chronic pelvic pain syndrome remains unstudied to the full. The major objective of clinical study is to rule out possible organic urologic diseases. The inflammatory chronic abacterial prostatis/ chronic pelvic pain syndrome is characterized by the inflammatory reaction in the prostate secretion in absence of bacteria in the diagnostics titer in the urine and the prostate secretion. Cyclogenase-2 inhibitors reduce the content of prostaglandins in the sperm and urine, pain sensation and edema of the prostate gland. Use of nimesulide in patients of this category allows removing pelvic pains, increasing blood flow in the prostate gland at low percentage of adverse events.

Retrospective study for risk factors for febrile UTI in spinal cord injury patients with routine concomitant intermittent catheterization in outpatient settings.

Retrospective study. The objective of this study was to investigate the clinical risk factors for febrile urinary tract infection (UTI) in spinal cord injury-associated neurogenic bladder (NB) patients who perform routine clean intermittent catheterization (CIC). Rehabilitation Hospital, Kobe, Japan. Over a 3-year period, we retrospectively assessed the clinical risk factors for febrile UTI in 259 spinal cord injury patients diagnosed as NB and performing routine CIC with regard to the factors such as gender, the presence of pyuria and bacteriuria, and the categories of the American Spinal Injury Association (ASIA) impairment scale. A total of 67 patients had febrile UTI in the follow-up period, with 57 cases of pyelonephritis, 11 cases of epididymitis and 2 cases of prostatitis, including the patients with plural infectious diseases. The causative bacteria were ranked as follows: Escherichia coli (74 cases), Pseudomonas aeruginosa (17 cases), Enterococcus faecalis (14 cases) and Klebsiella pneumoniae (12 cases). Antibiotic-resistant E. coli were seen, with 10.5% instances of extended-spectrum β-lactamase (ESBL) production and 23.8% of fluoroquinolone resistance. Multivariate analyses of clinical risk factors for febrile UTI showed that gender (male, P=0.0431), and ASIA impairment scale C or more severe (P=0.0266) were significantly associated with febrile UTI occurrence in NB patients with routine CIC. Our data demonstrated gender (male) and ASIA impairment scale C or more severe were significantly associated with febrile UTI occurrence in NB patients using routine CIC. Further prospective studies are necessary to define the full spectrum of possible risk factors for febrile UTI in these patients.

PD8-08 RISK FACTORS FOR FEBRILE UTI IN SPINAL CORD INJURY PATIENTS WITH ROUTINE CONCOMITANT INTERMITTENT CATHETERIZATION (CIC)

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Kidney & Bladder I1 Apr 2015PD8-08 RISK FACTORS FOR FEBRILE UTI IN SPINAL CORD INJURY PATIENTS WITH ROUTINE CONCOMITANT INTERMITTENT CATHETERIZATION (CIC) Fukashi Yamamichi, Katsumi Shigemura, Shigeto Mukai, Masashi Nomi, Akihiro Yanagiuchi, Atsushi Sengoku, Kazushi Tanaka, Soichi Arakawa, and Masato Fujisawa Fukashi YamamichiFukashi Yamamichi More articles by this author , Katsumi ShigemuraKatsumi Shigemura More articles by this author , Shigeto MukaiShigeto Mukai More articles by this author , Masashi NomiMasashi Nomi More articles by this author , Akihiro YanagiuchiAkihiro Yanagiuchi More articles by this author , Atsushi SengokuAtsushi Sengoku More articles by this author , Kazushi TanakaKazushi Tanaka More articles by this author , Soichi ArakawaSoichi Arakawa More articles by this author , and Masato FujisawaMasato Fujisawa More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.923AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Neurogenic bladder associated with spinal injury may have severe problems in their urinary tract system such as urinary tract infection (UTI). The purpose of this study is to investigate the clinical risk factor for febrile UTI in spinal cord injury-associated neurogenic bladder patients who perform routine concomitant intermittent catheterization (CIC). METHODS We investigated 321 (247 male and 74 female) spinal cord injury patients in these 3 years who were diagnosed as neurogenic bladder and perform routine CIC regarding the such factors febrile UTI, gender, the presence of pyuria and bacteriuria or categories of the American Spinal Injury Association (ASIA) impairment scale (Reference Manual for the International Standards for Neurological Classification of Spinal Cord Injury (Rev. 2003)). We examined to assess the clinical risk factors for febrile UTI. RESULTS Total 77 (24.0 %) patients had febrile UTI in these follow-up periods and 64 cases of pyelonephritis, 11 cases of epididymitis and 2 cases of prostatitis. As to infection events, 145 events of febrile UTI were observed and details were 130 cases of pyelonephritis, 13 cases of epididymitis and 2 cases of prostatitis. The causative bacteria were ranked as follows: Eschelicia coli (81 cases), Pseudomonas aeruginosa (21 cases), Enterococcus faecalis (19 cases) and Kllebsiella pneumoniae (15 cases). Antibiotic resistant E. coli were seen in 10.2 % of ESBL production and 23.8 % of fluoroquinolone-resistance. Our clinical risk factor investigation showed that gender (male, p=0.0023) and ASIA category C or more severe (A or B) (p=0.0040) had significantly associated with febrile UTI occurrence for neurogenic bladder patients with routine CIC in our set factors. This may suggest CIC in male required more skill than female and severe spinal cord injury caused less motor function related to CIC performance and less motor and sensory function related to for bladder function. CONCLUSIONS Our data demonstrated that male and ASIA classification C or more severe impairment in spinal injury-associated neurogenic bladder patients with routine CIC were significant risk factors for febrile UTI. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e193 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Fukashi Yamamichi More articles by this author Katsumi Shigemura More articles by this author Shigeto Mukai More articles by this author Masashi Nomi More articles by this author Akihiro Yanagiuchi More articles by this author Atsushi Sengoku More articles by this author Kazushi Tanaka More articles by this author Soichi Arakawa More articles by this author Masato Fujisawa More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Trueperella pyogenes multispecies infections in domestic animals: a retrospective study of 144 cases (2002 to 2012)

Background: Formerly, Arcanobacterium pyogenes was recently renamed Trueperella pyogenes. This opportunistic bacterium is related to miscellaneous pyogenic infections in animals. Most studies involving T. pyogenes are case reports, whereas few surveys have focused the major aspects of T. pyogenes infections involving a case series study design.Objective: The aim of this study was to retrospectively evaluate selected epidemiological and clinical aspects, as well as the in vitro antimicrobial susceptibility pattern of 144 cases of T. pyogenes infections among domestic animals from 2002 to 2012.Animals and methods: T. pyogenes was isolated from different clinical specimens from cattle, goats, sheep, pigs, horses, dogs, and buffaloes. Correlations were assessed by the Chi-square or Fisher's exact tests.Results: Mastitis (45.1%), abscesses (18.0%), pneumonia (11.1%), and lymphadenitis (9.0%) were the most common clinical manifestations. In addition, the organism was also isolated from other miscellaneous clinical specimens from cases of septicemia, encephalitis, pyometra, prostatitis, orchitis, seminal vesiculitis, pericarditis, and omphalitis. No statistical association was observed between T. pyogenes infections and age, gender, or season across the study. The most effective drugs against the pathogen were florfenicol (99.1%), cefoperazone (96.0%), cephalexin (95.0%), and ceftiofur (94.8%). High resistance rates were observed against trimethoprim-sulfamethoxazole (49.3%), followed by norfloxacin (10.9%) and tetracycline (9.2%).Conclusions: This study highlights the diversity of clinical manifestations and the opportunistic behavior of T. pyogenes infections in domestic animals, with predominance of mastitis, abscesses, pneumonia, and lymphadenitis. It also reinforces the importance of knowing the susceptibility profile before initiating therapy, to improve antimicrobial therapy approaches.