Acute Prostatitis Research Articles

Hypervirulent Klebsiella pneumoniae: Characteristic and clinical perspective

Background: Hypervirulent K. pneumoniae (hvKP). A virulent pathogen that has the ability to infect individuals in various age, has multiple ports of entry and cause infectious syndromes. Therefore urges an increase awareness and perspective on the characteristics and clinical feature of hvKP, to better understanding and providing appropriate treatment in cases of infection caused by hvKP. Main Text: Hypervirulent K. pneumoniae (hvKP) was first reported in Taiwan in 1986. This bacteria was responsible for liver abscess with septic endophthalmitis, of these cases some of patient have extrahepatic complications such as meningitis pneumonia, prostate abscess and pyogenic ophthalmia. There are several virulence factors hvKP such as, capsule as the main defensive factor, aerobactin provide iron supply and Colibactin can suppressing the activity of regulatory T lymphocyte cells, could improve survival hvKP by avoid the process of phagocytosis, complement, antimicrobial peptides and specific antibodies. The pathophysiology and clinical factors of hvKP showed similar symptom to conventional cKP except liver access and infectious syndrom. Conclusion: The threat of Hypervirulent K. pneumoniae (hvKP) increases worldwide due the virulence factors more vary compared to conventional cKP. Consequently, special measures such as vaccine need to be develop in order to eradicate this pathogen particularly among pediatric patient.

Prostate Cancer and Its Mimics-A Pictorial Review.

Multiparametric prostate MRI (mpMRI) is gaining wider recommendations for diagnosing and following up on prostate cancer. However, despite the high accuracy of mpMRI, false positive and false negative results are reported. Some of these may be related to normal anatomic structures, benign lesions that may mimic cancer, or poor-quality images that hamper interpretation. The aim of this review is to discuss common potential pitfalls in the interpretation of mpMRI. mpMRI of the prostates was performed on 3T MRI scanners (Philips Achieva or Siemens Magnetom Vida) according to European Society of Urogenital Radiology (ESUR) guidelines and technical requirements. This pictorial review discusses normal anatomical structures such as the anterior fibromuscular stroma, periprostatic venous plexus, central zone, and benign conditions such as benign prostate hyperplasia (BPH), post-biopsy hemorrhage, prostatitis, and abscess that may imitate prostate cancer, as well as the appearance of prostate cancer occurring in these locations. Furthermore, suggestions on how to avoid these pitfalls are provided, and the impact of image quality is also discussed. In an era of accelerating prostate mpMRI and high demand for high-quality interpretation of the scans, radiologists should be aware of these potential pitfalls to improve their diagnostic accuracy.

Outpatient sexually transmitted infection testing and treatment patterns in the United States: a real-world database study

BackgroundChlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are the most common notifiable sexually transmitted infections (STIs) in the United States. Because symptoms of these infections often overlap with other urogenital infections, misdiagnosis and incorrect treatment can occur unless appropriate STI diagnostic testing is performed in clinical settings. The objective of this study was to describe STI diagnostic testing and antimicrobial treatment patterns and trends among adolescent and adult men and women with lower genitourinary tract symptoms (LGUTS).MethodsWe analyzed insurance claims data from the IBM® MarketScan® Research Databases. Patients included were between 14 and 64 years old with LGUTS as determined by selected International Classification of Diseases codes between January 2010 and December 2019. Testing of STIs and relevant drug claims were captured, and distribution of testing patterns and drug claims were described.ResultsIn total, 23,537,812 episodes with LGUTS (87.4% from women; 12.6% from men) were analyzed from 12,341,154 patients. CT/NG testing occurred in only 17.6% of all episodes. For episodes where patients received treatment within 2 weeks of the visit date, 89.3% received treatment within the first 3 days (likely indicating presumptive treatment), and 77.7% received it on the first day. For women with pelvic inflammatory disease and men with orchitis/epididymitis and acute prostatitis, ≤ 15% received CT/NG testing, and around one-half received antibiotic treatment within 3 days.ConclusionsOur study revealed low CT/NG testing rates, even in patients diagnosed with complications commonly associated with these STIs, along with high levels of potentially inappropriate presumptive treatment. This highlights the need for timely and accurate STI diagnosis in patients with LGUTS to inform appropriate treatment recommendations.

Candida Prostatitis: A Review and Update

Candidiasis is a terminology that is used for a fungal infection that is caused by a yeast which is a fungus that called candida species. Some species of candida can cause infection in human beings and the commonest candida species that can infect human beings is candida Albicans. Candida normally lives upon the skin as well as inside the human body, such as the mouth, the throat, the gut, and the vagina, without causing problems. Candida can cause infections if it grows out of control or if it enters deep into the body. For example, it could cause infections in the bloodstream or internal organs like the kidney, the heart, or the brain. Candida infection can be localized to one body organ or it could be a disseminated candida infection affecting various organs. Candida infection does tend to afflict immune-supressed individuals more often in comparison with immune competent individuals. Candida prostatitis an uncommon condition which clinicians should have a high index of suspicion for because it does manifest with non-specific symptoms that tend to be associated with more common conditions of the prostate and the urinary tract. Candida infection of the prostate gland may be an isolated de novo infection or it may be associated disseminated candida infection, or it may also be associated with prostate cancer or various immune-suppression conditions. Candida infection of the prostate gland could manifest as an acute infection/inflammation of the prostate gland or a chronic inflammation of the prostate gland or it could manifest as prostatic abscess. Some of the potential manifestations of candida prostatitis and or prostatic abscess include: (a) incidental finding upon biopsy of the prostate gland or following trans-urethral resection of prostate gland or prostatectomy. ( b) patient may manifest with lower urinary tract symptoms, (c) a patient may manifest with urinary retention that may be acute or chronic, (d) a patient may manifest with raised levels of serum prostate specific antigen (PSA), € at times when digital rectal examination is undertaken on a patient who has Candida prostatitis, the prostate gland may feel benign and in the case of a candida prostatic abscess rectal examination may demonstrate bogginess in the area of the prostate with soft fluctuant feeling. (f) Eosinophil count in some cases of Candida prostatitis would tend to be normal but in some cases of candida infection of the prostate gland, there could be Eosinophilia but this would not be diagnostic of Candida infection, (g) a history of having had coital contact with an individual who has been treated for candida infection or a history of past treatment of the individual should alert all clinicians to exclude the possibility of candida prostatitis. (h) on rare occasions urine culture or culture of expressed prostatic secretions would yield a growth of Candida. Diagnosis of Candida infection or abscess of the prostate gland may be confirmed by positive culture of Candida in prostate biopsy specimen or resected or excised prostate specimen. Treatment of Candida Prostatitis / prostatic abscess does tend to entail: (a) Treatment with appropriate antifungal medicament, plus (b) Complete radiology image-guided aspiration / drainage of any abscess seen plus / minus or endoscopic deroofing trans-urethral resection of the prostate to ensure the abscess drains out completely. Because recurrence of Candida prostatitis or prostatic abscess or Candida infection elsewhere can occur, it is important for patients to have regular follow-up assessments to ensure recurrence disease does not develop and if it develops, it is diagnosed quickly in order to initiate prompt treatment. It is also important to assess all coital contacts of the patient to ascertain if they have Candida infection to enable prompt treatment of their infection. If an individual who has candida prostatitis or prostatic abscess is also found to have contemporaneous adenocarcinoma of the prostate, the carcinoma of the prostate gland should be treated appropriately based upon the Gleason Grade and the Stage of the carcinoma, the performance status and age of the individual patient based upon the national and international guidelines pertaining to prostate cancer as a separate multi-disciplinary team discussion of the patient management.

Targeted Antimicrobial Prophylaxis with Cefmetazole Based on Presence of Fluoroquinolone-Resistant Isolates to Prevent Post-Prostate Biopsy Infectious Complications

Fluoroquinolones (FQs) have been traditionally used for prophylaxis against bacterial infection. However, the rapid emergence of FQ-resistant Escherichia coli due to overuse and misuse have resulted in an increase in post-biopsy infections. We requested 723 patients undergoing transrectal or transrectal plus transperineal targeted prostate biopsy to provide preprocedure rectal swabs. The rectal swabs were plated onto deoxycholate hydrogen sulfate lactose agar culture and FQ resistance tests were conducted using the disc diffusion method following the guidelines of the Clinical and Laboratory Standards Institute. All patients undergoing biopsy were given a 1.0 g intravenous injection of cefmetazole (CMZ) 30 min before and 12 h after biopsy. Patients with FQ-resistant organisms received an additional 1.0 g intravenous injection of CMZ every 12 h for an additional 1.5 days, while those without FQ-resistant organisms received levofloxacin 500 mg for 4 days. We evaluated infectious symptoms during the 30 days after the biopsy. We also evaluated the incidence of acute prostatitis within 7 days after the biopsy and isolation rates of FQ-resistant strains. A total of 289 patients (40%) had FQ-resistant isolates on rectal swabs. The overall infectious complication rate was 0.69%. Two patients with FQ-resistant isolates and three patients without them experienced infectious episodes. One patient with FQ-resistant isolates and two patients without them suffered acute prostatitis. The difference in the rates of infectious complication and acute prostatitis rates between FQ-resistant and FQ-susceptible carriers were not significant (p = 1.0 and 1.0, respectively). Post-biopsy sepsis was identified in one patient (0.14%) who had FQ-resistant Escherichia coli. Targeted antimicrobial prophylaxis with cefmetazole based on presence of FQ-resistant isolates on rectal swabs may prevent post-prostate biopsy infectious complications, especially in geographic lesions with a high incidence of FQ-resistant strains in rectal flora.

MP73-11 MEDIUM TERM OUTCOMES FOLLOWING PRIMARY FOCAL CRYOTHERAPY FOR LOCALISED PROSTATE CANCER IN 323 PATIENTS, A MULTI-INSTITUTIONAL OBSERVATIONAL STUDY OVER 10 YEARS

You have accessJournal of UrologyCME1 Apr 2023MP73-11 MEDIUM TERM OUTCOMES FOLLOWING PRIMARY FOCAL CRYOTHERAPY FOR LOCALISED PROSTATE CANCER IN 323 PATIENTS, A MULTI-INSTITUTIONAL OBSERVATIONAL STUDY OVER 10 YEARS Deepika Reddy, Max Peters, Marieke Van Son, Mariana Bertoncelli Tanaka, Philipp Huber, Derek Lomas, Arnas Rakauskas, Saiful Miah, David Eldred-Evans, Emma Cullen, Tim Dudderidge, Stuart McCracken, Damian Greene, Raj Nigam, Neil McCartan, Massimo Valerio, Clement Orczyk, Jaspal Virdi, Manit Arya, Taimur Shah, and Hashim Ahmed Deepika ReddyDeepika Reddy More articles by this author , Max PetersMax Peters More articles by this author , Marieke Van SonMarieke Van Son More articles by this author , Mariana Bertoncelli TanakaMariana Bertoncelli Tanaka More articles by this author , Philipp HuberPhilipp Huber More articles by this author , Derek LomasDerek Lomas More articles by this author , Arnas RakauskasArnas Rakauskas More articles by this author , Saiful MiahSaiful Miah More articles by this author , David Eldred-EvansDavid Eldred-Evans More articles by this author , Emma CullenEmma Cullen More articles by this author , Tim DudderidgeTim Dudderidge More articles by this author , Stuart McCrackenStuart McCracken More articles by this author , Damian GreeneDamian Greene More articles by this author , Raj NigamRaj Nigam More articles by this author , Neil McCartanNeil McCartan More articles by this author , Massimo ValerioMassimo Valerio More articles by this author , Clement OrczykClement Orczyk More articles by this author , Jaspal VirdiJaspal Virdi More articles by this author , Manit AryaManit Arya More articles by this author , Taimur ShahTaimur Shah More articles by this author , and Hashim AhmedHashim Ahmed More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003341.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Early outcomes following focal cryotherapy have demonstrated oncological and clinical safety. We report on the largest observational series from 7 centres across the UK. METHODS: 323 patients treated between June 2004- August 2021 with at least 12 months follow up recorded into the International Cryotherapy Evaluation registry were evaluated for safety and oncological outcomes. Kaplan Meier estimates were used to determine the Failure Free Survival (FFS), defined as avoidance of third ablative therapy, salvage whole gland or systemic therapy, prostate cancer metastases or prostate cancer specific death. Adverse events (AE) were reported according to the Clavien-Dindo classification. RESULTS: Median (IQR) follow up was 35 (20-52) months, median patient age was 68 (63-73) years. 174 (54%) patients and 144 (45%) had D’Amico intermediate, and high-risk disease respectively. Neoadjuvant ADT was prescribed in 33 (10%) of cases, quadrant ablation performed in 113 (35%), hemiablation in 194 (60%) and hockey-stick ablation in 16 (5%). FFS at 6.5 years was 71% (95% CI 59-80%); D’Amico intermediate 66% (95%CI 44-81%) and high risk 73% (59-84%), p=0.80 (Figure 1 & 2). 25 (8%) reported an AE with 5 UTIs, 1 epididymo-orchitis, 1 prostatic abscess (conservatively managed) and 1 sepsis event resulting in the only Clavien-Dindo 3 event. There were no rectal injuries. CONCLUSIONS: To our knowledge, this largest study reporting outcomes following primary focal cryotherapy, demonstrates good medium-term oncological outcomes with 99% having intermediate and high risk cancer. There were low rates of adverse events. Our data supports focal therapy as part of the counselling of options for treatment of localised clinically significant prostate cancer. Source of Funding: n/a © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1039 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Deepika Reddy More articles by this author Max Peters More articles by this author Marieke Van Son More articles by this author Mariana Bertoncelli Tanaka More articles by this author Philipp Huber More articles by this author Derek Lomas More articles by this author Arnas Rakauskas More articles by this author Saiful Miah More articles by this author David Eldred-Evans More articles by this author Emma Cullen More articles by this author Tim Dudderidge More articles by this author Stuart McCracken More articles by this author Damian Greene More articles by this author Raj Nigam More articles by this author Neil McCartan More articles by this author Massimo Valerio More articles by this author Clement Orczyk More articles by this author Jaspal Virdi More articles by this author Manit Arya More articles by this author Taimur Shah More articles by this author Hashim Ahmed More articles by this author Expand All Advertisement PDF downloadLoading ...

Factors Deciding Conservative or Intervention Treatment for Prostate Abscess: A Retrospective Case-Control Study

Prostate abscess (PA) can lead to severe urosepsis and septic shock if not treated promptly. However, early diagnosis can be hindered by the declining incidence of PA, especially in developing countries and high-risk patients. Despite the prevalence of PA, there is currently a lack of well-established contemporary guidelines or treatment algorithms. This study aimed to review the etiology, pathophysiology, diagnosis, and treatment options for PA, as well as analyze the characteristics, background profiles of patients, and clinical course. Ultimately, the goal was to develop a personalized treatment strategy for patients with PA. This retrospective study examined 44 patients diagnosed with PA at a tertiary medical center between 2010 and 2020. The patients were divided into two groups based on their treatment: conservative treatment or intervention (transurethral resection of the prostate [TURP] or transurethral prostate drainage [TPD]). The study evaluated various factors, including patients' background profiles, comorbidities, laboratory data, and PA size and volume. Complications of the interventions were also analyzed. No significant differences were found in basic data between the conservative treatment group (19 patients) and intervention group (25 patients; 20 for TURP, 5 for TPD). However, it was observed that single abscesses, size <2.2 cm, and prostate volume <48 cm3, may be suitable for conservative treatment. Patients with diabetes mellitus and human immunodeficiency virus should be monitored for thrombotic events. In addition, there was a significant difference in white blood count between the two groups (12.1 ± 7.0 vs. 17.6 ± 9.7 × 109/L, p < 0.05). A subgroup analysis of the intervention group showed no significant difference in the risk of complications between TPD and TURP. Patients with poorly controlled diabetes mellitus and immunodeficiency are at a high risk of PA but are not indicated for surgical treatment. The PA profile, including number, size, volume, and percentage to prostate volume, should be considered when deciding on surgical intervention for patients with PA. Patients with higher leukocytosis may require surgical treatment. Overall, these findings can help guide the development of a personalized treatment strategy for patients with PA.

Ultrasound-guided SoracteLite™ transperineal laser ablation (TPLA) of the prostate for the treatment of symptomatic benign prostatic hyperplasia (BPH): a prospective single-center experience

PurposeTo evaluate the efficacy and safety of ultrasound-guided transperineal laser ablation (TPLA) in patients with symptomatic BPH.Materials and methodsFrom January 2020 to January 2022, 63 prospectively enrolled patients underwent TPLA with a 1064-nm continuous-wave diode laser (EchoLaser, Elesta SpA). Primary endpoints were the change in IPSS, QoL, Qmax, PVR and prostate volume at 3 and 12 months.ResultsAt 3 months, IPSS improved from 20.8 ± 7.4 to 11.0 ± 6.6 (p < 0.001), QoL from 4.7 ± 1.4 to 1.5 ± 1.2 (p < 0.001) and Qmax from 8.6 ± 3.5 mL/s to 13.2 ± 5.7 mL/s (p = 0.083). PVR decreased from 124.8 ± 115.4 mL to 43.6 ± 53.6 mL (p < 0.001), and prostate volume decreased from 63.6 ± 29.7 mL to 45.6 ± 21.8 mL (p = 0.003). At 12 months, IPSS improved from 20.8 ± 7.4 to 8.4 ± 5.9 (p < 0.001), QoL from 4.7 ± 1.4 to 1.2 ± 0.8 (p < 0.001), and Qmax from 8.6 ± 3.5 mL/s to 16.2 ± 4.3 mL/s (p = 0.014). PVR decreased from 124.8 ± 115.4 mL to 40.6 ± 53.6 mL (p = 0.003), and prostate volume decreased from 63.6 ± 29.7 mL to 42.8 ± 14.2 mL (p = 0.071). Transient complications consisted of two patients with prostatic abscess (Clavien-Dindo grade IIIa) and one patient with orchitis (Clavien-Dindo grade II).ConclusionsTPLA for symptomatic BPH provides clinical benefits at 3 and 12 months, and the treatment is well tolerated.

Imaging case series of melioidosis: the great masquerader

BackgroundMelioidosis is an infectious disease caused by Gram-negative bacterium Burkholderia pseudomallei. It is endemic to Southeast Asia. Inhalation, inoculation and ingestion are major routes of transmission. Increased risk of infection is seen in patients with diabetes, alcoholism, chronic renal and liver failure and malignancy. The aim of the present case series is to describe the varied imaging manifestations of melioidosis.Case presentationThis is a retrospective review of imaging findings in eight patients with culture-proven B. pseudomallei infections diagnosed in our institute from September 2019 to September 2021. A total of eight culture-proven melioidosis cases were reported from our institute. All of them had multiorgan involvement and predisposing conditions or risk factors, most common being diabetes mellitus and alcoholism. Lung was the most common organ involved showing nodules and consolidations followed by liver and spleen demonstrating multiple ‘honeycomb’-like abscesses. Musculoskeletal manifestations included osteomyelitis and intramuscular abscess. Cerebral abscess, cerebral infarcts, prostatic abscess, abdominal aortic mycotic aneurysm with periaortic hematoma and splenic vein thrombosis with splenic infarcts were a few other manifestations.ConclusionsMelioidosis is a great mimicker with acute, subacute or chronic clinical course involving multiple organs and resembling other common infections. Hence, it should be considered as a possible etiological agent when evaluating patients with risk factors and multiorgan involvement.

What is the optimal length of antibiotic treatment for acute bacterial prostatitis?

What is the optimal length of antibiotic treatment for acute bacterial prostatitis?

Prostatic Abscess about a Case at Sikasso Hospital

Introduction: The purpose of this study was to conduct an analysis of the diagnostic and therapeutic aspects of prostate abscess and a review of the literature. Clinical Observation: We report the case of a 24-year-old patient; admitted to our ward for acute detention associated with a febrile state at (38°C). On physical examination, the digital rectal examination could not assess the condition of the prostate due to severe pain and the rest of the examination was unremarkable. We formulated the following diagnostic hypotheses: prostate abscess, prostate cyst, acute prostatitis. Ultrasound allowed the diagnosis of a prostatic intraparenchymal cyst. The CBC reveals hyperleukocytosis and the ECBU came back positive for Escherichia coli. The diagnosis of a prostate abscess was retained after a guided echo puncture. Treatment consisted of transperineal drainage combined with antibiotic therapy suitable for ECB of pus aspirated during ultrasound-guided puncture. The evolution was favourable. Conclusion: Prostatic abscess is a rare pathology. Faced with a prostate collection in a febrile context, a puncture under ultrasound guidance could confirm the diagnosis. His treatment of choice remains endoscopic drainage and adapted antibiotic therapy.

Prostatic Abscess Due to Idiopathic Granulomatous Disease: A Rare Complication of a Chameleon Disorder &amp;lt;br/&amp;gt;—Prostatic Abscess Due to Idiopathic Granulomatous Disease

Background: Prostatic abscesses are usually diagnosed in the setting of bacterial prostatitis. Rarely, they reveal or complicate granulomatous prostatitis (GP). Four cases of idiopathic xanthogranulomatous GP have been described previously and the present case report is the first of typical idiopathic variety. The case: A 60-year-old man presented with urine retention that was associated with pyuria and massively enlarged prostate. Cystoscopy revealed prostatic abscess (PA) that was opened. Urine and prostatic culture were negative for bacteria. Prostatic biopsy revealed multiple non-caseating granulomata surrounded by lymphocytes, plasma cells yet without foamy histiocytes, parasites and vasculitis. Special stains were negative for vasculitis, fungiand acid-fast organisms. The patient was treated with Solumedrol 1 g intravenously daily for 3 days followed by Prednisone 1 mg/kg/day for 1 month followed by gradual tapering till discontinuation by 3rd month. Moreover, he had received Mycophenolate mofetil (MMF) 1 g twice/daily. By the end of 2nd month; he was asymptomatic and without pyuria. Repeat cystourethroscopy and MRI scan of the prostate showed near normal prostate. In Conclusion: Idiopathic GP can present with PA that requires proper drainage and since it is a locally hyperimmune disease with genetic predisposition; MMF therapy will be maintained for a total of 2 years to prevent future disease-relapse.

Incidental Findings in Prostate above the Age of 50 Years in Autopsy of 100 Cases

Background: Autopsy study is used to disclose many hidden prostatic pathologies and their incidence. Thecurrent study aims to evaluate the histopathological pattern of prostatic lesions such as nodular hyperplasia ofthe prostate, precancerous lesions, and latent cancer in autopsy series of males over the age of 50 and to correlatethem with age.Methods: The present study was a prospective autopsy study carried out in the pathology department, afteren bloc harvestation of prostate gland from autopsies of men aged more than 50 years by the forensic team ofGovernment Medical College Patiala.Results: Age ranges from 51-90 years and the mean age was 58.57 ± 8.11years. The weight of the prostate glandranged from 18 to 42 grams with mean weight 27.01 ± 3.34g. Benign prostatic hyperplasia was the commonpathological finding (79%), 38 cases of chronic non-specific prostatitis, 3 cases with acute prostatitis and 4 caseswere associated with prostatic intraepithelial neoplasia. Prostatic adenocarcinoma was detected in 9 cases.Conclusions: The present study shows that normal prostate gains weight with advancing age. The majority ofcases are in the 6th decade, benign prostatic hyperplasia is the most common lesion encountered

Klebsiella pneumoniae-induced liver and prostate abscesses.

Klebsiella pneumoniae-induced liver and prostate abscesses.

Diagnosis and spread of prostate gland pathology in dogs in the city of Voronezh

The authors analyzed domestic and foreign sources of literature on the prob- lems of pathology of the sexual sphere of males. In practice, benign hyperplasia, acute and chronic prostatitis, abscess and prostate tumors in males are widespread diseases. The most important task of practicing veterinarians is the early diagnosis of prostate pathology in males of reproductive age. With early diagnosis of the disease, timely effective treatment of breeding animals, restoration of their reproductive function is possible. The paper presents the results of our own research on the spread of pathology of the reproductive system of males of different breeds and ages in the conditions of the veterinary clinic of the city of Voronezh.

Transperineal laser ablation as a new minimally invasive surgical therapy for benign prostatic hyperplasia: a systematic review of existing literature.

Transperineal laser ablation (TPLA) of the prostate is a new, minimally invasive technique for benign prostatic hyperplasia (BPH) with promising effectiveness and safety outcomes. This systematic review aims to provide an update of existing literature. A literature review was performed in Pubmed/MEDLINE, Embase, Cochrane Library, and clinicaltrials.gov from January 2000 up to April 2023. Data extraction and risk of bias were performed independently by three authors. A total of 11 studies were included, among which 9 were observational, 1 randomized controlled trial, 1 animal study, while 2 of them were comparative (1 with prostatic artery embolization and 1 with transurethral resection of the prostate). Functional outcomes were improved in the majority of studies both for objective (maximum flow rate and post-void residual) and subjective outcomes (improvement of International Prostate Symptom Score and quality of life). Complication rates ranged between 1.9% and 2.3% for hematuria, 3.7% and 36.3% for dysuria, 1.9% and 19% for acute urinary retention, 0.6% and 9.1% for orchitis/urinary tract infections, and 0.6% and 4.8% for prostatic abscess formation. Regarding sexual function, >95% of patients retained their ejaculation while erectile function was maintained or improved. TPLA of the prostate is an innovative, minimally invasive technique for managing patients with BPH. Existing studies indicate an effective technique in reducing International Prostate Symptom Score and quality of life scores, post-void residual reduction, and increase in Qmax, albeit the measured improvements in terms of Qmax are not equal to transurethral resection of the prostate. Although sexual function is maintained, the mean catheterization time is 7 days, and no long-term data are available for most patients.

A rare case of Prostatic abscess in an adolescent managed effectively by conservative medical management with antibiotics

A rare case of Prostatic abscess in an adolescent managed effectively by conservative medical management with antibiotics

Treatment Modality of Prostatic Abscess according to Size: A Retrospective Study

Treatment Modality of Prostatic Abscess according to Size: A Retrospective Study

A Case of Korean Medicine Treatment for a Patient with Acute Bacterial Prostatitis Who Did Not Improve with Antibiotics

Objectives: The purpose of this study was to report the clinical effects of pharmacopuncture, acupuncture, and ohrimsan on prostatitis that was not improved by antibiotics.Methods: The patient underwent So-Yeom pharmacopuncture injection, acupuncture, and ohrimsan. A numerical rating scale (NRS) was used to obtain a sense of residual urine and the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) was used to evaluate the treatment effects.Results: NRS for the sense of residual urine decreased from 70 before treatment to 0 after treatment. The NIH-CPSI was 19 on the first day of admission and decreased to 8 on the day of discharge. No side effects were observed after treatment.Conclusions: The traditional Korean medicine of pharmacopuncture, acupuncture, and ohrimsan is effective for treating prostatitis that is not improved by antibiotics.

Prostate-specific antigen levels depending on frequency of ejaculation and time since last ejaculation

Factors such as prostatitis or benign prostate hyperplasia are known to increase prostate-specific antigen (PSA) levels, whereas the impact of sexual behavior is unclear. Aim of this study was to investigate the effect of frequency of ejaculation and time since last ejaculation on PSA levels. The first 2.500 men of the Bavarian Men's Health (BMH) Study were included in this analysis. Men after transurethral resection of the prostate, acute prostatitis or taking finasteride were excluded. Men were grouped according to sexual orientation identity, frequency and time since last ejaculation. For each group median and quartiles of PSA-level were calculated and log-transformed PSA was compared between groups in analysis of variance with F-test. Median age was 50.4 years (min: 46.6y, max: 52.4y). Median PSA was 0.87 ng/ml (Q1:0.58; Q3:1.40); in heterosexuals (94.1% of population): 0.87 ng/ml (Q1:0.57; Q3:1.39), in homosexuals (5.0%): 0.94 ng/ml (Q1: 0.64; Q3:1.48) and in bisexuals (0.9%): 0.88 ng/ml (Q1: 0.52; Q3:1.67) (p=0.148). Shorter time since last ejaculation was associated with higher PSA-levels: ≤24h (32.5%): 0.92 ng/ml (Q1:0.62; Q3:1.44), >24-48h (15.4%): 0.90 ng/ml (Q1:0.60; Q3:1.40), >48h (52.1%): 0.82 ng/ml (Q1:0.54; Q3:1.38) (p=0.006). Higher frequency of sexual intercourse was associated with higher PSA-levels: ≥ 2 times/week (14.7%): 0.92 ng/ml (Q1:0.68; Q3:1.43), > 1 time/month up to 1 time/week (44.0%): 0.85 ng/ml (Q1:0.56; Q3:1.36) and ≤ 1 time/month (41.3%): 0.87 ng/ml (Q1:0.56; Q3:1.45) (p=0.011). Higher frequency of masturbation was also associated with higher PSA-levels: ≥ 2 times/week (30.3%): 0.95 ng/ml (Q1:0.62; Q3:1.52), > 1 time/month up to 1 time/week (38.3%): 0.82 ng/ml (Q1:0.57; Q3:1.34) and ≤ 1 time/month (31.4%): 0.87 ng/ml (Q1:0.56; Q3:1.41) (p=0.005). Shorter time since last ejaculation, higher frequency of sexual intercourse and masturbation were associated with higher PSA levels. none