Prostatic Infarction Research Articles

Characteristics of prostatc infarcts and their effect on serum prostate-specific antigen and prostatc acid phosphatase

Objectives. To determine how prostatic infarcts affect serum prostate-specific antigen (PSA) and prostatic acid phosphatase (PAP) levels. Methods. Two hundred eighteen clinically benign, whole prostates were obtained atautopsy, completely sectioned, and examined histologically. PSA and PAP levels were determined from premortem serum. Results. Six of the 218 (2.8%) prostates had infarcts. The infarcts were usually multipleand usually located in the central and/or middle concentric zones of the middle third of the prostate without a preference for a particular lobe. Serum PSA by immunoradiometric assay were elevated in all 6 cases. Serum PAP by both enzymatic assay (ACA), and immunoradiometric assay were available for 5 cases and were elevated by both methods in 2 cases, approached elevated levels by both methods in 1 case, and were normal by both methods in 2 cases. The PSA and PAP levels appeared to be affected more by the age than by the size of the infarct. Conclusions. Prostatic infarcts elevate PSA levels more frequently than PAP levels, andprostatic infarcts may be responsible for some unexplained elevations of serum PSA and PAP levels.

Post-operative retention associated with acute prostatic infarction.

Twenty-one patients with post-operative retention following unassociated surgery and requiring transurethral resection of the prostate were compared with patients with acute retention (control group). Histological evidence of acute prostatic infarction was significantly increased in the post-operative retention group. Prolonged operative hypotension was associated with acute prostatic infarction, as were smoking and pre-existing cardiovascular disease.

An immunohistological study of granulomatous prostatitis

Granulomatous prostatitis may result from tuberculosis and fungal infection and has been described following prostatic surgery. In most cases, however, the aetiology is unknown, although it may be due to a reaction to extravasated or altered prostatic secretions. We have investigated cells (macrophages, lymphocytes), serum proteins (fibrinogen, alpha 1-antitrypsin) and prostatic epithelial products (prostatic-specific antigen and prostatic acid phosphatase) in diffuse granulomatous prostatitis (3 cases), focal periacinar prostatic granulomas (9) and focal prostatic infarcts (5), using an immunohistological technique. T-lymphocytes and macrophages are present in diffuse and focal granulomatous prostatitis, but few B-lymphocytes occur. Fibrinogen-related antigen is absent from granulomas, but a small amount is present within infarcts, whereas plentiful alpha 1-antitrypsin was detected both in granulomas and infarcts. Significant reduction in prostatic-specific antigen and acid phosphatase reactivity occurs in granulomatous prostatitis. This suggests that cytokines derived from activated macrophages and T-lymphocytes may be exerting a cell regulatory effect and altering cell secretions, as well as causing destruction of the prostatic epithelium.

Acute Urinary Retention Associated with Prostatic Carcinoma

We describe the prospective evaluation of 90 patients seen at 2 medical centers who presented with acute urinary retention. All patients had a pre-retention history obtained, as well as careful prostate examination, perineal prostate biopsy and followup treatment or monitoring. Prostate cancer was found in 12 of the 90 patients (13.3 per cent), while 1 had metastatic leukemia to the prostate. Of the 90 patients 69 (76.7 per cent) had a palpably benign prostate and 2 malignancies (2.9 per cent) were diagnosed, while 11 malignancies occurred in 21 patients (52.4 per cent) with a suspicious examination. A total of 46 patients (51.1 per cent) underwent further prostate resection and no malignancy was found in any of these specimens: 43 underwent transurethral resection (24.9gm. average), while 3 underwent open prostatectomy (97gm. average). Other etiologies of acute retention included benign hyperplasia, other underlying illness, medical procedures, medications, prostatitis and prostatic infarction. Among the 44 patients who did not undergo prostatectomy 13 had treatment of the diagnosed cancer, 9 had resolution of retention and symptoms without intervention, 9 remained catheterized due to severe medical problems, 8 were treated for prostatitis, 2 had discontinuation of sympathomimetic drugs and 1 each underwent urethrotomy, bladder neck incision and resolution of prostatic infarction. In contrast to the older literature in which approximately 25 per cent of the patients presenting with acute urinary retention had prostate cancer, our data suggest a lower incidence. Prostatic biopsy for patients who present with acute urinary retention and a benign examination does not appear to be justified.

Acute and chronic retention of urine: Relevance of raised serum prostatic acid phosphatase levels A prospective study

A prospective study of serum prostatic acid phosphatase (PAP) levels in benign prostatic disease is reported. In 12 patients with acute retention the initial PAP level when compared with the level twenty-four hours after catheterization showed a significant fall (p < 0.02). The initial PAP level was raised above the upper limit of normal in 7 patients (in 3 markedly so, of whom 2 had subsequent histologic evidence of prostatic infarction). In 10 patients with chronic retention there was a significant rise in the PAP level twenty-four hours after catheterization, but in only 1 case did this exceed the normal range. We discuss the significance of a raised PAP level in patients with acute retention and suggest that it may indicate a group of patients in whom the etiology of acute retention is spontaneous prostatic infarction and subsequently may require different management.

Prostatic infarction.

Prostatic infarction is a relatively frequent complication of adenoma of the bladder neck. Nevertheless its importance is minimal as compared with infarctions of vital organs like the brain, heart, lungs or kidneys. General and local factors may play a role in its pathogenesis. Besides other factors, it may contribute to the development of acute retention. Attention is called to the difficulties of differential diagnosis at both gross and microscopic examinations. A misdiagnosis is most frequently made in neoplastic diseases of the prostate.

Role in acute urinary retention

The relationship between prostatic infarction and acute urinary retention was studied. Serial sections of two groups of 100 prostates each were studied for evidence of infarction. One group consisted of patients with acute urinary retention while the other group consisted of patients with benign prostatic hypertrophy. Eighty-five per cent of the retention group had prostatic infarcts while only 3 per cent of the patients with benign prostatic hypertrophy had infarcts. Despite the close association of acute urinary retention with infarction of the prostate, the exact mechanism in the production of acute retention is as yet undetermined.

The Incidence of Elevated Acid Phosphatase in Prostatic Infarction

The Incidence of Elevated Acid Phosphatase in Prostatic Infarction

Necrosis of the Prostate: A Case Report

No AccessJournal of Urology1 Dec 1964Necrosis of the Prostate: A Case Report Robert Zufall Robert ZufallRobert Zufall More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)64037-0AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "Necrosis of the Prostate: A Case Report." The Journal of Urology, 92(6), p. 710 © 1964 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByFeero P, Nickel J, Brown P and Young I (2018) Prostatic Infarction Associated with Aortic and Iliac Aneurysm RepairJournal of Urology, VOL. 143, NO. 2, (367-368), Online publication date: 1-Feb-1990. Volume 92Issue 6December 1964Page: 710 Advertisement Copyright & Permissions© 1964 by The American Urological Association Education and Research, Inc.MetricsAuthor Information Robert Zufall More articles by this author Expand All Advertisement PDF DownloadLoading ...

A Further Clinical and Pathological Study of Prostatic Infarction

A Further Clinical and Pathological Study of Prostatic Infarction