ABSTRACT
Objective:To evaluate the diagnostic value of serum prostate-specific antigen (PSA) levels and multi-parameter magnetic resonance imaging (mpMRI) in patients with granulomatous prostatitis after intravesical Bacillus Calmette-Guérin (BCG) therapy.Methods:The medical records of eight patients with pathologically proven granulomatous prostatitis in Shandong Provincial Hospital Affiliated to Shandong University from January, 2015 to June, 2020, were enrolled and analyzed in this retrospective study. All 8 patients (ages 47-76, mean 63.6) underwent pelvic mpMRI and serum tPSA levels before TURBT, which showed the results of tPSA, f/t and mpMRI were normal before TURBT (0.45-3.62 ng/ml, 0.20-0.51 and normal signal intensities on T1WI and T2WI, respectively). All patients underwent intravesical BCG therapy after post-TURBT 4-6-weeks’ intravesical gemcitabine therapy as a result of pathologically proven middle and high risk NMIBC via cystoscopy.Results:The results of tPSA levels in all 8 patients were elevated after intravesical BCG therapy after 9-15 months (mean 10.5 months), with 4 patients above 4 (6.77-12.89)ng/ml and 4 patients within the normal ranges(2.02-2.68)ng/ml, and f/t levels decreased to lower than 0.16 (0.09-0.15)in all patients. The mpMRI abnormal signals in all patients were all located in the peripheral zone of prostate. All nodular lesions of prostate mpMRI showed lower signal intensity (SI) on T2WI, higher SI on DWI and lower SI on ADC after BCG therapy. All patients underwent prostate biopsy for abnormal signal on prostate mpMRI. The biopsy pathologic results of all patients were granulomatous prostatitis.Conclusions:When elevated PSA and abnormal signals on prostate mpMRI after intravesical BCG therapy occurred, prostate biopsy may not be required for secondary granulomatous prostatitis patients with non-muscle invasive bladder cancer in combination of clinical history.
ABSTRACT
To evaluate the safety and effectiveness of the combined photoselective vaporization of the prostate [PVP] and bipolar transurethral resection of the prostate [TURP] in high-risk symptomatic patients with large prostates. Between January 2007 and January 2010, a prospective study was performed in Shandong Provincial Hospital, Shandong University, Jinan, Shandong Province, China. One hundred and one patients presenting with various kinds of systematic diseases, and with an American Society of anesthesiologists score of 3 or greater underwent PVP plus bipolar TURP for severe lower urinary tract symptoms due to benign prostatic hyperplasia with prostatic volume greater than 80 ml. The international Prostate Symptom Score [IPSS] and quality-of-life questionnaire [IPPS-QoL], maximum flow rates [Qmax], postvoid urine residues [PVR], and MRI prostatic volumes were recorded. Perioperative data, functional outcome, and complications were evaluated. Patients were reassessed at 3, 6, and 12 months. The mean operation time was 68.5 +/- 23.9 minutes. The mean pre-and post-operative prostate volumes were 102.2 +/- 33.1 ml and 40.4 +/- 15.6 ml. No severe complications were observed. Significant differences in IPSS,Qmax, and PVR values were recorded within the follow-up period. The results of our study show that PVP plus bipolar TURP have an excellent efficiency and low morbidity in high-risk patients with large prostates
Subject(s)
Humans , Male , Transurethral Resection of Prostate , Adenoma , Prostatic Hyperplasia/therapy , Surveys and Questionnaires , Prostate , Prospective Studies , Magnetic Resonance ImagingABSTRACT
with flutamide has a syn-ergistic action in inhibiting the proliferation of LNCaP.