Detection rate and clinical pattern of prostate cancer in Kuwait: a single-center experience

To determine the detection rate and clinical pattern of prostate cancer in Kuwait. One hundred and fifty-three males suspected of having prostate cancer based on elevation of prostate-specific antigen [PSA] of more than 4 ng/ml underwent transrectal-ultrasound [TRUS]-guided needle biopsy of the prostate between January 2003 and January 2008; these formed the study group. Analysis of prostate cancer was based on age, prostate volume, PSA level and on finding any abnormality based on a combination of the diagnostic tools. A diagnosis of prostate cancer was histologically confirmed in 42 [27.4%] patients. In those aged <55, 56-65, 66-75 and >76 years, the detection rates were 16.7, 17.6, 33.3 and 40.7%, respectively. In those with prostate volumes of >71, 51-70, 31-50 and <30 g, the detection rates were 18.2, 23.8, 30.8 and 42.9%, respectively. When the PSA levels were divided into groups of 4-10, 10-20, 20-100 and >100 ng/ml, the cancer detection rate was 11.8, 20.5, 47.1 and 83.3%, respectively. When 1, 2 and 3 of the 3 diagnostic tools [digital rectal examination, PSA, TRUS] were abnormal, the detection rate was 15.6, 27.9 and 80%, respectively. Our data showed that the prostate cancer rate differs according to the region and that the rate was low in our center. Higher PSA and higher number of diagnostic tools with abnormal findings were associated with a higher incidence of prostate cancer

Bilateral emphysematous pyelonephritis and emphysematous cystitis with autosomal-dominant polycystic kidney disease: Is conservative management justified?

To report a case of bilateral emphysematous pyelonephritis [EPN] and emphysematous cystitis in a 64-year-old diabetic male with autosomal-dominant polycystic kidney disease [ADPKD]. A 64-year-old diabetic male presented with worsening of renal function and fluid overload. Diagnosis was confirmed by computerized tomography [CT scan] and conservative management with broad-spectrum antibiotics was instituted. There was good clinical response and repeated CT scan showed complete resolution. This case shows that conservative management is an acceptable alternative to surgery in EPN occurring with ADPKD. However, it is recommended that patients should be closely monitored, both clinically and radiologically, and percutaneous catheter drainage or surgical intervention carried out whenever deemed necessary