Serum prostate-specific antigen levels in Middle Eastern men with subclinical prostatitis

To investigate the influence of subclinical or histologically diagnosed prostatitis on serum prostate-specific antigen [PSA] in patients investigated for prostatic disease in Kuwait. Serum PSA was assayed in patients investigated for prostatic disease in Mubarak Al-Kabeer Hospital, Kuwait, between December 2002 and December 2004. These included patients undergoing transrectal ultrasound with needle biopsy of the prostate gland and those who were treated with transurethral resection of the prostate or retropubic prostatectomy. The tissue was evaluated for prostatitis as well as the underlying disease, and the type and severity of prostatitis were compared with levels of serum PSA. Of the 331 tissue specimens, 18 [5.4%] did not show prostatitis, while 233 [70.4%] with benign prostate and 80 [24.2%] with malignant prostate disease showed prostatitis. Of 270 men with known serum PSA levels, 198 and 72 had benign and malignant prostate disease, respectively. Of the 198, 77 [41%] with benign prostate disease and prostatitis and of the 72, 52 [76%] with malignant prostate disease and prostatitis had serum PSA levels >10 ng/ml. The data showed that although raised serum PSA is more commonly associated with prostate cancer, subclinical prostatitis is a significant source of high serum PSA in over 40% of men in Kuwait. That local factors may obscure the usefulness of serum PSA as a screening tool suggests the need for a locally applicable paradigm to identify prostate cancer

Sectorial technetium-99m-dimercaptosuccinic acid scintigraphy for monitoring the effect of extracorporeal piezoelectric lithotripsy for calyceal calculi on regional renal function

To apply a semiquantitative method for analysis of technetium-99m-dimercaptosuccinic acid [99mTc-DMSA] renal scintigraphy for monitoring the effect of extracorporeal piezoelectric lithotripsy [EPL] in patients with calyceal stones on regional kidney function and to check whether EPL had caused any deleterious effect on the target calyceal renal parenchymal function. Patients and Forty patients [mean age 35 years] suffering from calyceal stones documented by abdominal plain radiography, intravenous urogram or abdominal ultrasound were studied. All patients were treated by EPL. 99mTc-DMSA scan was performed before and 4 weeks after EPL. Sector analysis involved calculation of the relative function of the target calyx to the function of the ipsilateral kidney and the relative function of the treated kidney to global renal function. The stone sizes were 6-11 mm in diameter and 11 were located in the upper, 13 in the middle and 16 in the lower calyx. After EPL, the overall stone clearance rate was 85% [100% for calculi in the upper and middle calyces, 62% for lower calyces]. The sector analysis did not show statistically significant change of the relative regional [calyceal] or whole kidney function between the pre- and post-EPL 99mTc-DMSA scans. Using sector analysis, EPL appeared to be a safe modality and its usage was not associated with any untoward effect on calyceal or whole kidney function. Sector analysis of 99mTc-DMSA renal scan is a simple semiquantitative method for monitoring regional changes of kidney function after EPL for treatment of calyceal stone