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Med. lab ; 26(1): 91-98, 2022. ilus, Grafs, Tabs
Article in Spanish | LILACS | ID: biblio-1370967


El antígeno específico de próstata (PSA, del inglés, Prostate Specific Antigen) es una glicoproteína producida por la próstata, y es el marcador tumoral de mayor uso. Sin embargo, su baja especificidad para diferenciar entre cáncer de próstata y otras alteraciones no malignas, como la hipertrofia benigna de la próstata (HBP) y la prostatitis aguda, limitan su utilidad diagnóstica

Prostate Specific Antigen (PSA) is a glycoprotein produced by the prostate and is the most widely used tumor marker. However, its low specificity to differentiate between prostate cancer and other non-malignant conditions, such as benign prostate hypertrophy (BPH) and acute prostatitis, limits its diagnostic utility

Prostate-Specific Antigen , Prostatic Hyperplasia , Prostatitis , Platelet Membrane Glycoproteins , Biomarkers, Tumor
Asian Journal of Andrology ; (6): 323-331, 2022.
Article in English | WPRIM | ID: wpr-928541


We investigated the therapeutic effects of superoxide dismutase (SOD) from thermophilic bacterium HB27 on chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and its underlying mechanisms. A Sprague-Dawley rat model of CP/CPPS was prepared and then administered saline or Thermus thermophilic (Tt)-SOD intragastrically for 4 weeks. Prostate inflammation and fibrosis were analyzed by hematoxylin and eosin staining, and Masson staining. Alanine transaminase (ALT), aspartate transaminase (AST), serum creatinine (CR), and blood urea nitrogen (BUN) levels were assayed for all animals. Enzyme-linked immunosorbent assays (ELISA) were performed to analyze serum cytokine concentrations and tissue levels of malondialdehyde, nitric oxide, SOD, catalase, and glutathione peroxidase. Reactive oxygen species levels were detected using dichlorofluorescein diacetate. The messenger ribonucleic acid (mRNA) expression of tissue cytokines was analyzed by reverse transcription polymerase chain reaction (RT-PCR), and infiltrating inflammatory cells were examined using immunohistochemistry. Nuclear factor-κB (NF-κB) P65, P38, and inhibitor of nuclear factor-κBα (I-κBα) protein levels were determined using western blot. Tt-SOD significantly improved histopathological changes in CP/CPPS, reduced inflammatory cell infiltration and fibrosis, increased pain threshold, and reduced the prostate index. Tt-SOD treatment showed no significant effect on ALT, AST, CR, or BUN levels. Furthermore, Tt-SOD reduced inflammatory cytokine expression in prostate tissue and increased antioxidant capacity. This anti-inflammatory activity correlated with decreases in the abundance of cluster of differentiation 3 (CD3), cluster of differentiation 45 (CD45), and macrophage inflammatory protein 1α (MIP1α) cells. Tt-SOD alleviated inflammation and oxidative stress by reducing NF-κB P65 and P38 protein levels and increasing I-κBα protein levels. These findings support Tt-SOD as a potential drug for CP/CPPS.

Animals , Chronic Pain , Cytokines/metabolism , Fibrosis , Humans , Inflammation/metabolism , Male , NF-kappa B/metabolism , Pelvic Pain/pathology , Prostatitis/metabolism , Rats , Rats, Sprague-Dawley , Superoxide Dismutase , Syndrome
Asian Journal of Andrology ; (6): 213-218, 2022.
Article in English | WPRIM | ID: wpr-928528


Experimental autoimmune prostatitis (EAP)-induced persistent inflammatory immune response can significantly upregulate the expression of N-methyl-D-aspartic acid (NMDA) receptors in the paraventricular nucleus (PVN). However, the mechanism has not yet been elucidated. Herein, we screened out the target prostate-derived inflammation cytokines (PDICs) by comparing the inflammatory cytokine levels in peripheral blood and cerebrospinal fluid (CSF) between EAP rats and their controls. After identifying the target PDIC, qualified males in initial copulatory behavior testing (CBT) were subjected to implanting tubes onto bilateral PVN. Next, they were randomly divided into four subgroups (EAP-1, EAP-2, Control-1, and Control-2). After 1-week recovery, EAP-1 rats were microinjected with the target PDIC inhibitor, Control-1 rats were microinjected with the target PDIC, while the EAP-2 and Control-2 subgroups were only treated with the same amount of artificial CSF (aCSF). Results showed that only interleukin-1β(IL-1β) had significantly increased mRNA-expression in the prostate of EAP rats compared to the controls (P < 0.001) and significantly higher protein concentrations in both the serum (P = 0.001) and CSF (P < 0.001) of the EAP groups compared to the Control groups. Therefore, IL-1β was identified as the target PDIC which crosses the blood-brain barrier, thereby influencing the central nervous system. Moreover, the EAP-1 subgroup displayed a gradually prolonged ejaculation latency (EL) in the last three CBTs (all P < 0.01) and a significantly lower expression of NMDA NR1 subunit in the PVN (P = 0.043) compared to the respective control groups after a 10-day central administration of IL-1β inhibitors. However, the Control-1 subgroup showed a gradually shortened EL (P < 0.01) and a significantly higher NR1 expression (P = 0.004) after homochronous IL-1β administration. Therefore, we identified IL-1β as the primary PDIC which shortens EL in EAP rats. However, further studies should be conducted to elucidate the specific molecular mechanisms through which IL-1β upregulates NMDA expression.

Animals , Cytokines/metabolism , Disease Models, Animal , Ejaculation/physiology , Interleukin-1beta/metabolism , Male , N-Methylaspartate/metabolism , Prostate/metabolism , Prostatitis/metabolism , Rats , Receptors, N-Methyl-D-Aspartate/metabolism
Article in Chinese | WPRIM | ID: wpr-887506


To summarize professor

Acupuncture , Acupuncture Points , Acupuncture Therapy , Humans , Male , Meridians , Prostatitis/therapy
Article in Chinese | WPRIM | ID: wpr-877598


OBJECTIVE@#To observe the clinical therapeutic effect of electroacupuncture (EA) combined with tamsulosin hydrochloride sustained release capsule on chronic prostatitis (CP) of damp and heat stasis.@*METHODS@#A total of 70 patients with CP of damp and heat stasis were randomized into an acupuncture plus medication group (35 cases, 4 cases dropped off) and a medication group (35 cases, 5 cases dropped off). In the medication group, tamsulosin hydrochloride sustained release capsule was given orally, 0.2 mg a time, once each night. On the basis of treatment in the medication group, EA was applied at Guanyuan (CV 4), Sanyinjiao (SP 6) and Yinglingquan (SP 9), with disperse-dense wave, 5 mA in intensity for 30 min. Treatment for 30 days was as one course, and totally 3 courses were required in both groups. Before treatment, 1, 2, 3 months into treatment and at the follow-up of 2 months after treatment, the TCM syndrome score and National Institutes of Health chronic prostatitis symptom index (NIH-CPSI) score were observed, and the clinical efficacy was evaluated in both groups.@*RESULTS@#Compared before treatment, the TCM syndrome scores of 3 months into treatment and follow-up were decreased in the acupuncture plus medication group (@*CONCLUSION@#Acupuncture combined with medication can improve the clinical symptoms in patients with CP of damp and heat stasis, and its therapeutic effect is superior to simple western medication.

Acupuncture Points , Acupuncture Therapy , Chronic Disease , Hot Temperature , Humans , Male , Prostatitis/drug therapy , Treatment Outcome
Rev. argent. radiol ; 84(4): 115-122, ago. 2020. tab, graf, il.
Article in Spanish | LILACS | ID: biblio-1149663


Resumen Objetivo: El objetivo de este estudio es demostrar la utilidad de una secuencia tardía post-contraste en la resonancia magnética multiparamétrica de próstata (RMMP) para caracterizar lesiones PI-RADS II. Materiales y métodos: Se analizaron en forma retrospectiva las RMMP realizadas entre enero de 2015 y diciembre de 2016. El protocolo de la RMMP fue basado en las recomendaciones del PI-RADS versión 2, y se agregó una adquisición tardía luego del dinámico post-contraste. Los reportes fueron revisados bajo la versión 2.1. Resultados: Se seleccionaron 31 pacientes que presentaron lesiones categorizadas como PI-RADS II en la zona periférica, los cuales se encontraban en seguimiento del antígeno prostático específico y presentaron confirmación histológica de prostatitis crónica. Se evidenció un realce tardío de la lesión en todos los pacientes. Según los resultados histopatológicos, 30 presentaban prostatitis crónica y el restante tejido benigno (tejido fibromuscular). Discusión: La prostatitis crónica no muestra realce temprano, y presenta realce tardío debido al tejido conectivo fibroso que la compone. En la RMMP, la prostatitis puede imitar el cáncer de próstata. Agregar una adquisición tardía solo adiciona 150 segundos al estudio y podría ayudar a resolver aquellos casos inciertos categorizados como PI-RADS III empleando las secuencias convencionales, debido a que el realce tardío de la lesión es altamente sugestivo de un proceso inflamatorio (PI-RADS II). Conclusión: La presencia de realce tardío es una herramienta útil para realizar un adecuado diagnóstico de una lesión PI-RADS II en la zona periférica, pudiendo evitar una biopsia innecesaria.

Abstract Objective: The aim of this study is to demonstrate the utility of a post-contrast late sequence in multiparametric magnetic resonance imaging (RMMP) to characterize PI-RADS II lesions. Materials and methods: The RMMPs performed between January 2015 and December 2016 were retrospectively analyzed. The RMMP protocol was based on the recommendations of the PI-RADS version 2, and a late acquisition was added, after the dynamic post-contrast. The reports were reviewed under the version 2.1. Results: 31 patients with PI-RADS II lesions in the peripheral zone were selected, who were in prostate specific antigen follow-up and had histological confirmation of chronic prostatitis. A late enhancement of the lesion was evidenced in all patients. According to the histopathological results, 30 had chronic prostatitis and the remaining benign tissue (fibromuscular tissue). Discussion: Chronic prostatitis does not show early enhancement, and presents late enhancement due to its fibrous connective tissue. In RMMP, prostatitis may mimic prostate cancer. Adding a late sequence only adds 150 seconds to the study and could help to resolve those uncertain cases categorized as PI-RADS III using traditional sequences because the late enhancement of the lesion is highly suggestive of an inflammatory process (PI-RADS II). Conclusion: The presence of late enhancement is a useful tool to perform an adequate diagnosis of a PI-RADS II lesion in the peripheral zone, helping to avoid an unnecessary biopsy.

Humans , Male , Middle Aged , Aged , Prostatitis/diagnostic imaging , Multiparametric Magnetic Resonance Imaging/methods , Prostate/pathology , Prostatic Neoplasms/diagnostic imaging , Biopsy , Retrospective Studies
Medicina (B.Aires) ; 80(3): 241-247, jun. 2020.
Article in Spanish | LILACS | ID: biblio-1125075


La segunda parte del Consenso Argentino Intersociedades de Infección Urinaria incluye el análisis de situaciones especiales. En pacientes con sonda vesical se debe solicitar urocultivo solo cuando hay signo-sintomatología de infección del tracto urinario, antes de instrumentaciones de la vía urinaria o como control en pacientes post-trasplante renal. El tratamiento empírico recomendado en pacientes sin factores de riesgo es cefalosporinas de tercera generación o aminoglucósidos. Las infecciones del tracto urinario asociadas a cálculos son siempre consideradas complicadas. En caso de obstrucción con urosepsis, deberá realizarse drenaje de urgencia por vía percutánea o ureteral. En pacientes con stents o prótesis ureterales, como catéteres doble J, el tratamiento empírico deberá basarse en la epidemiología, los antibióticos previos y el estado clínico. Antes del procedimiento de litotricia extracorpórea se recomienda pesquisar la bacteriuria y, si es positiva, administrar profilaxis antibiótica según el antibiograma. Cefalosporinas de primera generación o aminoglúcosidos son opciones válidas. Se recomienda aplicar profilaxis antibiótica con cefalosporinas de primera generación o aminoglúcosidos antes de la nefrolitotomía percutánea. La biopsia prostática trans-rectal puede asociarse a complicaciones infecciosas, como infecciones del tracto urinario o prostatitis aguda, principalmente por Escherichia coli u otras enterobacterias. En pacientes sin factores de riesgo para gérmenes multirresistentes y urocultivo negativo se recomienda realizar profilaxis con amikacina o ceftriaxona endovenosas. En pacientes con urocultivo positivo, se realizará profilaxis según antibiograma, 24 horas previas a 24 horas post-procedimiento. Para el tratamiento dirigido de la prostatitis post-biopsia trans-rectal, los carbapenémicos durante 3-4 semanas son el tratamiento de elección.

The second part of the Inter-Society Argentine Consensus on Urinary Tract Infection (UTI) includes the analysis of special situations. In patients with urinary catheter, urine culture should be requested only in the presence of UTI symptomatology, before instrumentation of the urinary tract, or as a post-transplant control. The antibiotics recommended for empirical treatment in patients without risk factors are third-generation cephalosporins or aminoglycosides. UTIs associated with stones are always considered complicated. In case of obstruction with urosepsis, an emergency drainage should be performed via a percutaneous nefrostomy or ureteral stenting. In patients with stents or ureteral prostheses, such as double J catheters, empirical treatment should be based on epidemiology, prior antibiotics, and clinical status. Before the extracorporeal lithotripsy procedure, bacteriuria should be investigated and antibiotic prophylaxis should be administered in case of positive result, according to the antibiogram. First generation cephalosporins or aminoglycosides are valid alternatives. The use of antibiotic prophylaxis with first-generation cephalosporins or aminoglycosides before percutaneous nephrolithotomy is recommended. Transrectal prostatic biopsy can be associated with infectious complications, such as UTI or acute prostatitis, mainly due to Escherichia coli or other enterobacteria. In patients without risk factors for multiresistant bacteria and negative urine culture, prophylaxis with intravenous amikacin or ceftriaxone is recommended. In patients with positive urine culture, prophylaxis will be performed according to the antibiogram, from 24 hours before to 24 hours post-procedure. For the targeted treatment of post-transrectal biopsy prostatitis, carbapenems for 3-4 weeks are the treatment of choice.

Humans , Male , Female , Urinary Tract Infections/etiology , Urinary Tract Infections/drug therapy , Consensus , Anti-Infective Agents, Urinary/therapeutic use , Argentina , Prostatitis/etiology , Prostatitis/drug therapy , Lithotripsy/adverse effects , Stents/adverse effects , Risk Factors , Nephrolithiasis/complications , Urinary Catheters/adverse effects , Nephrolithotomy, Percutaneous/adverse effects
Medicina (B.Aires) ; 80(3): 229-240, jun. 2020. tab
Article in Spanish | LILACS | ID: biblio-1125074


La Sociedad Argentina de Infectología y otras sociedades científicas han actualizado estas recomendaciones utilizando, además de información internacional, la de un estudio multicéntrico prospectivo sobre infecciones del tracto urinario del adulto realizado en Argentina durante 2016-2017. La bacteriuria asintomática debe ser tratada solo en embarazadas, a quienes también se las debe investigar sistemáticamente; los antibióticos de elección son nitrofurantoína, amoxicilina, amoxicilina-clavulánico, cefalexina y trimetoprima-sulfametoxazol. Ante procedimientos que impliquen lesión con sangrado del tracto urinario se recomienda solicitar urocultivo para pesquisar bacteriuria asintomática, y, si resultara positivo, administrar antimicrobianos según sensibilidad desde inmediatamente antes hasta 24 horas luego de la intervención. En mujeres, la cistitis puede ser tratada con nitrofurantoina, cefalexina, o fosfomicina y no se recomienda usar trimetoprima-sulfametoxazol o fluoroquinolonas; en pielonefritis puede emplearse ciprofloxacina, cefixima o cefalexina si el tratamiento es ambulatorio o ceftriaxona, cefazolina o amikacina si es hospitalario. En los hombres, las infecciones del tracto urinario se consideran siempre complicadas. Se recomienda tratamiento con nitrofurantoina o cefalexina por 7 días, o bien monodosis con fosfomicina. Para la pielonefritis en hombres se sugiere ciprofloxacina, ceftriaxona o cefixima si el tratamiento es ambulatorio y ceftriaxona o amikacina si es hospitalario. Se sugiere tratar las prostatitis bacterianas agudas con ceftriaxona o gentamicina. En cuanto a las prostatitis bacterianas crónicas, si bien su tratamiento de elección hasta hace poco fueron las fluoroquinolonas, la creciente resistencia y ciertas dudas sobre la seguridad de estas drogas obligan a considerar el uso de alternativas como fosfomicina.

The Argentine Society of Infectious Diseases and other scientific societies have updated these recommendations based on data on urinary tract infections in adults obtained from a prospective multicenter study conducted in Argentina during 2016-2017. Asymptomatic bacteriuria should be treated only in pregnant women, who should also be systematically investigated; the antibiotics of choice are nitrofurantoin, amoxicillin, clavulanic/amoxicillin, cephalexin and trimethoprim-sulfamethoxazole. In procedures involving injury to the urinary tract with bleeding, it is recommended to request urine culture and, in the presence of bacteriuria, antimicrobial treatment according to sensitivity should be prescribed from immediately before up to 24 hours after the intervention. In women, cystitis can be treated with nitrofurantoin, cephalexin or fosfomycin, while trimethoprim-sulfamethoxazole and fluoroquinolones are not recommended; pyelonephritis can be treated with ciprofloxacin, cefixime or cephalexin in ambulatory women or ceftriaxone, cefazolin or amikacin in those who are hospitalized. In men, urinary tract infections are always considered complicated; nitrofurantoin or cephalexin are recommended for 7 days, alternatively fosfomycin should be given in a single dose. In men, ciprofloxacin, ceftriaxone or cefixime are suggested for pyelonephritis on ambulatory treatment whereas ceftriaxone or amikacin are recommended for hospitalized patients. Acute bacterial prostatitis can be treated with ceftriaxone or gentamicin. Fluoroquinolones were the choice treatment for chronic bacterial prostatitis until recently; they are no longer recommended due to the increasing resistance and recent concerns regarding the safety of these drugs; alternative antibiotics such as fosfomycin are to be considered.

Humans , Male , Female , Pregnancy , Argentina , Urinary Tract Infections/drug therapy , Consensus , Anti-Infective Agents, Urinary/therapeutic use , Prostatitis/diagnosis , Prostatitis/drug therapy , Pyelonephritis/diagnosis , Pyelonephritis/drug therapy , Urinary Tract Infections/diagnosis , Prospective Studies , Cystitis/diagnosis , Cystitis/drug therapy
Int. braz. j. urol ; 46(1): 60-66, Jan.-Feb. 2020. tab
Article in English | LILACS | ID: biblio-1056357


ABSTRACT Objectives: To investigate the characteristics of cases of NIH category I acute prostatitis developed after transrectal prostate biopsy and clarifiy the risk factors and preventive factors. Materials and Methods: We retrospectively reviewed the medical records of 3.479 cases of transrectal ultrasound-guided needle biopsies performed with different prophylactic antibiotherapy regimens at two different institutions between January 2011 and February 2016. The patients of Group I have received ciprofl oxacin (n=1.523, 500mg twice daily) and the patients of Group II have received ciprofl oxacin plus ornidazole (n=1.956, 500mg twice daily) and cleansing enema combination as prophylactic antibiotherapy. The incidence, clinical features and other related microbiological and clinical data, were evaluated. Results: Mean age was 62.38±7.30 (47-75), and the mean prostate volume was 43.17±15.20 (21-100) mL. Of the 3.479 patients, 39 (1.1%) developed acute prostatitis after the prostate biopsy procedure. Of the 39 cases of acute prostatitis, 28/3.042 occurred after the first biopsy and 11/437 occurred after repeat biopsy (p=0.038). In Group I, 22 of 1.523 (1.4%) patients developed acute prostatitis. In Group II, 17 of 1.959 (0.8%) patients developed acute prostatitis. There was no statistical difference between the two groups according to acute prostatitis rates (X2=2.56, P=0.11). Further, hypertension or DM were not related to the development of acute prostatitis (P=0.76, X2=0.096 and P=0.83, X2=0.046, respectively). Conclusions: Repeat biopsy seems to increase the risk of acute prostatitis, while the use of antibiotics effective for anaerobic pathogens seems not to be essential yet.

Humans , Male , Aged , Ornidazole/administration & dosage , Prostatitis/etiology , Biopsy, Needle/adverse effects , Ciprofloxacin/administration & dosage , Antibiotic Prophylaxis/methods , Enema/methods , Anti-Bacterial Agents/administration & dosage , Prostate/pathology , Prostatitis/prevention & control , Time Factors , Biopsy, Needle/methods , Reproducibility of Results , Retrospective Studies , Risk Factors , Treatment Outcome , Ultrasonography, Interventional , Drug Combinations , Middle Aged
Med. lab ; 24(1): 13-35, 2020.
Article in Spanish | LILACS, COLNAL | ID: biblio-1096999


Los procesos inflamatorios e infecciosos que se desencadenan en la próstata, primordial glándula reproductiva masculina, originan las tres principales enfermedades de este órgano: prostatitis, hiperplasia prostática benigna y cáncer. Para entender la relación que existe entre estas tres patologías y los procesos de infección e inflamación, se realizó una revisión de la literatura científica, a conveniencia, en la base de datos PubMed, empleando los términos próstata, prostatitis, hiperplasia prostática benigna y cáncer de próstata. La literatura revisada resalta la importancia del adecuado funcionamiento del sistema inmune en el tejido prostático para eliminar los microorganismos causantes de infecciones, proceso a través del cual se desencadena la inflamación del tejido. Además, infecciones urinarias ascendentes, que culminan en prostatitis crónica, favorecen el desarrollo de la hiperplasia prostática benigna, agrandamiento y fibrosis de la próstata en hombres adultos, e incluso su progresión a cáncer en individuos genéticamente susceptibles. Por otro lado, las limitaciones en el diagnóstico de las alteraciones prostáticas promueven la inflamación crónica, y el uso indiscriminado de antibióticos de amplio espectro para el tratamiento de la prostatitis, impulsa la diseminación sexual de microorganismos multirresistentes al tratamiento. Las alteraciones prostáticas, en especial la prostatitis, continúan siendo patologías enigmáticas de difícil diagnóstico y tratamiento. El estudio de la próstata, sus alteraciones y su relación con el sistema inmune contribuirán a limitar el uso indiscriminado de antibióticos y a reducir los costos en salud y los efectos sobre la calidad de vida de los individuos afectados

Inflammatory and infectious processes triggered in the prostate, the primary male reproductive gland, originate the three main diseases of this organ: prostatitis, benign prostatic hyperplasia and cancer. To understand the relationship between these three pathologies and inflammatory and infectious processes, a review of the scientific literature was carried out in PubMed database using the terms prostate, prostatitis, benign prostatic hyperplasia and prostate cancer. The revised articles highlight the importance of properly immune system functioning in the prostate tissue to remove the microorganisms that cause infections, a process which also triggers tissue inflammation. In addition, ascending urinary infections, which culminate in chronic prostatitis, favor the development of benign prostatic hyperplasia, enlargement and fibrosis of the prostate in adult men, and even its progression to cancer in genetically susceptible individuals. Furthermore, limitations in the diagnosis of prostatic disorders promote chronic inflammation, and the indiscriminate use of broad spectrum antibiotics for prostatitis treatment leads to sexual dissemination of multidrug-resistant microorganisms. Prostatic disorders, especially prostatitis, continue to be enigmatic pathologies of difficult diagnosis and treatment. The study of the prostate, its disorders and its relationship with the immune system will contribute to limit the indiscriminate use of antibiotics and to reduce health costs and the effects on the quality of life of affected individuals

Humans , Middle Aged , Aged , Prostate , Prostatic Hyperplasia , Prostatic Neoplasms , Prostatitis , Infections , Inflammation
Article in English | WPRIM | ID: wpr-886660


@#BACKGROUND: This is a rare case of two large urinary bladder stones causing severe infection of the urinary tract affecting the bone marrow due to chronic immune stimulation in a patient with recurrent anemia. Urinary bladder calculi are hard masses of minerals. They develop when the minerals in concentrated urine crystallize. This often happens when the bladder cannot be emptied. Signs and symptoms can vary from severe abdominal pain to blood in the urine. Sometimes, bladder stones don't cause any symptoms. If left untreated, bladder stones may lead to infections and other complications such as hepatic abscess via a hematogenous route. CASE: This is a case of a seventy-eight-year-old man with a history of multiple blood transfusions secondary to anemia of unknown cause. He came into our institution for a second opinion. We worked up the patient, which showed hepatic abscess and two large urinary bladder calculi. Further investigation of the anemia later led to a diagnosis of primary myelofibrosis. DIAGNOSTICS: Ultrasound showed a complex mass on the left hepatic lobe measuring 7.5 cm x 6.0 cm x 2.1 cm consistent with a hepatic abscess. The culture of the abscess was positive for E. coli. Computed Tomography (CT) scan of the lower abdomen showed heterogeneous mass measuring 8.6 cm x 8.7 cm x 9.2 cm within the urinary bladder (see Figure 2). Urinalysis was consistent with a urinary tract infection. Urine culture showed E. coli. Video-assisted cystoscopy showed two urinary bladder calculi, measuring 1.5 cm x 3.2 cm x 4.2 cm weighing 30 grams each (see Figure 3). The calculi were composed of 100% Calcium Oxalate. He underwent a series of diagnostic examinations for anemia including gastroscopy to rule out a bleeding ulcer. Complete blood count showed hemoglobin of 77 g/L and a hematocrit of 0.23. Finally, bone marrow core biopsy was done which is consistent with primary myelofibrosis. CONCLUSION: Urinary bladder stones can be asymptomatic and may present only with vague abdominal pain. It should be one of the considerations in asymptomatic patients with long-standing prostatitis or benign prostatic hyperplasia. Detailed history, thorough physical examinations, and cautious diagnostic tests are mandatory to confirm the diagnosis. A hepatic abscess may arise from infections in the urinary tract such as prostatitis through hematogenous extension. Therefore, it is important to address the origin of the infection to prevent such complications. This is a rare case of an elderly man who presented with chronic anemia and later found out to have large urinary bladder stones that caused severe infection leading to immune stimulation of the bone marrow, hence the diagnosis of primary myelofibrosis by bone marrow biopsy. Such a rare case must be thought of holistically and analytically.

Male , Prostatitis , Prostatic Hyperplasia , Urinary Bladder Calculi , Liver Abscess , Anemia
Int. braz. j. urol ; 45(3): 495-502, May-June 2019. tab, graf
Article in English | LILACS | ID: biblio-1012326


ABSTRACT Background: Our study investigates whether Native Thiol, Total Thiol and disulphide levels measured in serum of patients with prostate cancer and prostatitis and of healthy subjects, have any role in differential diagnosis. Materials and Methods: Patients followed up for histopathologically verified diagnosis of prostate cancer and prostatitis in 2016-2017 at the Medicalpark Gaziantep Hospital Urology Clinic were included in the study. Native Thiol (NT), Total Thiol (TT), Dynamic Disulphide (DD) levels in serum were measured by a novel automated method. Results: NT, TT, DD, NT / TT ratios, DD / TT ratio and DD / NT ratio were measured as 118.4 ± 36.8μmoL / L, 150.3 ± 45.3μmoL / L, 15.9 ± 7μmoL / L, 78.8 ± 7μmoL / L, 10.5 ± 3.5μmoL / L, 13.8 ± 5.8μmoL / L respectively in patients with prostate cancer; as 116.4 ± 40.5μmoL / L, 147.5 ± 50.1μmoL / L, 15.5 ± 8.7μmoL / L, 79.7 ± 9μmoL / L, 10.1 ± 4.5μmoL / L, 13.5 ± 7.2μmoL / L in patients with prostatitis and as 144.1 ± 21.2μmoL / L, 191 ± 32.3μmoL / L, 23.4 ± 10.1μmoL / L, 76.1 ± 98.3μmoL / L, 11.9 ± 4.1μmoL / L, 16.4 ± 6.9μmoL / L in healthy subjects. Significant difference was detected between groups of NT, TT and DD levels (p = 0.008, p = 0.001, p = 0.002). No significant difference was detected in terms of the NT / TT, DD / TT and DD / NT rates (p = 0.222, p = 0.222, p = 0.222). Conclusions: Serum NT, TT, DD levels in patients with prostatitis and prostate cancer were found significantly lower compared to the control group. This indicates that just as inflammation, prostate cancer also increases oxidative stress on tissues.

Humans , Male , Aged , Prostatic Neoplasms/blood , Prostatitis/blood , Sulfhydryl Compounds/blood , Disulfides/blood , Prostatic Neoplasms/diagnosis , Prostatitis/diagnosis , Reference Values , Biomarkers, Tumor/blood , Case-Control Studies , Reproducibility of Results , Retrospective Studies , Risk Factors , Analysis of Variance , Statistics, Nonparametric , Risk Assessment , Oxidative Stress/physiology , Diagnosis, Differential , Middle Aged
Int. braz. j. urol ; 45(2): 246-252, Mar.-Apr. 2019. tab, graf
Article in English | LILACS | ID: biblio-1002205


ABSTRACT Objectives: To evaluate the frequency of NIH category IV prostatitis, and the use of expressed prostatic secretions tests in an effort to improve the reliability of prostate specific antigen as an indicator, to avoid unnecessary prostate biopsy. Materials and Methods: 178 expressed prostatic secretion positive patients with serum prostate specific antigen levels of ≥ 2.5 ng / mL were included in present prospective study. The diagnostic evaluation included detailed history and physical examination, digital rectal examination, urine analysis, urine culture, and expressed prostatic secretions tests. Transrectal ultrasonography was used both to measure prostate volume and conduct 12 core prostate biopsy. Results: The prevalence of NIH category IV prostatitis was 36.9% (178 / 482) in our population of men. In our study patients (n: 178) prostate biopsy results were classified as; 66 prostatitis, 81 BPH, and 31 Pca. In asymptomatic prostatitis group, expressed prostatic secretion mean leucocyte ratio was higher compared to other two groups (p < 0.0001). The relation between number of expressed prostatic secretion leucocytes and prostatitis, benign prostate hyperplasia, and prostate cancer is analyzed. If 16 is taken as the cut of number for leucocyte presence, its sensitivity is 0.92 (AUC = 0.78 p = 0.01). Conclusions: The number of leucocytes in expressed prostatic secretion is higher in the chronic prostatitis group. If the leukocyte presence of 16 and above is taken as the cut off point, the sensitivity becomes 0.92 (AUC = 0.78). We firmly believe that our new cut off value may be used as to aid prostate specific antigen and derivates while giving biopsy decision.

Humans , Male , Aged , Prostate/pathology , Prostatic Hyperplasia/metabolism , Prostatic Neoplasms/metabolism , Prostatitis/mortality , Biopsy/standards , Prostate-Specific Antigen/blood , Prostate/metabolism , Prostatic Hyperplasia/diagnosis , Prostatic Neoplasms/diagnosis , Prostatitis/classification , Prostatitis/pathology , Biomarkers, Tumor/metabolism , Chronic Disease , Prospective Studies , Diagnosis, Differential , Digital Rectal Examination , Middle Aged
Rev. Soc. Argent. Diabetes ; 53(1): 41-44, Ene.-Abr. 2019.
Article in Spanish | LILACS | ID: biblio-1021906


La cistitis bacteriana aguda es un proceso infeccioso de la vejiga. La prescencia de disuria, polaquiuria, tenesmo, dolor hipogástrico y/o hematuria, aumenta la probabilidad diagnóstica. Ante la sospecha clínica debe solicitarse sedimento urinario y evaluar presencia de leucocituria, piuria o microhematuria, y requerir urocultivo previo al inicio del tratamiento. La prostatitis bacteriana aguda es una entidad poco frecuente pero que requiere diagnóstico y tratamiento precoz, con aislamiento del gérmen. La uretritis puede ser de etiología infecciosa o no. En estas patologías, el tratamiento no difiere de los pacientes sin diabetes, pero deben tenerse presente factores como la neuropatía autonómica que puede encubrir la sintomatología y aumentar el riesgo de descompensación metabólica y cetoacidosis

Acute bacterial cystitis is an infectious process of the bladder. The presence of dysuria, pollakiuria, tenesmus, hypogastric pain and/or hematuria increases the diagnostic probability. In view of clinical suspicion, urinary sediment should be requested to evaluate the presence of leukocyturia, pyuria or microhematuria, and urine culture requested before starting treatment. Acute bacterial prostatitis is a less frequent entity but requires early diagnosis and treatment, with germ isolation. Urethritis can be of infectious etiology or not. In these pathologies, treatment does not differ from patients without diabetes, but factors such as autonomic neuropathy that can conceal the symptoms and increase the risk of metabolic decompensation and ketoacidosis should be considered

Prostatitis , Urethritis , Cystitis
Biol. Res ; 52: 30, 2019. tab, graf
Article in English | LILACS | ID: biblio-1011432


BACKGROUND: Chronic prostatitis has been supposed to be associated with preneoplastic lesions and cancer development. The objective of this study was to examine how chronic inflammation results in a prostatic microenvironment and gene mutation in C57BL/6 mice. METHODS: Immune and bacterial prostatitis mouse models were created through abdominal subcutaneous injection of rat prostate extract protein immunization (EAP group) or transurethral instillation of uropathogenic E. coli 1677 (E. coli group). Prostate histology, serum cytokine level, and genome-wide exome (GWE) sequences were examined 1, 3, and 6 months after immunization or injection. RESULT: In the EAP and E. coli groups, immune cell infiltrations were observed in the first and last months of the entire experiment. After 3 months, obvious proliferative inflammatory atrophy (PIA) and prostatic intraepithelial neoplasia (PIN) were observed accompanied with fibrosis hyperplasia in stroma. The decrease in basal cells (Cytokeratin (CK) 5+/p63+) and the accumulation of luminal epithelial cells (CK8+) in the PIA or PIN area indicated that the basal cells were damaged or transformed into different luminal cells. Hic1, Zfp148, and Mfge8 gene mutations were detected in chronic prostatitis somatic cells. CONCLUSION: Chronic prostatitis induced by prostate extract protein immunization or E. coli infection caused a reactive prostatic inflammation microenvironment and resulted in tissue damage, aberrant atrophy, hyperplasia, and somatic genome mutation.

Animals , Male , Mice , Precancerous Conditions/genetics , Prostatitis/genetics , Escherichia coli Infections/pathology , Mutation/genetics , Precancerous Conditions/microbiology , Precancerous Conditions/pathology , Prostatitis/microbiology , Prostatitis/pathology , Immunohistochemistry , Chronic Disease , Disease Models, Animal , Mice, Inbred C57BL
Article in English | WPRIM | ID: wpr-763188


PURPOSE: The purpose of this study was to determine whether histologic inflammation (HI) in initial and repeat prostate biopsy specimens was significantly associated with the detection of prostate cancer. MATERIALS AND METHODS: Between 2005 and 2017, the clinicopathological records of patients with high prostate-specific antigen (PSA) levels who underwent initial and repeat prostate biopsies were retrospectively reviewed. The presence of HI and its degree in each biopsied specimen were interpreted by one uropathologist with 20 years of experience. The association between HI and cancer diagnosis was statistically assessed, with p 0%) on biopsied specimens, respectively. Comparison of the cancer and noncancer groups revealed that a greater rate of HI specimens in the initial biopsy was associated with fewer prostate cancer diagnoses following repeat biopsy (p < 0.001). Other comparisons between the cancer and non-cancer groups showed that the cancer group had a significantly higher rate of hypertension, whereas those non-cancer group had a significantly higher rate of benign prostatic hyperplasia and prostatitis (p < 0.05). CONCLUSION: A finding of a lesser degree of HI in the initial and a greater degree of HI in the repeat biopsied specimens was associated with the higher probability of cancer diagnosis in patients with high PSA levels.

Biopsy , Diagnosis , Humans , Hypertension , Inflammation , Prostate , Prostate-Specific Antigen , Prostatic Hyperplasia , Prostatic Neoplasms , Prostatitis , Retrospective Studies
Article in Chinese | WPRIM | ID: wpr-777245


The technical combination of acupuncture is a combination therapy based on the purpose of improving clinical efficacy. After years of clinical practice, the author has gradually summarized the dominant disease spectrum of combination therapy, especially for the treatment of difficult diseases such as male and dermatological. In the treatment of chronic prostatitis, the combination of acupuncture at "Zhibian (BL 54) through Shuidao (ST 28) therapy" is adopted. When urticaria is treated, the embedding, fire needle, needle knife and filiform needle can be combined to ensure better effect. Regarding the evidence-based acupuncture treatment research of chronic prostatitis and urticaria, it is believed that acupuncture treatment has been recommended as grade Ⅱ and Ⅰ, and there is no reliable treatment method in modern medicine. The author enumerates two cases of related diseases and explains the advantages of combination therapy.

Acupuncture Points , Acupuncture Therapy , Combined Modality Therapy , Humans , Male , Moxibustion , Prostatitis , Therapeutics , Treatment Outcome
Article in English | WPRIM | ID: wpr-776637


OBJECTIVE@#To evaluate the efficacy and safety of essential oil treatment for type III chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).@*METHODS@#A randomized controlled trial was conducted from December 2014 to October 2015. Seventy type III CP/CPPS patients were assigned to the essential oil group (35 cases) or almond placebo oil control group (35 cases) by a random number table. The oil was smeared by self-massage on the suprapubic and sacral region once a day for 4 weeks. The National Institutes of Health Chronic Prostatitis Syndrome Index (NIH-CPSI) and expressed prostatic secretions (EPS) were examined. The primary outcome was NIH-CPSI pain domain. The secondary outcomes included other NIH-CPSI domains and laboratory examinations of EPS. Adverse events were also observed.@*RESULTS@#Sixty-six subjects completed the full 4-week treatment. There was no significant difference between almond oil control and essential oil groups in terms of the total score of NIH-CPSI, pain, quality of life and urination domain scores of NIH-CPSI and EPS examinations (P>0.05). In the essential oil group, pain between rectum and testicles (perineum) in the domain of pain or discomfort was significantly reduced at week 2 and week 4 compared with almond oil control group (P<0.01). No serious adverse events occurred.@*CONCLUSION@#The essential oil may reduce the pain or discomfort in the perineum region in patients with CP/CPPS. (Registration No. ChiCTR-IPR-14005448).

Adult , Chronic Pain , Drug Therapy , Humans , Male , Oils, Volatile , Therapeutic Uses , Pelvic Pain , Drug Therapy , Pilot Projects , Prostatitis , Drug Therapy , Syndrome , Treatment Outcome
Article in English | WPRIM | ID: wpr-742355


PURPOSE: To determine the role of metabolic syndrome (MetS) as a risk factor for acquired premature ejaculation (PE) after considering the various risk factors, such as lower urinary tract symptoms, erectile dysfunction, hypogonadism, and prostatitis. MATERIALS AND METHODS: From January 2012 to January 2017, records of 1,029 men were analyzed. We performed multivariate analysis to identify risk factors for PE, including the covariate of age, marital status, International Prostate Symptom Score, International Index of Erectile Function (IIEF) score, National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) score, serum testosterone levels, and all components of MetS. Acquired PE was defined as self-reported intravaginal ejaculation latency time ≤3 minutes, and MetS was diagnosed using the modified National Cholesterol Education Program Adult Treatment Panel III criteria. RESULTS: Of 1,029 men, 74 subjects (7.2%) had acquired PE and 111 (10.8%) had MetS. Multivariate analysis showed that the IIEF overall satisfaction score (odds ratio [OR]=0.67, p<0.001), NIH-CPSI pain score (OR=1.07, p=0.035), NIH-CPSI voiding score (OR=1.17, p=0.032), and presence of MetS (OR=2.20, p=0.022) were significantly correlated with the prevalence of acquired PE. In addition, the Male Sexual Health Questionnaire for Ejaculatory Dysfunction scores and ejaculation anxiety scores progressively decreased as the number of components of MetS increased. CONCLUSIONS: MetS may be an independent predisposing factor for the development of acquired PE. Effective prevention and treatment of MetS could also be important for the prevention and treatment of acquired PE.

Academies and Institutes , Adult , Anxiety , Causality , Cholesterol , Education , Ejaculation , Erectile Dysfunction , Humans , Hypogonadism , Lower Urinary Tract Symptoms , Male , Marital Status , Multivariate Analysis , Obesity , Premature Ejaculation , Prevalence , Prostate , Prostatitis , Reproductive Health , Risk Factors , Testosterone