Acute prostatitis after prostate biopsy under ciprofloxacin prophylaxis with or without ornidazole and pre-biopsy enema: analysis of 3. 479 prostate biopsy cases

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.

Lateral decubitus position vs. lithotomy position: which is the best way to minimize patient's pain perception during transrectal prostate biopsy?

ABSTRACT Introduction Considering the distinctive nature in terms of psychological stress and anal tone of position which is generally selected between lithotomy and left lateral decubitus (LLD), we postulated its effect on pain perception during biopsy, and investigated their association. Materials and Methods A prospective study for comparison of two biopsy positions which were perform in a different working day was conducted for 208 men (lithotomy position=86, LLD=122). The decision on the position was made solely based on the patient’s preference for the biopsy day, and all procedures were performed according to the identical protocol (12-core biopsy with intrarectal lidocaine gel), probe, and needle. The maximal degree of pain during the entire process was assessed using a visual analogue scale (VAS), immediately after biopsy. After propensity matching, a total of 152 patients were finally selected (lithotomy group=76, LLD=76), then peri-biopsy parameters were compared. Results Between groups, no differences were observed across all variables including age, obesity, prostate volume, serum PSA, international prostate symptom score, and cancer detection rate, except mean (±standard deviation) VAS score (3.89±2.01 vs. 4.58±2.22, p=0.049). VAS score showed significant association solely with patient’s position (Pearson’s coefficient=-0.165, p=0.042). In multiple linear regression models regarding the effect of clinical variables on VAS score, patient position was a single independent predictor favoring lithotomy position to decrease perceived pain (B=-0.928, p=0.024). Conclusions These data suggest lithotomy position as a proper way to perform transrectal prostate biopsy with routine use of topical lidocaine gel in comparison with conventional LLD position.

Incidence of sepsis following transrectal ultrasound guided prostate biopsy at a tertiary-care medical center in Lebanon

ABSTRACT Background Urosepsis is a rare but life-threatening complication following transrectal ultrasound (TRUS) guided needle prostate biopsy. Despite the technological and pharmacological improvements, the problem of bacterial urosepsis after prostate biopsy remains. A strategy for preventing urosepsis following TRUS prostate biopsy in areas with high prevalence of resistant strains or patients presenting risk factors is lacking. Objectives The aim of this study was to assess the prevalence of urosepsis, as well its predictors, following TRUS guided needle biopsy of the prostate in a tertiary care medical center in Lebanon. Materials and Methods We carried out a retrospective study on all patients who underwent TRUS prostate biopsy at the American University of Beirut Medical Center between January 1, 2011 and June 31, 2013. Patients’ hospital charts were reviewed. Data collected included demographic information, pre-procedure disease specific information, as well as post-procedure information. Predictors of urosepsis following TRUS were assessed. Results In total, 265 patients were included in this study, where the prevalence of urosepsis following TRUS prostate biopsy was found to be 9.4%. The significant independent predictors of urosepsis were found to be: age with an OR=0.93 (95% CI: 0.88–1.00, p-value=0.03), and hypertension comorbidity with an OR=3.25 (95% CI: 1.19–8.85, p-value=0.02). Conclusion We found a high prevalence of urosepsis among patients who have undergone TRUS prostate biopsy, and identified two significant risk factors. The results of this study highlight the importance of implementing strategies for prevention of urosepsis following TRUS prostate biopsy.

The efficacy of duration of prophylactic antibiotics in transrectal ultrasound guided prostate biopsy

ABSTRACT Introduction: We aimed to evaluate the efficacy of the duration of prophylactic antibiotic administration in patients undergoing transrectal ultrasound (TRUS) guided biopsy. Material and Methods: A total of 367 patients undergoing a prostate biopsy between September 2007 and June 2009 was reviewed retrospectively and divided into 2 groups according to prophilaxy: oral ciprofloxacin (750 mg every 12 hours) for 3 or more days in Group-1 and single day in Group-2. Demographic characteristics of patients, symptoms, PSA values, IPSS scores, prostate sizes, pathologic results and complications were compared between the groups. Results: The mean age of all patients was 63.92 years and the mean PSA was 13.61ng/ dL. The pre-biopsy mean IPSS score was 12.47 and mean prostate volume 52.53 mL. For 78.2% of patients the current biopsy was their first biopsy. Cancer detection rate was 24.2%. Fever was observed in 3 (1.2%) patients in Group-1 and 5 (4.0%) patients in Group-2. Local infections occurred in 2 (0.8%) and 1 (0.8%) patients respectively in Groups 1 and 2. Acute prostatitis was observed in only 1 (0.8%) patient in Group-2. Accepted after revision: None of the patients developed septicemia or other serious infection. There was no statistically significant difference in terms of fever, local infections (epididimitis, orchitis, etc.) and acute prostatitis. Conclusions: In a selected patient population single dose prophylaxis with ciprofloxacin can be safely administered compared to other regimens of 3 or more days. Increasing the duration of antibiotic prophylaxis does not decrease infectious complications.

Effect of patient position on pain scales during transrectal ultrasound-guided prostate biopsy

PURPOSE: Transrectal ultrasound (TRUS)-guided prostate biopsy is the most useful technique for the diagnosis of prostate cancer; however, many patients describe the procedure as uncomfortable and painful. We investigated the effect of the patient's position on pain scales during TRUS-guided prostate biopsy. MATERIALS AND METHODS: Between July 2012 and June 2013, a total of 128 consecutive patients who underwent TRUS-guided prostate biopsy were included in this study. Seventy patients underwent the procedure in the lithotomy position performed by a urologist and the other patients (n=58) underwent the procedure in the left lateral decubitus (LLD) position performed by a radiologist. Pain was assessed by using visual analogue scale (VAS) scores from 0 to 10. Using a linear regression model, we analyzed the correlation between pain scale score and clinical variables with a focus on patient position. RESULTS: No significant differences related to age, body mass index, prostate volume, prostate-specific antigen (PSA), hematuria, pyuria, International Prostate Symptom Score, or the cancer detection rate were observed between the lithotomy and the LLD groups. In the correlation analysis, VAS score showed a significant correlation with diabetes mellitus, PSA level, and lithotomy position (p<0.05). In the multiple linear regression model, VAS score showed a significant correlation with lithotomy position (beta=-0.772, p=0.003) and diabetes mellitus (beta=-0.803, p=0.033). CONCLUSIONS: We suggest that the lithotomy position may be the proper way to reduce pain during TRUS-guided prostate biopsy.

Antibiotic prophylaxis with intravenous ceftriaxone and fluoroquinolone reduces infectious complications after transrectal ultrasound-guided prostatic biopsy

PURPOSE: To assess the rates of infectious complications before and after the change of prophylactic antibiotic regimens in prostate needle biopsy. MATERIALS AND METHODS: The records of 5,577 patients who underwent prostate needle biopsy at Asan Medical Center between August 2005 and July 2012 were retrospectively reviewed. Group 1 (n=1,743) included patients treated between 2005 and 2009 with fluoroquinolone for 3 days, group 2 (n=2,723) included those treated between 2009 and 2012 with ceftriaxone once before the biopsy and fluoroquinolone before biopsy and continue therapy for 3 days, and group 3 (n=1,111) received the same treatment for more than 7 days after the biopsy. Univariable and multivariable logistic regression models addressed risk factors associated with infectious complication after prostate needle biopsy. RESULTS: Infectious complication after prostate needle biopsy developed in 18 (group 1), seven (group 2), and two patients (group 3) (p=0.001). In group 1, seven patients with infectious complication had positive blood cultures and harbored fluoroquinolone-resistant Escherichia coli, four had ceftriaxone susceptible isolates, and three had extended spectrum beta-lactamase-positive E. coli. Two patients in group 1 required intensive care because of septic shock. In multivariable analysis, the patients with combination of fluoroquinolone and ceftriaxone had significantly lower infectious complication rate than the fluoroquinolon alone (p=0.003). CONCLUSIONS: Antibiotic prophylaxis with ceftriaxone and fluoroquinolone before prostate needle biopsy decreased the risk of potentially serious infectious complications.

Needle tract seeding following percutaneous biopsy of renal cell carcinoma

A 66-year-old man underwent computed tomography-guided needle biopsy of a suspicious renal mass. Two months later he underwent partial nephrectomy. Histology revealed a 30-mm clear cell renal cell carcinoma, up to Fuhrman grade 3. An area of the capsule was interrupted, which corresponded to a hemorrhagic area on the cortical surface. Under microscopy, this area showed a tongue of tumor tissue protruding through the renal capsule. A tumor deposit was found in the perinephric fat. These features suggest that tumor seeding may have occurred during the needle biopsy.

Parvimonas micra chest wall abscess following transthoracic lung needle biopsy

No abstract available.

Utilidad de la biopsia percutánea core guiada por tomografía computada (TC) en lesiones pulmonares: experiencia de 7 años / Percutaneous CT-guided cutting needle biopsy of pulmonary lesions: Retrospective analysis of 153 procedures

Background: CT guided percutaneous biopsy of pulmonary lesions is a widely used technique. Aim: To evaluate the yield and complication rate of CT-guided percutaneous core biopsy of pulmonary lesions. Material and Methods: A retrospective study of 153 consecutive lung biopsies performed in a 7-yearperiod was undertaken. Patients and lesions characteristics were reviewed. The yield for the diagnosis of malignant and benign lesions and the complication rate were calculated. Lesion size and depth from the pleural surface were analyzed as potential predictive variables for occurrence of a false-negative diagnosis of malignancy. The final diagnosis was established by surgical biopsy of the lesion or clinical and imaging follow up. Results: The mean age of patients was 66 ± 14 years and 55% were mole. The final diagnosis of the lesion was malignant in 139 and benign in 14 cases (prevalence of malignancy 90.8%). For the diagnosis of malignancy, the overall yield ofthe biopsy was 91.5%o with a sensitivity of 90.6%>. A specific diagnosis of benign lesions was obtained in 5 out ofl4 biopsies (35%). We did not identify an association between the lesion size or depth and the rate of false-negative diagnosis of malignancy. The pneumothorax rate was 13.7%o (n = 21) and eight (38%) required drainage. The average lesion depth of patients that had a pneumothorax was significant greater than the cases without the complication. No major bleeding complications occurred. Conclusions: Percutaneous CT-guided cutting needle biopsies of pulmonary lesions have an excellent diagnostic accuracy for malignant pulmonary lesions, at a low complication rate.

New kidney immobilization method for percutaneous renal biopsy technique in cats: Operational aspects and complications / Novo método de imobilização do rim para biopsia renal percutânea em gatos: Aspectos operacionais e complicações

PURPOSE: Evaluate a new immobilization kidney method for collecting blind percutaneous renal biopsies (RB) in healthy cats. METHODS: Ten cats were biopsied by a modified blinded percutaneous technique using semi-automated needles. Were evaluated the operational aspects of the technique, its complications, and the quality of the obtained samples. The evaluation included physical examination, hemogram, urinalysis, abdominal ultrasound, renal function, and histopathology of the biopsy specimens. RESULTS: The developed technique was fast and easy to perform; it required two operators, and the right kidney was elected for specimen collection. After the RB, a decrease in hematocrit levels was observed in addition to hematuria and perirenal transient hematoma; however, no clinical consequences were observed, and normal parameters were restored within 48 hrs. There were no major complications or deaths, alterations in the physical examination or renal function, or signs of infection. Of the samples, 95 percent revealed the presence of renal tissue, and in 100 percent of the cats the samples were of diagnostic quality. CONCLUSION: The technique was easily performed, provided adequate material for diagnosis with minimal transient complications.

OBJETIVO: Avaliar um novo método de imobilização do rim para coleta de biopsia renal (BR) percutânea às cegas em gatos hígidos. MÉTODOS: Dez gatos foram biopsiados por uma técnica de biopsia percutânea às cegas modificada, com uso de agulha semi-automática. Foram avaliados os aspectos operacionais da técnica, complicações e a qualidade das amostras obtidas. A avaliação incluiu exame físico, hemograma, urinálise, ultrassonografia abdominal, função renal e análise histopatológica do espécime de biopsia. RESULTADOS: A técnica foi de fácil realização; foram requeridos dois operadores, e o rim direito foi eleito para a coleta da BR. Após a BR, diminuição do hematócrito foi observada, em conjunto com hematúria e hematoma peri-renal transitório; entretanto, não foram observadas conseqüências clínicas, e os parâmetros normais foram restabelecidos em 48 horas. Não ocorreram complicações maiores ou óbitos, alterações ao exame físico, função renal ou sinais de infecção. Das amostras obtidas, 95 por cento revelaram presença de tecido renal, e em 100 por cento dos gatos as amostras apresentaram qualidade para diagnóstico. CONCLUSÃO: A técnica foi realizada facilmente, forneceu material adequado para diagnóstico, com complicações clínicas mínimas.

Reducing infectious complications after transrectal prostate needle biopsy using a disposable needle guide: is it possible?

PURPOSE: To investigate whether the use of a disposable needle guide results in a decreased incidence of infectious complication after transrectal prostate needle biopsy (TPNB). MATERIALS AND METHODS: Fifty five patients who underwent 10-core TPNB were randomized into two groups. A pre-biopsy blood and urine examination was performed in both groups. Group 1 (25 patients) underwent biopsy with disposable biopsy needle guide and Group 2 (30 patients) underwent biopsy with reusable biopsy needle guide. All patients had a blood and negative urine culture before the procedure. The patients received ciprofloxacin 500 mg twice a day beginning the day before the biopsy and continued for 3 days after. Serum C-reactive protein levels and urine and blood specimens were obtained 48h after the biopsy. Primary endpoint of the study was to determine the effect of needle guide on the bacteriologic urinary tract infection (UTI) rate and secondary end point was to determine symptomatic UTI. RESULTS: The mean age of the patients was 63.46 (range 55 to 68) years. There were no significant differences regarding the prostate-specific antigen level, prostate size, existence of comorbidity in two groups before the procedure. Bacteriologic and symptomatic UTI was detected in 4 percent vs. 6.6 percent and 4 percent vs. 3.9 percent in Group 1 and 2 relatively (P > 0.05). CONCLUSION: The use of a disposable needle guide does not appear to minimize infection risk after TPNB. Large scale and randomized studies are necessary to determine the effect of disposable needle guide on infection rate after TPNB.

Safety of ultrasound-guided transrectal extended prostate biopsy in patients receiving low-dose aspirin

PURPOSE: To determine whether the peri-procedural administration of low-dose aspirin increases the risk of bleeding complications for patients undergoing extended prostate biopsies. MATERIALS AND METHODS: From February 2007 to September 2008, 530 men undergoing extended needle biopsies were divided in two groups; those receiving aspirin and those not receiving aspirin. The morbidity of the procedure, with emphasis on hemorrhagic complications, was assessed prospectively using two standardized questionnaires. RESULTS: There were no significant differences between the two groups regarding the mean number of biopsy cores (12.9 ± 1.6 vs. 13.1 ± 1.2 cores, p = 0.09). No major biopsy-related complications were noted. Statistical analysis did not demonstrate significant differences in the rate of hematuria (64.5 percent vs. 60.6 percent, p = 0.46), rectal bleeding (33.6 percent vs. 25.9 percent, p = 0.09) or hemospermia (90.1 percent vs. 86.9 percent, p = 0.45). The mean duration of hematuria and rectal bleeding was significantly greater in the aspirin group compared to the control group (4.45 ± 2.7 vs. 2.4 ± 2.6, p = < 0.001 and 3.3 ± 1.3 vs. 1.9 ± 0.7, p < 0.001). Multivariate logistic regression analysis revealed that only younger patients (mean age 60.1 ± 5.8 years) with a lower body mass index (< 25 kg/m2) receiving aspirin were at a higher risk (odds ratio = 3.46, p = 0.047) for developing hematuria and rectal bleeding after the procedure. CONCLUSIONS: The continuing use of low-dose aspirin in patients undergoing extended prostatic biopsy is a relatively safe option since it does not increase the morbidity of the procedure.

Utilidad y complicaciones de la biopsia percutánea esplénica con aguja tru-cut guiada por imágenes / Ultrasound guided needle biopsy of the spleen: review of 13 procedures

Background: Needle biopsies of the spleen were avoided due to the fear of bleeding in a highly vascularized organ. However their safety, even using 18 gauge needles, has been demonstrated. Aim: To report the experience with ultrasound guided needle biopsies of the spleen. Material and Methods: Retrospective review of records of ultrasound guided biopsies of the spleen using Tru-cutTM needles, performed between 2005 and 2009. Results: Thirteen procedures performed in 12 patients were identified. A specific diagnosis was achieved in nine (69 percent) procedures (lymphoma in four, melanoma in 2, sarcoma in 1, extremedullary erythropoiesis in one and splenic cryptococcosis in one. Two patients with negative results were subjected to a new biopsy, which yielded the diagnosis of lymphoma. A third patient was studied elsewhere, finding a malignant tumor. Two patients had complications, one had a vagal reaction and other had a perisplenic hematoma without clinical repercussion. Conclusions: Ultrasound guided needle biopsy of the spleen is a safe and useful procedure.

Objetivo: Reportar la experiencia de biopsias percutáneas esplénicas con aguja tru-cut guiadas por imágenes. Materiales y Métodos: Revisión retrospectiva de biopsias esplénicas con aguja tru-cut guiadas por ultrasonido (US) y tomografía computada (TC) realizadas en nuestro hospital desde Enero de 2005 a Abril de 2009. Resultados: Se identificaron un total de 13 procedimientos. La biopsia percutánea logró un diagnóstico específico en 9 (69 por ciento) de las 13 intervenciones. Los diagnósticos fueron linfoma (n = 4), melanoma (n = 2), sarcoma (n = 1), hematopoyesis extramedular (n = 1) y criptococosis esplénica (n = 1). De las biopsias no diagnósticas 3 casos correspondieron a patología neoplásica y uno a patología benigna. Se reportaron 2 complicaciones (15 por ciento). Discusión: La biopsia esplénica percutánea guiada por imágenes con aguja tru-cut es un procedimiento útil y seguro, capaz de determinar el diagnóstico definitivo en la mayoría de los pacientes y evitar la mayoría de las esplenectomías diagnósticas.

Segurança e eficácia da técnica de biopsia pulmonar transtorácica percutânea para avaliação histopatológica do parênquima pulmonar de ovinos clinicamente sadios / Safety and effectiveness of the transthoracic percutaneous lung biopsy technique for histopathological evaluation of the lung parenchyma in healthy sheep

Foram analisados os resultados e complicações decorrentes do emprego da técnica de biopsia pulmonar transtorácica percutânea em 20 ovinos clinicamente sadios. Os animais foram submetidos ao exame clínico seguido da biopsia com agulha semi-automática no 7º espaço intercostal direito, 5cm acima do olécrano. Foram analisados o número de tentativas para a execução do procedimento e o tamanho dos fragmentos. As amostras obtidas foram avaliadas histologicamente. Posteriormente ao abate, foi realizado o exame pos mortem para avaliação de complicações da técnica e das eventuais lesões provocadas. Entre todos os animais submetidos à biopsia apenas dois demonstraram resistência a técnica, sendo obtidos fragmentos pulmonares de 4-7mm de comprimento, com média de 1,8±1 tentativas por fragmento. As principais alterações relacionadas à técnica foram tosse, dispnéia inspiratória, elevação das freqüências cardíaca e respiratória e aumento do ruído broncobronquiolar. Ao exame post mortem observou-se hemorragia dos músculos intercostais e pleura visceral em todos os animais. Das 20 tentativas de execução da técnica, 18 obtiveram sucesso, enquanto que em duas o fígado foi equivocadamente puncionado. As amostras de tecido pulmonar foram consideradas representativas, pois foi possível a visualização de estruturas íntegras, incluindo bronquíolos e alvéolos. Podemos concluir que a biopsia pulmonar é segura e eficaz para obtenção de amostras pulmonares com fins de diagnóstico histológico.

The results and complications arising from use of the percutaneous transthoracic lung biopsy technique in 20 clinically healthy sheep were analyzed. The animals were subjected to clinical examination followed by lung biopsy with a semi-automatic needle in the 7th right intercostal space, 5cm above the olecranon. The number of attempts to implement the procedure and size of the fragments were evaluated. The samples were evaluated histologically. After the slaughter, a postmortem examination assessed the technical complications and possible injuries. Among all animals which underwent biopsy only two did not tolerate the technique. Lung fragments measuring 4-7mm were obtained by an average of 1.8 attempts per fragment. The main changes related to the procedure were cough, labored breathing, increased heart and breathing rate, and increased bronco-bronchiolar sound. The postmortem examination revealed bleeding of the intercostal muscles and visceral pleura of various extend in all lambs, and a wound up to 14mm length in the lung of two animals that did not tolerate the procedure. From 20 attempts to implement the technique, 18 were successful, while in two of them the liver was mistakenly punctured. Samples of lung tissue were representative. It was possible to visualize intact structures, including bronchioles and alveoli. It could be concluded that lung biopsy is a safe and effective procedure to obtain lung samples for histological diagnosis.

Percutaneous image guided cutting needle biopsy of mediastinal masses: diagnostic yield and complications

To evaluate image guided cutting needle biopsy of mediastinal masses for diagnostic yield and complications. This was a descriptive study. Computed Tomography [CT] and ultrasound guided biopsies of mediastinal masses were performed in 30 patients. Tissue core obtained, were preserved in formalin and sent for histological examination. X-ray chest taken for evidence of pneumothorax and mediastinal widening. Hemoptysis, pneumothorax other complication were recorded. Definite histological diagnosis was obtained in all 30 patients. 70% [n=21] were malignant disease and 30% [n=9] were benign pathologies. Sensitivity and specificity, positive and negative predictive values were 100%. Pneumothorax occurred in 7% [n=2] cases. Hemoptysis occurred in 10% [n=3] cases. Chest intubation was not required in cases of pneumothorax. No hemodynamic instability occurred. There was no major complication. Image guided percutaneous transthoracic cutting needle biopsy in mediastinal masses is an accurate procedure for specific histological diagnosis and has a low complication rate

Effects of prostate manipulation on serum total and free prostate specific antigen, and free-to-total prostate specific antigen ratio

To evaluate the effects of the different types of manipulation on prostate total specific antigen [tPSA], free prostate specific antigen [fPSA], and free-to-total prostate specific antigen [f/tPSA]. A total of 160 males were enrolled from January 2006 to December 2009 in the Urology Department, Beijing Anzhen Hospital affiliated to the Capital Medical University, Beijing, China. Of these patients, 23 had digital rectal examination [DRE], 21 had urethral catheterization, 28 had rigid cystoscopy, 35 had prostate biopsy, 35 underwent transurethral resection of the prostate [TURP], and 18 underwent suprapubic prostatectomy. Blood samples were taken before, at 24 hours, and 4 weeks after the manipulation for PSA tests. The DRE had no significant effect on PSA. Catheterization and cystoscopy exerted significant increases in tPSA at 24 hours. However, these small increases may not be clinically significant. The fPSA and f/tPSA were not significantly changed. There was a marked increase in tPSA and fPSA, associated with a decrease in f/tPSA at 24 hours after biopsy. No significant alterations were found in tPSA, fPSA, and f/tPSA at 4 weeks after catheterization, cystoscopy, and biopsy. The TURP and prostatectomy caused significant increases in tPSA and fPSA at 24 hours, associated with decreases in f/tPSA. The tPSA and fPSA values were below the baseline levels at 4 weeks after TURP and prostatectomy, however, f/tPSA remained constant. The DRE, catheterization, and cystoscopy had no crucial effect on PSA. Prostatic biopsy, TURP and prostatectomy significantly affected the PSA levels, and their longitudinal courses should be considered while evaluating different forms of PSA levels

Dolor trans biopsia de próstata guiada por ultrasonografía transrectal: comparación del uso o no de xilocaína gel como anestésico local: Instituto Especializado de Enfermedades Neoplásicas: Lima-Perú 2006 / Pain during transrectal ultrasound guided needle biopsy of the prostate: comparison of the use or not of lidocaine: Instituto Especializado de Enfermedades Neoplásicas: Lima-Perú

Desde julio de 2004 hasta marzo de 2005 se reclutaron 114 pacientes con indicación de biopsia de próstata bajo guía ecográfica los cuales se dividieron en dos grupos según la colocación o no de xilocaína gel al 2 por ciento intrarrectal antes del procedimiento. Se comparó el dolor que sintieron durante la biopsia a través de una escala de dolor. No hubo diferencia estadísticamente significativa entre los pacientes a quienes se colocó anestésico local frente a quienes no se les colocó. Por otro lado, el dolor fue mayor cuando se usó una aguja esterilizada que cuando se usó una aguja nueva.

From July 2004 until March 2005 we prospectively studied 114 patients who underwent transrectal ultrasound guided needle biopsy of the prostate. Patients were divided in two groups: intrarectal 2 percent lidocaine gel was used prior to biopsy in one of the groups. We compared the pain that patients felt during the procedure using a pain scale. We did not find differences between both groups, but the patients in whom we used a new needle felt less pain than the patients in whom we used a reesterilized one.

Four Cases of a Cerebral Air Embolism Complicating a Percutaneous Transthoracic Needle Biopsy

A percutaneous transthoracic needle biopsy is a common procedure in the practice of pulmonology. An air embolism is a rare but potentially fatal complication of a percutaneous transthoracic needle biopsy. We report four cases of a cerebral air embolism that developed after a percutaneous transthoracic needle biopsy. Early diagnosis and the rapid application of hyperbaric oxygen therapy is the mainstay of therapy for an embolism. Prevention is the best course and it is essential that possible risk factors be avoided.

Chest Computed Tomography (CT) Immediately after CT-Guided Transthoracic Needle Aspiration Biopsy as a Predictor of Overt Pneumothorax

BACKGROUND/AIMS: This study examined the correlation between pneumothorax detected by immediate post-transthoracic needle aspiration-biopsy (TTNB) chest computed tomography (CT) and overt pneumothorax detected by chest PA, and investigated factors that might influence the correlation. METHODS: Adult patients who had undergone CT-guided TTNB for lung lesions from May 2003 to June 2007 at Seoul National University Bundang Hospital were included. Immediate post-TTNB CT and chest PA follow-up at 4 and 16 hours after CT-guided TTNB were performed in 934 patients. RESULTS: Pneumothorax detected by immediate chest CT (CT-pneumothorax) was found in 237 (25%) and overt pneumothorax was detected by chest PA follow-up in 92 (38.8%) of the 237 patients. However, overt pneumothorax was found in 18 (2.6%) of the 697 patients without CT-pneumothorax. The width and depth of CT-pneumothorax were predictive risk factors for overt pneumothorax. CONCLUSIONS: CT-pneumothorax is very sensitive for predicting overt pneumothorax, and the width and depth on CT-pneumothorax are reliable risk factors for predicting overt pneumothorax.