Efficacy of a single- dose fosfomycin as antibiotic prophylaxis prior to transrectal ultrasound-guided prostate biopsy

Objectives@#The goal to prevent increasing antibiotic resistance in urologic procedures has a significant impact on the choice of preoperative antibiotic prophylaxis. The efficacy of an old-new antibioticfosfomycin in TRUS-guided prostate biopsy was also evaluated. @*Methods@#Included were patients who underwent TRUS-guided prostate biopsy from August 1, 2015- July 31, 2016. Patients who satisfied the inclusion criteria were included. Patients were asked to take a single dose of 3g oral fosfomycin 1-3 hours prior to the procedure. Urinalysis was taken pre biopsy and post biopsy (at least 7-10 days). Occurrence of afebrile and febrile UTI were noted. Patients were informed of the signs and symptoms that need to be reported to the investigators. @*Results@#There were 74 patients enrolled in the study. The mean average age of patients was 66.5(±7). Majority of patients were having moderate lower urinary tract symptoms (40.5%) followed by patients with indwelling foley catheter (31.1%). Seventeen percent of patients had concomitant diseases like diabetes mellitus, cystolithiasis, nephrolithiasis, hypertension, etc. Pre biopsy, 51.4% of patients had asymptomatic urinary tract infection and 35% of these patients showed resolution of UTI post biopsy. The incidence of febrile UTI was 4%, 3.8% of patients with UTI pre biopsy and 50% of patients without UTI pre biopsy. Finally, the presence of afebrile and febrile UTI pre and post biopsy was statistically significant at 5% level of significance. @*Conclusion@#Single dose oral fosfomycin as prophylactic antibiotic in TRUS- guided prostate biopsy can be an alternative to reduce the rate of fluoroquinolone- resistant infections.

Gross and microscopic testicular findings after spermatic vessel division

A high undescended testis is one of the major problems that face a urologist and transection of the spermatic vessels may solve the problem in bringing down the testis. Spermatic vessel transection was done on 21 cat testicles. Gross examination and biopsy was done, pre-transection followed by gross examination and orchiectomy 7 days post transection. Results revealed a decrease in size, 18/21 (85%) showed atrophy of the testis, change in color formation from pink to gray in 16/21 (76%) and 21/21 (100%) change in consistency from doughy to soft. Microscopic findings noted a significant decrease in the number of vessels in the interstitium, spermatogenic activity and germ cell content. There was no statistically significant change noted on the Leydig cell population (p0.05). Close observation and follow-up is warranted if this operation is done in humans because, according to the study, significant changes occur in the testis after transection of the spermatic vessels.