ABSTRACT
The classical bacteria that cause venereal diseases, e.g. gonorrhea, syphilis, chancroid and inguinal granuloma only account for a small proportion of all known STDs today. Other bacteria and viruses as well as yeasts, protozoa and epizoa must also be regarded as causative organisms of STD. Taken together, all sexually transmitted infections (STI) comprise more than 30 relevant STD pathogens. However, not all pathogens that can be sexually transmitted manifest diseases in the genitals and not all infections of the genitals are exclusively sexually transmitted. Concise information and tables summarising the diagnostic and therapeutic management of STDs in the field of Urology allow a synoptic overview and are in agreement with recent international guidelines of other specialties. Special considerations (i.e. HIV infection, pregnancy, infants, allergy) and recommended regimens may be looked up here.
Subject(s)
Bacterial Infections/therapy , Sexually Transmitted Diseases/etiology , Sexually Transmitted Diseases/therapy , Virus Diseases/therapy , Bacterial Infections/diagnosis , Bacterial Infections/epidemiology , Europe , Female , Humans , Incidence , Male , Pregnancy , Prognosis , Risk Assessment , Sexually Transmitted Diseases/epidemiology , Treatment Outcome , Urology/methods , Urology/standards , Virus Diseases/diagnosis , Virus Diseases/epidemiologyABSTRACT
OBJECTIVE: As a screening test for prostate cancer (PCA), prostate-specific antigen (PSA) may induce unnecessary prostate biopsy in patients with PSA 4.1-10.0 ng/ml. PCA detection may be delayed in patients with PSA < or =4.0 ng/ml. MRI-based PSA density of the prostate (PSAD) and of the prostatic transitional zone (PSAT) could improve differentiation of PCA and benign prostatic hyperplasia. MATERIAL AND METHODS: Total prostate and transitional zone volumes were planimetrically determined in axial, T2-weighted fast spin echo MR images of the prostate. Serum PSA concentration was measured with an automated standardized microparticle enzyme immune assay. PSAD and PSAT were calculated in 17 patients with clinically significant PCA and 42 patients with benign prostatic hypertrophy (BPH) (66 +/- 6 versus 64 +/- 8 years, p = 0.2410, t test) who had PSA levels < or =10.0 ng/ml. RESULTS: For differentiation of BPH and PCA, PSA alone above the optimal cutoff level of 4.2 ng/ml showed an odds ratio for PCA of 6.7 (95% confidence interval [CI], 1.9-23.2). PSAD showed an odds ratio for PCA of 71.3 (95% CI, 11.8-430.9) above the optimal cutoff level of 0.07 ng/ml/cc. PSAT demonstrated an odds ratio for PCA of 320.0 (95% CI, 27.1-3781.4) above the optimal cutoff level of 0.15 ng/ml/cc. CONCLUSIONS: In patients with PSA < or =10.0 ng/ml, MRI-based PSAD and PSAT appear to improve differentiation of prostate cancer and BPH and are feasible to reduce the frequency of unnecessary prostate biopsy.
