1/38. Prostate brachytherapy in patients with prior evidence of prostatitis.PURPOSE: To refute a misconception that a prior history of prostatitis is a contraindication to prostate brachytherapy. methods AND MATERIALS: Five patients with clinical or pathologic evidence of prior prostatitis were treated with transperineal brachytherapy. Four of the patients received a single i.v. dose of ciprofloxacin (500 mg) intraoperatively. Postimplant antibiotics were not given. The pretreatment biopsy slides were reviewed. RESULTS: Two of the five patients developed postimplant urinary retention requiring short-term catheterization, and both resolved spontaneously. One patient developed what appeared to be an exacerbation of his chronic prostatitis. CONCLUSION: We continue to recommend prostate brachytherapy for the treatment of clinically organ-confined cancer, with no concern about prior clinical or pathologic evidence of prostatitis.- - - - - - - - - - ranking = 1keywords = urinary (Clic here for more details about this article) |
2/38. Non-specific eosinophilic granulomatous prostatitis responded favorably to an antimicrobial agent and a hydrocortisone.A case of non-specific eosinophilic granulomatous prostatitis is presented. The patient was a 55-year-old man who was hospitalized with complaints of acute urinary retention and high-grade fever. Results of digital examination and transrectal ultrasonography of the prostate and elevated prostatic specific antigen were suggestive of prostatic cancer. Transrectal needle biopsy of the prostate was performed. Histological examination of the specimens revealed the formation of histiocytic granulomas with eosinophilic infiltration. The patient responded favorably to combination therapy with an antimicrobial agent and a hydrocortisone.- - - - - - - - - - ranking = 1keywords = urinary (Clic here for more details about this article) |
3/38. The perplexing problem of prostatitis.prostatitis presents the physician with a perplexing problem. It is seen often but is not easily treated. The acute form is serious but responds to antibiotic therapy. Chronic prostatitis does not respond well to any form of therapy, and opinion is divided regarding its cause. Bacterial localization tests have helped significantly in the diagnosis of chronic prostatitis. When Gram-negative organisms are found only in the prostatic fluid or in the last voided urine, bacterial prostatitis can be diagnosed. Most antibiotics, however, do not cross prostatic epithelium to combine with prostatic fluid; those that do are not effective against Gram-negative organisms. New agents hold promise but lack the test of time. While some cases of chronic disease definitely are caused by bacterial infection, most probably are not. The diagnosis in these instances is abacterial prostatitis. Treatment is symptomatic and varied. A phenomenon that adds to the mystery of etiology is the fact that antibiotics, particularly tetracycline, may help. psychotherapy often is needed but seldom is accepted. The physician must rule out underlying causes, such as a physical abnormality of the urinary system, for any form of prostatitis before considering it an isolated disorder.- - - - - - - - - - ranking = 1keywords = urinary (Clic here for more details about this article) |
4/38. Echinococcal cyst involving the prostate and seminal vesicles: a case report.Echinococcal cyst presenting with urinary symptomatology is uncommon. A case describing the symptoms, diagnostic procedures and treatment with good outcome is presented. The need for further followup is emphasized in that additional cysts can appear later in other sites.- - - - - - - - - - ranking = 1keywords = urinary (Clic here for more details about this article) |
5/38. Nocardia prostatitis in a small intestine transplant recipient.A 37-year-old small bowel transplant recipient with a history of urolithiasis was admitted for dysuria after passing a urinary stone. His laboratory evaluation showed increased blood urea nitrogen and creatinine. urinalysis showed increased white blood cells and positive leukocyte esterase. A computed tomography scan revealed signs of urinary tract obstruction and prostatic enlargement. He failed to respond initially to empiric antibiotic treatment with ciprofloxacin and ampicillin sulbactam while waiting for culture results. The pathogen recovered from both urine and blood culture was subsequently identified as nocardia asteroides complex. The isolate was sensitive to ceftriaxone and sulfa but resistant to ciprofloxacin. The patient improved on ceftriaxone and trimethoprim-sulfamethoxazole and completed a 6-month course without any relapse. Nocardia prostatitis is an uncommon infection and must be treated with a long course of antibiotics guided by susceptibility testing.- - - - - - - - - - ranking = 2keywords = urinary (Clic here for more details about this article) |
6/38. Isolated invasive candidal prostatitis.Fungal prostatitis is an uncommon entity. Herein we report a case of isolated candidal prostatitis in an elderly patient who presented with acute urinary retention and was clinically diagnosed as having benign hypertrophy of the prostate. histology of the resected prostate demonstrated invasive prostatic involvement by candida albicans. There was no evidence of systemic involvement by Candida. The relevant literature and treatment of isolated Candidal prostatitis have been highlighted.- - - - - - - - - - ranking = 1keywords = urinary (Clic here for more details about this article) |
7/38. Community-acquired methicillin-resistant staphylococcus aureus prostatic abscess.We present a 43-year-old man with a history of intravenous drug abuse who presented to the emergency department with a 5-week history of lower urinary tract symptoms. On digital rectal examination, a firm prostate with exquisite tenderness was noted. Computed tomography scan of the pelvis with contrast demonstrated a 4.4 by 2.7-cm prostatic abscess in the right lobe. Suppurative fluid was expressed from the right prostatic lobe during transurethral resection of the prostate. Cultures of blood and suppurative prostatic fluid grew methicillin-resistant staphylococcus aureus.- - - - - - - - - - ranking = 1keywords = urinary (Clic here for more details about this article) |
8/38. Granulomatous prostatitis due to mycobacterium avium complex.Granulomatous infections of the genitourinary tract are rare, especially those caused by nontuberculous mycobacteria. A case of prostatitis due to mycobacterium avium complex in an immunocompetent man is reported. The patient had sterile pyuria, and a Mantoux skin test, using 5 tuberculin units, was positive (induration, 10 mm in diameter). Pathologic examination of the prostate revealed necrotizing granulomata with acid-fast bacilli, and repeated performance of urine cultures before initiating therapy yielded M. avium complex.- - - - - - - - - - ranking = 1keywords = urinary (Clic here for more details about this article) |
9/38. Nonspecific granulomatous prostatitis.Nonspecific granulomatous prostatitis is a relatively rare disorder of the prostate. We encountered 4 cases of this type of chronic inflammation, including 1 case of xanthogranulomatous prostatitis. In all cases the diagnosis was made by histologic examination of specimens obtained by transurethral resection, retropubic prostatectomy, or transrectal needle biopsy. Echography revealed a hypoechoic lesion in the case of xanthogranulomatous prostatitis, while the other cases showed no specific findings except for the associated adenomas. The major symptoms were frequency and dysuria caused by urinary tract infection or benign prostatic hyperplasia associated with the granulomatous prostatitis.- - - - - - - - - - ranking = 1keywords = urinary (Clic here for more details about this article) |
10/38. Case report: endurance cycle ride associated with a significant rise in PSA.A number of disease processes are associated with an elevation in serum PSA. However, several studies have concluded that cycling is not an activity associated with an elevation in PSA. Herein, we summarise the literature and describe the case of a 54-year-old man who had presented to his General Practitioner (GP) with lower urinary tract symptoms 3 days after the completion of a 39-h endurance cycle ride. The PSA level was initially found to be elevated at 28 ng/ml, but decreased to 4 ng/ml and then 2 ng/ml within two and six months of the date of the cycle ride, respectively. It is probable that the elevation in PSA was caused by prolonged mechanical stimulation of the prostate during the cycle ride.- - - - - - - - - - ranking = 1keywords = urinary (Clic here for more details about this article) |
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