scholarly journals A clinico pathological study and management of benign enlargement of prostate

2018 ◽  
Vol 5 (4) ◽  
pp. 1275 ◽  
Author(s):  
Ashish Mor ◽  
Surender Mohan Sharma ◽  
Sujoy Mukherjee ◽  
Rishi Jindal
Keyword(s):  
Urinary Retention ◽  
Acute Urinary Retention ◽  
Prostate Volume ◽  
Stone Formation ◽  
Prostate Gland ◽  
Digital Rectal Examination ◽  
Pathological Study ◽  
Significant Relation ◽  
Residual Urine ◽  
Severe Group

Background: Benign prostatic hyperplasia (BPH) is the non-malignant enlargement of the prostate gland. Prolonged obstructions may eventually lead to acute urinary retention, recurrent urinary tract infection, hematuria, bladder calculi, and renal insufficiency.Methods: Hundred cases of benign enlargement of prostate were studied from November 2015 to 2016. Patients diagnosed as benign enlargement of prostate by clinical digital rectal examination, investigation like USG were included in this study. Patients with urinary retention due to strictures and urolithiasis, carcinoma were excluded.Results: Mean age of presentation was 64.4, and 34% were found to be in severe group of IPSS grading. There was a significant co-relation between the PVRU and prostate volume. There were 16% cases of acute urinary retention, 2% cases presented with bladder stones. Benign enlargement of prostate, IPSS score, Post voidal residual urine has a weak correlation with the increasing age as observed.Conclusions: Benign enlargement of prostate is a disease of elderly with peak incidence in the 5th and 6th decade of life, BPH has co-relation with inguinal hernia, AUR which is 16%. There was no correlation between the age of the patient and the severity of symptoms with respect to IPSS score. There was no correlation between the age of the patient and the severity of symptoms with respect to IPSS score. In present study there was a statistically significant relation were found between prostate volume and post voidal residual urine. Large amount of residual urine is the indication for surgery because it predisposes to infections and stone formation.

scholarly journals Diagnostic and therapeutic utility of transrectal ultrasound in urological office prostatic abscess management: A short report from a single urologic center

2014 ◽  
Vol 86 (4) ◽  
pp. 344 ◽  
Author(s):  
Andrea Fabiani ◽  
Alessandra Filosa ◽  
Valentina Maurelli ◽  
Fabrizio Fioretti ◽  
Lucilla Servi ◽  
...  
Keyword(s):  
Urinary Retention ◽  
Acute Urinary Retention ◽  
Transrectal Ultrasound ◽  
Digital Rectal Examination ◽  
Positive Culture ◽  
Needle Aspiration ◽  
Short Report ◽  
Prostatic Abscess ◽  
Fire Needle ◽  
Diagnostic Work

Objectives: Prostatic abscess (PA) is an infrequent condition in the modern antibiotic era. The everyday use of transrectal ultrasound (TRUS) during diagnostic work-up and the widespread recurrence to prostatic biopsies may lead to an increase of PA diagnosis. In this short report we analyze the patients characteristics and the management of seven recent cases of PA diagnosed in our institution. Materials and Methods: The records of 7 patients admitted to our Center for LUTS associated to septic fever or acute urinary retention, was prospectively collected. Suspect of PA was done on digital rectal examination (DRE) and confirmed by TRUS performed after urinary system ultrasound (UUS) evaluation. Patients were admitted to hospital only in case of septic signs. A sovrapubic (SPC) or urethral catheter (UC) was placed depending on symptoms. A TRUS-guided aspiration of PA was performed with patient in lithotomic position, using a 18 gauge two-part needle, side/end fire needle access. Patient was discharged with antibiotic therapy and followed up until complete resolution of the PA and symptoms. Results: Mean age was 62 years (range 24-82). Two patients were diabetics and one was affected by the immunodeficiency acquired syndrome (HIV). In one case, PA was detected after a persistent fever post TRUS guided prostate biopsy. Average prostate volume was 69 ml (range 19-118 ml). DRE was able to diagnose PA only in 2 cases (29%), UUS evaluation in 1 case (14%). All cases were confirmed by TRUS as hypo-anechoic areas with or without internal echoes in all patients. Mean PA dimension was 3.64 cm (range 1.5-8). SPC was placed in 3 cases (43%), UC in 3 patients (43%). Only 1 patient refused catheterization. Side fire needle aspiration was performed in all cases and in combination with end fire access in case of particular location of abscess cavities. Second look was needed in 2 cases (29%). Antibiotics were administered in all cases. The aspirated pus showed a positive culture for Escherichia coli (43%), Klebsiella pneumoniae (29%), Pseudomonas aeruginosa (14%) and Enterococcus faecalis (14%). PA resolution time mean was 9 days (range 3-24). Conclusions: TRUS evaluation in case of persistent LUTS associated with fever or acute urinary retention is determinant in the diagnosis of PA. Office or institutional management with TRUS needle aspiration is a good option in these cases.

scholarly journals Simultaneous transurethral resection of the prostate and cystolithotripsy: A urological dilemma examined

2020 ◽  
Vol 15 (7) ◽  
Author(s):  
Sander Mekke ◽  
Hossain Roshani ◽  
Paul Van Zanten ◽  
Lorena Grondhuis Palacios ◽  
Joost Egberts ◽  
...  
Keyword(s):  
Relative Risk ◽  
Urinary Retention ◽  
Transurethral Resection ◽  
Operative Time ◽  
Prostate Volume ◽  
Stone Formation ◽  
Number Needed To Treat ◽  
Bladder Stones ◽  
Significant Difference ◽  
Retrospective Nature

Introduction: Controversy exists over whether transurethral resection of the prostate (TURP) in men with bladder stones prevents recurrence of stone formation and facilitates stone discharge. We sought to evaluate whether TURP in patients who underwent cystolithotripsy led to a lower recurrence of bladder stones for which a re-cystolithotripsy was necessary. Methods: Patients (n=127) who underwent transurethral cystolithotripsy with (n=38) or without simultaneous TURP (n=89) between January 2009 and December 2013 were retrospectively included in five centers in the Netherlands. Median followup was 48 months. The primary endpoint was to compare the relative risk between both groups for re-cystolithotripsy due to recurrent bladder stones. Secondary outcomes were the relative risk of urinary retention, the need for a (re-)TURP and the average time until recurrence. Results: Patients who underwent a cystolithotripsy with a simultaneous TURP had a lower need for re-cystolithotripsy, resulting in a risk reduction of 72%. (relative risk [RR] 0.28 [0.07–1.13], p=0.06, number needed to treat [NNT]=7). The length of in hospital stay (3.4 vs. 1.6 days, p<0.01) and operative time (58 vs. 33 minutes, p<0.01) was longer when a TURP was performed. There was no significant difference in complication rate, occurrence of urinary retention, re-TURP, and re-admission. Eighty-one percent of patients who did not undergo a TURP remained free of bladder stone recurrence. Due the retrospective nature of the study, essential data concerning prostate volume and micturition analysis was lacking. Conclusions: A simultaneous TURP in patients who underwent a cystolithotripsy showed a trend towards a protective effect on the need for re-cystolithotripsy.

Prostate Volume and Serum Prostate–Specific Antigen as Predictors of Acute Urinary Retention

2000 ◽  
Vol 38 (5) ◽  
pp. 563-568 ◽  
Author(s):  
M.J. Marberger ◽  
J.T. Andersen ◽  
J.C. Nickel ◽  
M.-P. Malice ◽  
M. Gabriel ◽  
...  
Keyword(s):  
Urinary Retention ◽  
Acute Urinary Retention ◽  
Prostate Volume ◽  
Specific Antigen

scholarly journals Diethylstilbestrol 1 mg in the Treatment of Acute Urinary Retention due to Prostatic Obstruction in the Elderly: A Preliminary Study

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Leonardo Oliveira Reis ◽  
Gustavo Borges De Mendonça ◽  
Bruno D. Carneiro ◽  
Edson Schneider ◽  
Eduardo Varella Gewehr ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Urinary Retention ◽  
Acute Urinary Retention ◽  
Prostate Volume ◽  
Urine Volume ◽  
The Elderly ◽  
Upper Urinary Tract ◽  
Transurethral Resection Of Prostate ◽  
Free Trial ◽  
Tract Dilation

Patients who failed a catheter-free trial after acute urinary retention and one week of full dose alpha-blocker and 5-alpha-reductase inhibitor were offered Diethylstilbestrol 1 mg plus Aspirin 100 mg over 4 weeks. Prostate volume, age, serum creatinine, and initial retention drained urine volume were recorded. After excluding cardiovascular morbidity (n=7), upper urinary tract dilation (n=3), compromised renal function (n=2), urinary tract infection (n=2), neurological diagnosis (n=2), or preferred immediate channel transurethral resection of prostate (n=5), 48 of 69 consecutive patients ≥70 years were included. Mean age was 76.6 years (70–84), mean prostate volume 90 cm3(42–128), and mean follow-up 204 days; 58% (28/48) were passing urine and 42% (20/48) were catheter dependent after 4 weeks Diethylstilbestrol trial. Mean age and drained urine volume of catheter dependent patients were 82.4 years and 850 mL compared with 74.6 years and 530 mL in catheter-free men, respectively. Age and drained urine volume were independent predictors of catheter-free trial (bothP<0.01). Seventy-five percent (6/8) of patients 80 years and older were catheter dependent. Transient nipple/breast tenderness and gynecomastia were the only adverse effects reported by 21% (10/48) and 4% (2/48), respectively. No patient presented severe complications.

scholarly journals Pure Small Cell Carcinoma of Prostate in a Patient Presenting with Acute Urinary Retention: A Rare Case Report

2020 ◽  
Vol 1 (4) ◽  
pp. 23-29
Author(s):  
Sezgin Okçelik ◽  
Elmas Özgün ◽  
Şakir Eser ◽  
Mehmet Polat ◽  
Muhammed Cihan Temel ◽  
...  
Keyword(s):  
Case Report ◽  
Cell Carcinoma ◽  
Urinary Retention ◽  
Small Cell Carcinoma ◽  
Outpatient Clinic ◽  
Acute Urinary Retention ◽  
Digital Rectal Examination ◽  
Clinical Findings ◽  
Small Cell ◽  
Carcinoma Of The Prostate

Small cell carcinoma of the prostate is a rare and highly aggressive subtype of prostate cancers. In this case report, we evaluated a patient applied our outpatient clinic with acute urinary retention, whose pathology reported as pure small cell carcinoma of the prostate. A 73-year-old male patient was admitted to our outpatient clinic with acute urinary retention. Digital rectal examination was normal. The PSA value was 1.81 ng/dl. Prostate size was 101 cc. Open prostatectomy was performed. The pathology of the patient was reported as pure small cell prostate carcinoma. Four cycles of etoposide and cisplatin chemotherapy were administered to the patient. The patient died 13 months later after the first diagnosis. We evaluated the pathological and clinical findings of small cell carcinoma of the prostate.

scholarly journals Monotherapy versus combination therapy in the treatment of benign prostatic hyperplasia: A single center study

2020 ◽  
Vol 24 (3) ◽  
pp. 333-337
Author(s):  
Wishyar Al-Bazzaz ◽  
Omar Alkhayat ◽  
Ali AlKhayat
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Combination Therapy ◽  
Urinary Retention ◽  
Prostate Specific Antigen ◽  
Acute Urinary Retention ◽  
Prostate Volume ◽  
Combined Treatment ◽  
Specific Antigen ◽  
Prostatic Hyperplasia ◽  
Once Daily

Background and objectives: Most benign prostatic hyperplasia patients do not present obvious indicators for surgical intervention, so most of these patients are treated initially with medical therapy. This study aimed to compare the incidence of acute urinary retention after treatment with monotherapy with the incidence after combination therapy and determine the need for surgery in both methods. Methods: This is a retrospective study of the medical records of 248 benign prostatic hyperplasia patients who had attended Rizgary Teaching Hospital from May 2012 to June 2017. These patients were divided into two groups of 138 and 110 patients who have been treated by 0.4 mg tamsulosin capsule once daily and 0.4 mg tamsulosin capsule plus 5mg finasteride tablet once daily, respectively. Benign prostatic hyperplasia outcomes (acute urinary retention, benign prostatic hyperplasia related surgery) were compared between these two groups according to prostate volume and serum prostate specific antigen. Results: The combined treatment had significantly reduced the incidence of acute urinary retention and benign prostatic hyperplasia related surgery than monotherapy (P = 0.006 and 0.044, respectively). Similarly, when prostate volume and prostate specific antigen were above the cutoff value, both acute urinary retention and benign prostatic hyperplasia related surgery were lower in the combination therapy group than the monotherapy group. Conclusion: Combined therapy (0.4 mg tamsulosin plus 5mg finasteride) was significantly superior to 0.4 mg tamsulosin alone in the reduction of the incidence of acute urinary retention and benign prostatic hyperplasia related surgery among benign prostatic hyperplasia patients. Keywords: Benign prostatic hyperplasia; Acute urinary retention; Benign prostatic hyperplasia related surgery; Prostate volume; Prostate specific antigen.

scholarly journals THE INFLUENCE OF TRANSRECTAL MULTIFOCAL PROSTATE BIOPSY UNDER ULTRASOUND CONTROL ON THE DEGREE OF INFRAVESICAL OBSTRUCTION IN DIFFERENT GROUPS OF PATIENTS

2016 ◽  
Vol 5 ◽  
pp. 13-16
Author(s):  
Ashot Gevorkyan ◽  
Ilya Lumpov ◽  
Armen Avakyan
Keyword(s):  
Prostate Cancer ◽  
Prostate Biopsy ◽  
Prostate Volume ◽  
Prostate Gland ◽  
Elevated Serum ◽  
Malignant Neoplasm ◽  
Primary Treatment ◽  
Infravesical Obstruction ◽  
Residual Urine ◽  
Time Flow

Prostate cancer - is a malignant neoplasm arising from prostatic epithelium. [1] It is well known, that prostate cancer is the most common cancer in men population. Most patients, who underwent a biopsy of prostate, have expressed varying degrees of benign prostatic hyperplasia and, accordingly, symptoms, specific to the disease, including symptoms of the lower urinary (LUTS). [2], Uroflowmetry is a method widely used around the world to assess the degree of severity of infravesical obstruction [3]. The aim was to determine the degree of influence of transrectal multifocal biopsy of the prostate under ultrasound control on the degree of infravesical obstruction [4]. The study included patients with elevated serum PSA over 4 ng/ml with the volume (Vpr) of prostate from 20 cm³ to 90 cm³, volume of residual urine no more than 50 cm ³. Uroflowmetry was performed with the determination of the volume of residual urine at the primary treatment. At 21 day after transrectal multifocal prostate biopsy under Ultrasound control all patients underwent uroflowmetry. The age of patients ranged from 40 to 70 years. Patients were divided into 3 groups depending on the volume of the prostate gland. The first group consisted of 28 people where prostate volume ranged from 20 cm³ to 40 cm³, in the second group, consisted of 25 persons, prostate volume ranged from 41 cm³ to 60 cm³, and in the third group, consisted of 30 people, prostate volume ranged from 61 cm³ to 90 cm³. The following indicators of urofloumetry were determined as the following: voided volume, max flow rate, average flow, voiding time, flow time, time to max flow, and the volume of residual urine. This study has demonstrated a high risk of complications in patients with prostate volume of more than 60 cm3 caused by infravesical obstruction after prostate biopsy.

scholarly journals Prostate Volume Measurement by Ultrasonography Over 40 Years Age of Bangladeshi Population

2022 ◽  
Vol 8 (1) ◽  
pp. 350-356
Author(s):  
Towhida Naheen
Keyword(s):  
Benign Prostatic Hyperplasia ◽  
Prostate Volume ◽  
Prostate Gland ◽  
Digital Rectal Examination ◽  
Volume Measurement ◽  
Prostatic Hyperplasia ◽  
P Value ◽  
College Hospital ◽  
Histologic Diagnosis ◽  
Bangladeshi Population

Background: Benign prostatic hyperplasia (BPH) or benign prostatic hypertrophy, is a histologic diagnosis status characterized by proliferation of the ‘glandular elements’ of the prostate, which may lead to an enlarged prostate gland. In many studies, people over the age of 40 years found as the most vulnerable for BPH. Ultrasonography is a prominent method to determine prostate volume or size. Aim of the study: The aim of the present study was to evaluate the prostate volume measurement for the Bangladeshi population over the age of 40 years by ultrasonography.Methods:This prospective, observational study was conducted in the Department of Anatomy, Chattogram Medical College Hospital, Chattogram, Bangladesh during the period from January 2019 to December 2020. In total 157 suspected patients of benign prostatic hyperplasia were selected as the study population. All patients were clinically diagnosed for BPH, based on the present prostate symptoms and digital rectal examination. To measure the prostate volume, abdominal ultrasonography was performed for all the patients. After enucleation, another ultrasonogram was performed for all the patients to measure the existing sizes of the prostates of the patients. All the data were processed, analyzed, and disseminated by MS-word and SPSS programs as per need.Results:Finally, in this study in analyzing the volumes of the prostates of the participants according to the abdominal ultra-sonographic reports of pre-operative stage we observed, in 9%, 34%, 31%, 30%, 21% and 32% patients, the prostate sizes (In cc) were <20, 21-40, 41-60, 61-80, 81-100 and >100 cc respectively. On the other hand, after enucleation, in 11.46%, 24.20%, 28.66%, 27.39%, 7.01% and 1.27% patients, the prostate sizes (In cc) were found <20, 21-40, 41-60, 61-80, 81-100 and >100 cc respectively. The mean changes of prostate sizes between pre- and post-operative stages among the participant was not significant where the P value was found 0.464.Conclusion:The findings of this study support the applications of abdominal ultrasonographic evaluation for suspected benign prostatic hyperplasia patients to know about the exact volumes of their prostates for selecting the appropriate surgical approach.

INVOLVEMENT OF THE PROSTATE BY CHRONIC LYMPHOCYTIC LYMPHOMA, CLINICAL AND PATHOLOGICAL CHARACTERIZATION

2016 ◽  
Vol 11 (3-4) ◽  
Author(s):  
RAMI ALAZAB
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Prostate Volume ◽  
Prostate Gland ◽  
Specific Antigen ◽  
Digital Rectal Examination ◽  
Lymphocytic Leukemia ◽  
Rectal Examination ◽  
Treatment Paradigm ◽  
Male Patients ◽  
Prostate Diseases

Introduction: Few reports have described the involvement of the prostate by hematolymphoid infiltrate; the usual presentation is that of benign prostatic hyperplasia, because of the rarity of the condition; there is no specific diagnostic or treatment paradigm. We set out to study the clinicopathological features for this occurrence. Material and Method: This is a retrospective review to describe the clinical and pathological characters of secondary involvement of the prostate by chronic lymphocytic leukemia/lymphoma. Cohort included male patients above the age of 40 years who were diagnosed to have CLL with secondary infiltration of the prostate gland.Results: Among 1512 pathologies reviewed; nine patients were found to have involvement of the prostate gland by CLL. The discovery of the prostate involvement was proved either by pathology examination of prostate chips obtained by Tran Urethral Resection of the prostate or Tranrectal Ultrasound guided prostate biopsy. The average age 57.6 years, prostate specific antigen 2.52 ng/ml   AUA-score 23/35, abnormal Digital Rectal Examination 2/9, prostate volume 64 gm. Cohort was contrasted with our institutional prostate diseases database.Conclusion: Prostate gland might be an overlooked site of Chronic Lymphocytic leukemia infiltrate; patients usually present with severe obstructive symptoms and/or abnormal PSA/Digital Rectal Examination. Urologists and pathologists and should be oriented to the mode of presentation, diagnostic and treatment approaches of this population of patients.

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