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.

Malakoplakia prostate presenting as urinary retention: a report of two cases and review of the literature

2021 ◽  
Vol 14 (7) ◽  
pp. e243927
Author(s):  
Swaroop Subbaraya ◽  
Ajit Sawant ◽  
Prakash Pawar ◽  
Sunil Patil
Keyword(s):  
Urinary Retention ◽  
Acute Urinary Retention ◽  
Specific Antigen ◽  
Transrectal Ultrasound ◽  
Transurethral Resection Of Prostate ◽  
Review Of The Literature ◽  
Ultrasound Guided ◽  
Prostatic Biopsy ◽  
Chronic Inflammatory Condition

Malakoplakia is a rare chronic inflammatory condition, which primarily occurs in genitourinary tract, with prostatic malakoplakia being extremely rare. We present two cases of acute urinary retention, with clinically firm nodular prostate and a raised serum prostate-specific antigen. Transrectal ultrasound-guided prostatic biopsy showed features of malakoplakia. There was a significant reduction of size of prostate on transrectal ultrasonography after 4 weeks of antibiotics. However, one patient had failed trial without catheter and was subjected to transurethral resection of prostate. The biopsy of the prostatic chips also showed features of malakoplakia. Other patient improved symptomatically after antibiotics and was managed conservatively. Both the patients are on regular follow-up and are asymptomatic. Prostatic malakoplakia presenting as urinary retention is very uncommon with around 12 cases in the literature. Recognition of prostatic malakoplakia is important because clinically it can masquerade prostatic malignancy. Treatment with antibiotics is necessary before subjecting the patients for surgery in patients with obstructive symptoms.

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 Presentation, diagnosis, management, and outcomes of prostatic abscess: comparison of three treatment modalities

2020 ◽  
Vol 12 ◽  
pp. 175628722093062
Author(s):  
Ibrahim Alnadhari ◽  
Venkata Ramana Pai Sampige ◽  
Osama Abdeljaleel ◽  
Walid El Ansari ◽  
Omar Ali ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Hospital Stay ◽  
Clinical Laboratory ◽  
Transrectal Ultrasound ◽  
Needle Aspiration ◽  
Treatment Modalities ◽  
Prostatic Abscess ◽  
Urinary Tract Symptoms ◽  
Management Modality

Purpose: The lack of available guidelines for the management of prostatic abscess (PA) results in inconsistencies in its management. The most commonly used management modalities were conservative treatment with parenteral antibiotics alone, transrectal ultrasound-guided (TRUS) needle aspiration, or transurethral deroofing (TUD). The current study is a retrospective study and examines prostatic abscess cases treated by either one or more of the different modalities. We assess and compare presentation, diagnosis, management, and outcomes of prostatic abscess and we compare the outcomes of the three management modalities. Methods: We retrieved the records of all patients ( n = 23) admitted to the Urology department at Al Wakra hospital with the computed tomography (CT) diagnosis of prostatic abscess from January 2013 to March 2018. Data collected included demographic, clinical, laboratory, and imaging findings, as well as management modality, duration of hospital stay, duration of follow up, outcome, and recurrence. Results: A total of nine (39.1%) patients had conservative treatment only; eight (34.8%) had TUD, and six (26.1%) had TRUS needle aspiration. The mean age was 52.7 years. Lower urinary tract symptoms and fever were the most common presentations (95.7% and 82.6%, respectively). CT scan of the abdomen and pelvis with contrast was undertaken for all patients and it showed that multiple abscesses were observed in 14 (60.9%) cases. The overall mean hospital stay was 8.45 days (range 2–21 days). We observed no recurrences for patients treated conservatively or those who undertook TUD, but three patient (50%) recurrences were noted in TRUS aspiration patients. There was no mortality across the sample. Conclusion: Early diagnosis of prostatic abscess and prompt management may have decreased the morbidity and mortality. Conservative management can succeed in subcentimeter abscesses but TUD is the definite therapy for large and multiloculated abscess. TRUS aspiration does have a role in treatment, but it has higher recurrence and longer hospital stay.

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.

Transrectal Ultrasound-Guided Needle Aspiration of a Prostatic Abscess

2009 ◽  
Vol 02 (06) ◽  
Author(s):  
Michael Nomikos ◽  
Ioannis Karyotis ◽  
Dimitrios Volanis ◽  
Dimitrios Delakas
Keyword(s):  
Transrectal Ultrasound ◽  
Needle Aspiration ◽  
Ultrasound Guided ◽  
Prostatic Abscess

The value of transrectal ultrasound guided needle aspiration in treatment of prostatic abscess

2004 ◽  
Vol 52 (1) ◽  
pp. 94-98 ◽  
Author(s):  
Çağatay Göğüş ◽  
Eriz Özden ◽  
Resul Karaboğa ◽  
Cemil Yağci
Keyword(s):  
Transrectal Ultrasound ◽  
Needle Aspiration ◽  
Ultrasound Guided ◽  
Prostatic Abscess

scholarly journals DOES TRANS RECTAL ULTRASOUND (TRUS) HELPS IN DIFFERENTIAL DIAGNOSIS OF PROSTATE LESIONS? A STUDY AT TERTIARY CARE CENTER.

2021 ◽  
pp. 16-22
Author(s):  
Dhagash Patel ◽  
Brijesh Modh ◽  
Kalpesh Bhabhor
Keyword(s):  
Predictive Value ◽  
Prostatic Carcinoma ◽  
Tertiary Care ◽  
Transrectal Ultrasound ◽  
Digital Rectal Examination ◽  
Statistical Characteristics ◽  
Care Hospital ◽  
Radionuclide Scintigraphy ◽  
Prostatic Abscess ◽  
Rectal Examination

BACKGROUND: There are successions of investigations used in evaluation of prostatic pathology. Currently digital rectal examination & serum PSA levels are used for screening of prostatic cancer. Many conventional imaging techniques like plain radiography, computed tomography, radionuclide scintigraphy and transabdominal sonography were proved to be ineffective in detection of many prostatic conditions specially cancer at an early stage. Transrectal ultrasound (TRUS) has traditionally been considered as the pivotal imaging test for the prostate, providing clinically important information regarding benign and malignant conditions. OBJECTIVES: to evaluate the TRUS and colour Doppler ndings in various benign and malignant prostatic lesions with respect to its site, echo pattern, capsular status, local invasion, vascularity and to correlate with other investigations, like digital rectal examination and serum PSA etc. and also to study the accuracy of TRUS in differentiating benign from malignant lesions. METHODOLOGY: A prospective observational study carried out over a period of 1.5 years at a tertiary care hospital. All male patient referred to department of radio diagnosis with prostate related complains referred from surgery department. Study includes clinical symptoms, family and personal history, laboratory examination like PSA, radiological examination, digital rectal examination. . Various statistical characteristics of the test such as sensitivity, specicity, positive predictive value, negative predictive value were calculated whenever applicable. Out of total 64 patients' recruited OBSERVATIONS: commonest age group was 61 – 70 years (39.1%). Commonest prostatic pathology encountered was BPH (56.2%) followed by prostatic carcinoma (31.3%), prostatitis (4.7%), prostatic abscess & calculus (3.1%) prostatic cyst (1.6%). 75% patients of prostatic carcinoma and 13.9% of Benign Prostate Hypertrophy show PSA value greater than 10ng/ml. Echotexture pattern found on TRUS, in prostatic carcinoma patients was hypoechoic echotexture in 70% patients followed by mixed echotexture in 20% patients. Examination in Color Doppler found, 80 % patients of prostatic carcinoma show increased vascularity and 25 % of benign lesion also shows increased vascularity including all three cases of prostatitis and one out of two case of prostatic abscess. Any single test alone is not helpful in arriving at a diagnosis, but all the thr CONCLUSION: ee tests i.e. PSA level, digital rectal examination, and transrectal ultrasound, together give very conrmatory result, specically to differentiate benign from malignant condition of prostate. . Considering that the initial screening of patients will help in reducing the number of negative biopsies (unnecessary), without impairing the cancer detection capacity.

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