Total Perineal Prostatectomy: A Retrospective Study in Six Dogs

Perineal hernia refers to the herniation of pelvic and abdominal viscera into the subcutaneous perineal region through a pelvic diaphragm weakness: a concomitant prostatic disease is observed in 25–59% of cases. Prostatectomy involves the removal of the prostate, either partially (partial prostatectomy) or completely (total prostatectomy). In case of complicated perineal hernia, staged procedures are recommended: celiotomy in order to perform colopexy, vasopexy, cystopexy, and/or to treat the prostatic disease, and perineal access in order to repair the perineal hernia. Very few reports relate prostatectomy using a perineal approach and, to the extent of the author’s knowledge, this technique has not been thoroughly investigated in the literature. The aim of this article is to retrospectively describe the total perineal prostatectomy in dogs presenting perineal hernia with concomitant prostatic diseases which required the removal of the gland. The experience in six dogs (three dogs with the prostate within hernial contents and three dogs with intrapelvic prostate) is reported as well as advantages, disadvantages, and limitations of the surgical procedure. In the authors’ clinical practice, total perineal prostatectomy has been a useful surgical approach to canine prostatic diseases, proven to be safe, well tolerated, and effective.

Intra- and Inter-observer Variability of Computed Tomographic Measurements of the Prostate Gland in Neutered Dogs

The purpose of this study was to evaluate the intra- and inter-observer variability of computed tomographic measurements of linear prostate dimensions in neutered dogs without signs of prostatic disease, to determine potential associations between prostatic parameters and body weight or age and to provide reference ranges. Length, width and height of the prostate gland were measured in 62 neutered dogs with no signs of prostatic disease by three observers with different levels of training. Statistically significant positive associations were found between all prostatic parameters and body weight and between all prostatic parameters and age at castration, but not with age. Formulae allowing the calculation of the expected values for prostatic parameters based on body weight are provided [length = 15.3 + body weight (BW) × 0.3; height = 9.7 + BW × 0.16; width = 9.5 + BW × 0.2]. These may represent a useful tool for computed tomographic evaluation of the size of the prostate in neutered dogs. Subjective evaluations of the morphological appearance of the prostate gland are also provided.

Serum Antioxidant Enzymes, Haematological Values and Uric Acid Concentrations in Prostatic Disease Patients: An Investigative Study

Aim: In this study, the haematology, serum antioxidant enzymes, and uric acid concentrations in prostatic disease patients attending the Nephrology Department of Abia State University Teaching Hospital, Aba were evaluated. Methodology: A total of one hundred and ten (110) adult males (aged 40-80 years) comprising of sixty (60) prostatic disease patients and 50 normal subjects were recruited. The prostatic disease patients comprised of 30 prostatitis, 20 Benign Prostatic Hyperplasia (BPH), and 10 prostate cancer patients. Haematological parameters, antioxidant enzyme levels, and uric acid concentration were determined on blood samples collected from the subjects between January 2017 and December 2019. Results: Results obtained following analysis indicated a significant fall in red blood cell count, haematocrit levels and haemoglobin concentrations in all the prostatic disease patients when compared with control subjects (p<0.05) but no significant difference was observed between the values of these parameters in the three categories of patients studied (p>0.05). Leukocyte and lymphocyte counts in the patients also did not significantly differ from those of the control subjects (p>0.05) but platelets counts were significantly lower (p<0.05). Significant elevations were observed in monocytes and granulocytes counts of prostatitis and prostate cancer patients (p<0.05). Serum antioxidant enzymes activities including superoxide dismutase (SOD) and glutathione peroxidase (GPx) were lower in the prostatic disease patients than in the control (p<0.05) with SOD and GPx levels being lowest in prostatitis and prostate cancer patients respectively while serum uric acid concentration was only higher than control in the prostatitis patients (p<0.05). Conclusion: We, therefore, conclude that complications and deaths due to prostatic diseases may be due to the systemic effects of anaemia and fall in the body’s antioxidant defense line accompanying the conditions.

Concentrations of canine prostate specific esterase, CPSE, at baseline are associated with the relative size of the prostate at three-year follow-up

Background Enlargement of the prostate is associated with prostatic diseases in dogs, and an estimation of prostatic size is a central part in the diagnostic workup. Ultrasonography is often the method of choice, but biomarkers constitute an alternative. Canine prostate specific esterase (CPSE) shares many characteristics with human prostate specific antigen (PSA) and is related to prostate size. In men with clinical symptoms of prostatic disease, PSA concentrations are related to prostate growth. The aims of the present follow-up study were to evaluate if the concentration of CPSE is associated with future growth of the prostate, and if analysis of a panel of 16 steroids gives further information on prostatic growth. Owners of dogs included in a previous study were 3 years later contacted for a follow-up study that included an interview and a clinical examination. The prostate was examined by ultrasonography. Serum concentrations of CPSE were measured, as was a panel of steroids. Results Of the 79 dogs included at baseline, owners of 77 dogs (97%) were reached for an interview, and 22 were available for a follow-up examination. Six of the 79 dogs had clinical signs of prostatic disease at baseline, and eight of the remaining 73 dogs (11%) developed clinical signs between baseline and follow-up, information was lacking for two dogs. Development of clinical signs was significantly more common in dogs with a relative prostate size of ≥2.5 at baseline (n = 20) than in dogs with smaller prostates (n = 51). Serum concentrations of CPSE at baseline were not associated with the change in prostatic size between baseline and follow-up. Serum concentrations of CPSE at baseline and at follow-up were positively associated with the relative prostatic size (Srel) at follow-up. Concentrations of corticosterone (P = 0.024), and the class corticosteroids (P = 0.0035) were positively associated with the difference in Srel between baseline and follow-up. Conclusions The results support the use of CPSE for estimating present and future prostatic size in dogs ≥4 years, and the clinical usefulness of prostatic size for predicting development of clinical signs of prostatic disease in the dog. The association between corticosteroids and prostate growth warrants further investigation.

OBSERVATION OF PROSTATE SPECIFIC ANTIGEN LEVEL ON ENLARGED PROSTATE IN RIMS RANCHI.

Aim and objective- To differentiate between physiological and pathological elevation of of PSA, importance of PSA level in various prostatic diseases, and monitoring the efcacy of therapy. Patient And Method- study conducted in department of surgery, Rajendra institute of medical sciences, Ranchi. Study in 60 patients in OPD and in ward patient. Result And Conclusion- There is physiological increase in serum PSA Level with increase in age in absence of any prostatic disease and symptom. Increase in PSA level in carcinoma prostate, monitoring of response of treatment and disease recurrence

Frequency of Prostate Cancer Among the Prostatic Tissue Samples- Collected From Different Tertiary Level Hospital in Dhaka City

Background: Prostate cancer is the development of cancer in the prostate, a gland in the male reproductive system. The cancer cells may spread from the prostate to other area of the body, particularly the bones and lymph nodes. It may initially cause no symptoms. A disease known as benign prostatic hyperplasiamay produce similar symptoms. Objective: To identify the frequency of prostate cancer in prostatic tissue submitted for histopathological examination in selected hospital of Dhaka City. Method: This analytical observational study consists of review of 3914 histopathological reports of prostatic specimen examined in 13 selected tertiary level hospitals in Dhaka city. This study was carried out from January 2007 to December 2009 (three years). All data were compiled, analyzed and appropriate statistical tests were done to make inference. Results: During the study period, among the 2914 histopathological specimen of prostatic tissue, 637(about 16%) cases were diagnosed as prostate cancer (including PIN), 3221 (about 82%) cases were benign prostatic hyperplasia, 53 (1 .35%) were chronic prostatitis and the remaining 3 cases were other rare disease e.g. lipid storage disease etc. Among the prostate cancer, most common was prostatic adenocarcinoma (about 95%); about 3% was Prostatic Intraepithelial Neoplasia (PIN), 1% squamous cell carcinoma arid I % are primary Transtiona1 cell carcinoma (TCC). Most of the patients diagnosed with prostate cancers are of advanced age - between 70 to 80 years (53.46%), and the second peak age is 60- 70 years (34.57 %). Of the prostate cancer cases 8.78% were well differentiated, 34.84% were moderately differentiated and 64.36% were poorly differentiated. The ratio between benign and malignant prostatic disease was about 5:1. Though all the prostatic diseases are common in elderly people, benign prostatic disease occurs more commonly: in younger patients than the prostate cancer. Conclusion: From this study it is evident that the burden of prostate cancer is still low in our context. But the disease seems to be increasing in recent years mainly due to increasing number of aged population. So in near future, the burden of the disease will be increasing throughout the world including our country. Prostate cancer is a slow growing tumor. It has a very sensitive tumor marker (PSA) also. Early diagnosis and proper management certainly improves the prognosis of the disease. There is a screening program for early diagnosis of the disease though it is relatively a costly program. Screening should be considered in persons who have a strong family history of prostate cancer. Every urologist, health policy makers should be aware of the burden of the disease and appropriate planning, necessary manpower & skill development, resource allocation should be made to combat the situation efficiently. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.88-92

Histopathological evaluation of clinically diagnosed prostatic lesions.

Objectives: To correlate the clinically diagnosed prostatic lesion with histopathological evaluation, Gleason scoring andserum prostate specific antigen (PSA) levels in a tertiary care centre. Study Design: Observational Study. Setting: The current study was conducted in multiple centers of Sindh like Department of Surgery Unit-III, Peoples University of Medical and Health Sciences, Nawabshah CMCH Larkana, Jinnah Sindh Medical University and Al-Tibri Medical College and Hospital Karachi. Period: January 2018 to December 2019. Material & Methods: on 112 consecutive cases of clinically diagnosed prostatic disease, all the relevant demographic and clinical details including digital rectal examination (DRE) findings and serum PSA levels were recorded on a proforma designed for the study. PSA values of all these cases were recorded before the surgical procedure. The tissue sample of prostate was collected after surgery and histologically analysed for the confirmation of diagnosis and the Gleason scoring was made. All the results obtained were statistically analysed and tabulated. Results: The age of patients ranged 34-81 years, with mean age of 58+3.4 years. The adenocarcinoma was detected in 05 cases, hyperplasia in 92 cases and hyperplasia with prostatitis in 07 cases. The carcinoma was clinically diagnosed in 17 cases but after histological evaluation, the carcinoma was confirmed in 03 cases and 02 cases of cancer were confirmed among clinically diagnosed cases of hyperplasia. Majority of cases of hyperplasia were having the PSA level < 4ng/ml No any case of adenocarcinoma have PSA level below 4ng/ml, and majority of the cases of denocarcinoma were having PSA level above 20ng/ml. majority of malignant lesions were having PSA level above 20ng/ml and the Gleason score above 6. No any case of malignancy was detected in those patients having PSA level below 4ng/ml. Conclusion: The histopathological evaluation with serum PSA levels is necessary in all cases of prostatic disease to rule out the possibility of malignant pathology.