The first experience of transperineal prostate biopsy without antibiotic prophylaxis

Objective: to study the safety of omitting the antibiotic prophylaxis before transperineal prostate biopsy.Materials and methods. The prospective randomized study included data, obtained during the diagnostical process of 85 patients, who underwent transperineal prostate biopsy in 2020. In the control group (n = 50) patients received 1 g Ceftriaxone IV 1 h before the biopsy. In the study group (n = 35) biopsy was performed without previous antibacterial prophylaxis. Age median was 63.2 (52-75) years.Results. No significant differences in the infection complications rate (UTI, soft tissues infections, prostatitis, fever, sepsis) were obtained between the groups. No patient developed UTI, prostatitis or sepsis, confirmed with urine culture.Conclusion. Performing transperineal prostate biopsy without antibiotic prophylaxis seems to be a safe alternative to common prophylaxis regiments, dedicated to infection complications prevention after prostate biopsy.

Laparoscopic plasty of giant diaphragmatic hernia using a biocarbonic implant

This article discusses the results of a prospective randomized study of laparoscopic plasty of giant hiatal hernias with a hernial defect area of 1020 cm2. A total of 92 patients underwent surgery from 2014 to 2020. The patients were divided into two study groups. Group 1 included 46 patients who underwent laparoscopic plasty of the esophageal hiatus by posterior cruroraphy. Group 2 consisted of 46 patients who underwent laparoscopic plasty of the esophageal hiatus using a two-layer Ultrapro (Ethicon) mesh biocarbonic implant according to the developed technique.

Quality of Life Following Two Different Techniques of an Open Ventral Hernia Repair for Large Hernias: a Prospective Randomized Study

Background: We compare the health-related quality of life (QoL) of patients with incision hernias before and after surgery with two different techniques.Methods: In this prospective randomized study, the study population consisted of all patients who underwent the first surgical incisional hernias repair during the 1-year study period. Patients who met the criteria for inclusion in the study were randomized into two groups: the first group consisted of patients operated by an open Rives sublay technique, and the second group included patients operated by a segregation component technique. The change in the quality of life before and 6 months after surgery was assessed using two general (Short form of SF-36 questionnaires and European Quality of Life Questionnaire - EQ-5D-3L), and three specific hernia questionnaires (Hernia Related Quality of Life Survey-HerQles, Eura HS Quality of Life Scale - EuraHS QoL, and Carolinas Comfort Scale – CCS).Results: A total of 93 patients were included in the study. Patients operated on by the Rives technique had a better role physical score before surgery, according to the SF-36 tool, although this was not found after surgery. The postoperative Qol measured with each scale of all questionnaires was significantly better after surgery. Comparing two groups of patients after surgery, only the pain domain of the EuraHS Qol questionnaire was worse in patients operated by a segregation component technique.Conclusion: Both techniques improve the quality of life after surgery. Generic QoL questionnaires showed no difference in the quality of life compared to repair technique but specific hernia-related questionnaires showed differences.