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APMIS : Acta Pathologica,... Apr 2022Cutibacterium acnes has been associated with chronic prostatitis, which can potentially favor the appearance of tumors in the prostate. Prostatitis is difficult to...
Cutibacterium acnes has been associated with chronic prostatitis, which can potentially favor the appearance of tumors in the prostate. Prostatitis is difficult to treat, and the drug needs to be able to penetrate the prostate. The aim was to investigate the pharmacokinetics of clindamycin in the interstitial fluid of rat prostate using microdialysis. Microdialysis probes were recovered in vitro and in vivo. Clindamycin was administered at 80 mg/kg iv bolus for plasma and tissue pharmacokinetic experiments. A microdialysis probe was implanted in the prostate gland for collections over an 8-hour period. The pharmacokinetic parameters were determined by both compartmental and non-compartmental approaches. Penetration was determined as the ratio between the area under the curve and the time of the clindamycin measurement in the prostate. The recovery of the in vivo probes was 38.11 ± 1.14%. The plasma profile was modeled by a two-compartment pharmacokinetic model. Clindamycin presented a prostate/plasma ratio of 1.02, with free concentrations above the minimum inhibitory concentration for Cutibacterium acnes isolates. This was the first study that determined clindamycin free concentrations in the prostatic fluid of rats. These findings suggest that clindamycin may be an effective alternative for the treatment of prostatitis caused by Cutibacterium acnes.
Topics: Animals; Anti-Bacterial Agents; Clindamycin; Male; Microbial Sensitivity Tests; Prostate; Prostatitis; Rats
PubMed: 34978745
DOI: 10.1111/apm.13205 -
The Canadian Journal of Urology Aug 2019Open prostatectomy and transurethral resection of the prostate (TURP) has been the gold standard therapy for moderate to severe lower urinary tract symptoms (LUTS)... (Review)
Review
INTRODUCTION
Open prostatectomy and transurethral resection of the prostate (TURP) has been the gold standard therapy for moderate to severe lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). In recent years, laser vaporization technologies have now been recognized by international guidelines as an effective treatment alternative to TURP for treating BPH.
MATERIALS AND METHODS
In this contemporary review, we aim to discuss the application, outcomes and safety of photoselective vaporization of the prostate (PVP), specifically with the GreenLight laser. We also discuss the properties and evolution of the GreenLight laser as understanding the basic principles of this laser system.
RESULTS
GreenLight PVP is a durable and effective alternative to TURP, especially in high-risk patients on systemic anticoagulation. Aside from providing similar efficacy and safety, the GreenLight PVP also allows for decreased hospitalization times, catheterization times and subsequently decreased healthcare costs. The latest generation laser, 180W XPS system, is found to be more cost-effective and efficacious in tissue vaporization when compared to previous laser generations.
CONCLUSIONS
Laser vaporization is a safe and effective option to treating LUTS secondary to BPH. A patient-centered approach considering patient preference and preoperative parameters should be employed to determine the ideal treatment option for each individual patient.
Topics: Color; Humans; Laser Therapy; Male; Prostatic Hyperplasia; Prostatism
PubMed: 31481143
DOI: No ID Found -
The Canadian Journal of Urology Feb 2016Benign prostatic hyperplasia (BPH) is a common condition that afflicts a large proportion of aging men. The primary care physician has an important role with the... (Comparative Study)
Comparative Study Review
Benign prostatic hyperplasia (BPH) is a common condition that afflicts a large proportion of aging men. The primary care physician has an important role with the identification and early treatment of bothersome urinary symptoms caused by BPH. This includes a detailed history and physical exam, as well as initiation of a number of medications such as alpha-blockers, 5-alpha reductase inhibitors and phosphodiesterase-5 inhibitors. It is also very important for the primary care giver to determine when additional evaluation and referral to a urologist needs to occur, specifically when surgical intervention is needed. This review will summarize the management of this common disorder and is designed to aid the generalist with the pertinent information needed to provide excellent care.
Topics: 5-alpha Reductase Inhibitors; Adrenergic alpha-Antagonists; Conservative Treatment; Drug Therapy, Combination; Humans; Male; Phosphodiesterase 5 Inhibitors; Prostatic Hyperplasia; Prostatism; Transurethral Resection of Prostate
PubMed: 26924590
DOI: No ID Found -
Medicine Nov 2023Prostate tuberculosis (PTB) has no specific symptoms, or insidious presentation in male reproductive system tuberculosis, and is difficult to detect in the early stage.... (Review)
Review
RATIONALE
Prostate tuberculosis (PTB) has no specific symptoms, or insidious presentation in male reproductive system tuberculosis, and is difficult to detect in the early stage. When PTB develops to the late stage, it leads to disease progression and irreversible organ and tissue damage. At present, the imaging manifestations of prostate tuberculosis vary and are not well known to imaging physicians and urologists.
DIAGNOSES AND INTERVENTIONS
This case was a PTB patient, whose main manifestation was elevated serum prostate-specific antigen and the diagnosis was confirmed by ultrasound-guided prostate biopsy. We analyzed the imaging performance of various imaging techniques, and summarized and explored the imaging characteristics reported in the previous literature, with the aim of improving the early detection rate and providing evidence-based practice for early regular antituberculosis treatment in PTB.
OUTCOMES
The multiparametric transrectal ultrasound performance of PTB is characteristic, and can be used for the differential diagnosis of prostate cancer causing elevated prostate-specific antigen levels in aged men.
Topics: Humans; Male; Aged; Prostate; Prostate-Specific Antigen; Magnetic Resonance Imaging; Image-Guided Biopsy; Prostatic Neoplasms; Prostatitis; Tuberculosis, Male Genital
PubMed: 38013327
DOI: 10.1097/MD.0000000000036172 -
Parasites, Hosts and Diseases Feb 2023Trichomonas vaginalis is a flagellated protozoan that causes trichomoniasis, a common nonviral sexually transmitted infection. T. vaginalis infection is asymptomatic in... (Review)
Review
Trichomonas vaginalis is a flagellated protozoan that causes trichomoniasis, a common nonviral sexually transmitted infection. T. vaginalis infection is asymptomatic in most infected men but can lead to chronic infection. The inflammatory response to chronic T. vaginalis infection may contribute to prostatic diseases, such as prostatitis and benign prostatic hyperplasia (BPH); however, studies on the relationship between T. vaginalis infection and prostate diseases are scarce. In this review, we discuss evidence from our studies on the involvement of T. vaginalis in the pathogenesis of prostate diseases, such as prostatitis and BPH. Studies of prostatitis have demonstrated that the attachment of T. vaginalis trophozoite to prostate epithelial cells (PECs) induces inflammatory cytokine production and inflammatory cell migration, leading to prostatitis. T. vaginalis also causes pathological changes, such as inflammatory cell infiltration, acinar changes, interstitial fibrosis, and mast cell infiltration, in prostate tissues of infected rats. Thus, T. vaginalis is considered an infectious agent that triggers prostatitis. Meanwhile, studies of prostatic hyperplasia revealed that mast cells activated by T. vaginalis-infected prostate cells secreted inflammatory mediators, such as β-hexosaminidase and tryptase, which promoted proliferation of prostate stromal cell (PSC). Moreover, interleukin-6 produced by proliferating PSCs induced the multiplication of BPH-1 epithelial cells as a result of stromal-epithelial interaction, suggesting that the proliferation of T. vaginalis-infected prostate cells can be induced through crosstalk with mast cells. These collective findings suggest that T. vaginalis contributes to the progression of prostatitis and prostatic hyperplasia by creating an inflammatory microenvironment involving PECs and PSCs.
Topics: Male; Humans; Rats; Animals; Trichomonas vaginalis; Prostatitis; Prostatic Hyperplasia; Trichomonas Infections; Prostate
PubMed: 37170459
DOI: 10.3347/PHD.22160 -
The Journal of Urology May 2018We performed a comprehensive literature review and meta-analysis to evaluate the association of inflammation on prostate needle biopsies and prostate cancer risk. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
We performed a comprehensive literature review and meta-analysis to evaluate the association of inflammation on prostate needle biopsies and prostate cancer risk.
MATERIALS AND METHODS
We searched Embase®, PubMed® and Web of Science™ from January 1, 1990 to October 1, 2016 for abstracts containing the key words prostate cancer, inflammation and biopsy. Study inclusion criteria were original research, adult human subjects, cohort or case-control study design, histological inflammation on prostate needle biopsy and prostate cancer on histology. Two independent teams reviewed abstracts and extracted data from the selected manuscripts. Combined ORs and 95% CIs of any, acute and chronic inflammation were calculated using the random effects method.
RESULTS
Of the 1,030 retrieved abstracts 46 underwent full text review and 25 were included in the final analysis, comprising a total of 20,585 subjects and 6,641 patients with prostate cancer. There was significant heterogeneity among studies (I = 84.4%, p <0.001). The presence of any inflammation was significantly associated with a lower prostate cancer risk in 25 studies (OR 0.455, 95% CI 0.337-0.573). There was no evidence of publication bias (p >0.05). When subanalyzed by inflammation type, acute inflammation in 4 studies and chronic inflammation in 15 were each associated with a lower prostate cancer risk (OR 0.681, 95% CI 0.450-0.913 and OR 0.499, 95% CI 0.334-0.665, respectively).
CONCLUSIONS
In a meta-analysis of 25 studies inflammation on prostate needle biopsy was associated with a lower prostate cancer risk. Clinically the presence of inflammation on prostate needle biopsy may lower the risk of a subsequent prostate cancer diagnosis.
Topics: Biopsy, Needle; Humans; Incidence; Male; Prostate; Prostatic Neoplasms; Prostatitis; Risk Assessment
PubMed: 29246732
DOI: 10.1016/j.juro.2017.11.120 -
International Journal of Molecular... Aug 2019Inflammation is inherent in prostatic diseases and it is now accepted that it may facilitate cellular proliferation in both benign and malignant conditions. The strong... (Review)
Review
Inflammation is inherent in prostatic diseases and it is now accepted that it may facilitate cellular proliferation in both benign and malignant conditions. The strong relationship between prostatic inflammation and pathogenesis of benign prostatic hyperplasia (BPH) is supported by epidemiologic, histopathologic and molecular evidence. Contrariwise, the role of inflammation in prostate carcinogenesis is still controversial, although current data indicate that the inflammatory microenvironment can regulate prostate cancer (PCa) growth and progression. Knowledge of the complex molecular landscape associated with chronic inflammation in the context of PCa may lead to the introduction and optimization of novel targeted therapies. In this perspective, evaluation of the inflammatory component in prostate specimens could be included in routine pathology reports.
Topics: Animals; Biomarkers; Cell Transformation, Neoplastic; Disease Progression; Disease Susceptibility; Humans; Inflammation Mediators; Male; Prevalence; Prostatic Neoplasms; Prostatitis
PubMed: 31390729
DOI: 10.3390/ijms20153833 -
The Prostate May 2024Gut microbiome is a community of microorganisms that lives in the human intestine and exerts various functions on the host, including metabolic, immunoregulatory, and... (Review)
Review
BACKGROUND
Gut microbiome is a community of microorganisms that lives in the human intestine and exerts various functions on the host, including metabolic, immunoregulatory, and control over cell proliferation. Gut microbiome alterations have been associated with various pathological conditions, such as diabetes mellitus, obesity, and cardiovascular diseases. Gut-prostate axis is explained by the association between gut microbiome quantitative and functional alterations along with increased intestinal epithelial permeability with prostatediseases. However, the pathophysiological mechanisms and clinical importance of this association are not completely clarified yet.
METHODS
We conducted a narrative review of the most relevant articles in the Medline (US National Library of Medicine, Bethesda, MD, USA), Scopus (Elsevier, Amsterdam, The Netherlands) and Web of Science Core Collection (Thomson Reuters, Toronto, ON, Canada) databases. No chronological restrictions were applied, and the most related papers published until December 2023 were included.
RESULTS
Gut microbiota (GM) and its metabolites are capable of modifying host androgen level, as well as prostate cancer (PCa) therapy response. Moreover, patients with inflammatory bowel disease have higher rates of prostatitis-like symptoms and a potential risk of developing PCa.
CONCLUSIONS
There is evidence that interventions on the GM and its metabolites have a high potential to serve as diagnostic and therapeutic tools for prostate diseases, including PCa.
Topics: Male; Humans; Prostate; Prostatitis; Gastrointestinal Microbiome; Diabetes Mellitus; Prostatic Neoplasms
PubMed: 38353479
DOI: 10.1002/pros.24675 -
Radiology Oct 2018History A 68-year-old man with a remote history of a previously resected high-grade urothelial carcinoma in the renal pelvis was being observed and was undergoing...
History A 68-year-old man with a remote history of a previously resected high-grade urothelial carcinoma in the renal pelvis was being observed and was undergoing urologic treatment for recurrent low-grade urothelial carcinoma of the bladder. During his most recent evaluation, he reported no specific symptoms and denied experiencing hematuria, dysuria, or abdominal pain. At routine surveillance MRI of the abdomen and pelvis (images not shown), a lesion was noted in the peripheral zone of the prostate gland. The prostate-specific antigen level was elevated (7.51 ng/mL [normal range, 0.00-4.00 ng/mL]). The patient had no family history of prostate cancer and had never undergone prostate biopsy. MRI of the prostate with an endorectal coil was subsequently performed.
Topics: Aged; Humans; Magnetic Resonance Imaging; Male; Prostate; Prostate-Specific Antigen; Prostatitis; Urinary Bladder Neoplasms
PubMed: 30230997
DOI: 10.1148/radiol.2018161272 -
Journal of Endourology Jul 2018To assess if prostatic urethral lift (PUL) can be as effective on larger prostates. PUL is an endoscopic device that retracts prostatic tissue to relieve benign...
OBJECTIVES
To assess if prostatic urethral lift (PUL) can be as effective on larger prostates. PUL is an endoscopic device that retracts prostatic tissue to relieve benign prostatic hypertrophy (BPH) obstruction. In 2013, PUL was approved for patients with a prostate size of <80 g and no median lobes. The approval was primarily based on the L.I.F.T. study, which only evaluated patients with prostates between 30 and 80 g in size.
MATERIALS AND METHODS
Seventy-four patients underwent PUL between April 2, 2014, and December 2, 2015, for BPH management. Fifty-one patients were in the <80 g prostate group (median: 46 g, range: 20-78 g) and 23 in the >80 g prostate group (median: 112 g, range: 81-254 g). Student t-tests and Fisher's exact tests were used to compare continuous and categorical variables. p-Value of <0.05 was considered statistically significant.
RESULTS
Median time between PUL and follow-up AUA symptom score (AUASS) was 144 days. A difference between the numbers of PUL implants used was seen. A significant improvement in AUASSs was seen in both groups following the procedure. There was no significant difference in age, AUASS before or after the procedure, or need for an additional outlet procedure between the two groups.
CONCLUSION
Early experience finds that a sufficient number of men with larger prostates appear to benefit from PUL. Patients with >80 g prostate size were more likely to have a median lobe and may benefit from resection of the median lobe at time of the PUL. Long-term follow-up is needed to evaluate the durability of the PUL procedure.
Topics: Aged; Endoscopy; Humans; Male; Middle Aged; Prostatic Hyperplasia; Prostatism; Prostheses and Implants; Quality of Life; Treatment Outcome; Urethra
PubMed: 29631445
DOI: 10.1089/end.2017.0855