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PloS One 2012Chronic inflammation in the prostate, seen as infiltration of inflammatory cells into the prostate gland in histological samples, affects approximately half the male...
Chronic inflammation in the prostate, seen as infiltration of inflammatory cells into the prostate gland in histological samples, affects approximately half the male population without indication of prostate disease, and is almost ubiquitous in patients diagnosed with benign prostate hyperplasia and cancer. Several studies have demonstrated the gram-positive bacterium Propionibacterium acnes to be frequently present in prostate tissue from men suffering from prostate disease. P. acnes has been shown to be associated with histological inflammation in human prostatectomy specimens, and also to induce strong inflammatory response in prostate-derived tissue culture models. The present paper describes a rat model for assessment of the pathogenic potential of P. acnes in prostate. Prostate glands of Sprague Dawley rats (n = 98) were exposed via an abdominal incision and live P. acnes or, in control rats, saline were injected into the ventral and dorso-lateral lobes. Rats were sacrificed 5 days, 3 weeks, 3 months and 6 months post infection, and prostate tissue was analyzed for bacterial content and histological inflammation. Rat sera were assessed for levels of CRP and anti-P. acnes IgG. Live P. acnes could be recovered from the dorso-lateral lobes up to 3 months post infection, while the ventral lobes were cleared from bacteria at that time. In samples up to 3 months post infection, the dorso-lateral lobes exhibited intense focal inflammation. CRP and IgG levels were elevated throughout the span of the experiment, and reached maximum levels 3 weeks and 3 months post infection, respectively. We show that P. acnes have the potential to cause chronic infection in previously healthy prostate, and that the infection has potential to cause chronic histological inflammation in the infected tissue. The high prevalence of P. acnes in human prostate tissue calls for resolution of pathogenic details. The present rat model suggests that complications such as chronic inflammation may be induced by P. acnes infection.
Topics: Animals; Antigens, Bacterial; Chronic Disease; Disease Models, Animal; Humans; Immunoglobulin G; Inflammation; Male; Propionibacterium acnes; Prostate; Prostatic Diseases; Prostatic Hyperplasia; Rats; Rats, Sprague-Dawley
PubMed: 23240022
DOI: 10.1371/journal.pone.0051434 -
European Urology Dec 2013Prostate biopsy is commonly performed for cancer detection and management. The benefits and risks of prostate biopsy are germane to ongoing debates about prostate cancer... (Review)
Review
CONTEXT
Prostate biopsy is commonly performed for cancer detection and management. The benefits and risks of prostate biopsy are germane to ongoing debates about prostate cancer screening and treatment.
OBJECTIVE
To perform a systematic review of complications from prostate biopsy.
EVIDENCE ACQUISITION
A literature search was performed using PubMed and Embase, supplemented with additional references. Articles were reviewed for data on the following complications: hematuria, rectal bleeding, hematospermia, infection, pain, lower urinary tract symptoms (LUTS), urinary retention, erectile dysfunction, and mortality.
EVIDENCE SYNTHESIS
After biopsy, hematuria and hematospermia are common but typically mild and self-limiting. Severe rectal bleeding is uncommon. Despite antimicrobial prophylaxis, infectious complications are increasing over time and are the most common reason for hospitalization after biopsy. Pain may occur at several stages of prostate biopsy and can be mitigated by anesthetic agents and anxiety-reduction techniques. Up to 25% of men have transient LUTS after biopsy, and <2% have frank urinary retention, with slightly higher rates reported after transperineal template biopsy. Biopsy-related mortality is rare.
CONCLUSIONS
Preparation for biopsy should include antimicrobial prophylaxis and pain management. Prostate biopsy is frequently associated with minor bleeding and urinary symptoms that usually do not require intervention. Infectious complications can be serious, requiring prompt management and continued work into preventative strategies.
Topics: Bacterial Infections; Biopsy, Needle; Erectile Dysfunction; Humans; Male; Pain; Prostate
PubMed: 23787356
DOI: 10.1016/j.eururo.2013.05.049 -
Journal of Korean Medical Science Apr 2018The prostate is prone to infections. Hypothetically, bacteria can be inoculated into the prostate during a transrectal prostate biopsy (TRPB) and progress into chronic...
BACKGROUND
The prostate is prone to infections. Hypothetically, bacteria can be inoculated into the prostate during a transrectal prostate biopsy (TRPB) and progress into chronic bacterial prostatitis. Therefore, we examined new bacterial infections in biopsied prostates after TRPB and whether they affect clinical characteristics in the biopsied patients.
METHODS
Of men whose prostate cultures have been taken prior to TRPB, 105 men with bacteria-free benign prostate pathology underwent an additional repeated prostate culture within a year after TRPB.
RESULTS
Twenty out of 105 men (19.05%) acquired new bacteria in their naïve prostates after TRPB. Except for one single case of infection, 19 men had acquired gram-positive bacteria species. Between the culture-positive and negative groups, there were no significant differences in age, serum prostate-specific antigen (PSA) level, white blood cell (WBC) counts in expressed prostatic secretion (EPS), prostate volume, symptom severities in Korean version of the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) questionnaire, and patient-specific risk factors for biopsy associated infectious complications. Additionally, the TRPB procedure increased the WBC counts in post-biopsy EPS ( = 0.031, McNemar test), but did not increase the serum PSA level and symptoms of NIH-CPSI in 20 men who acquired new bacteria after TRPB.
CONCLUSION
The TRPB procedure was significantly associated with acquiring new bacterial infections in the biopsied prostate, but these localized bacteria did not affect patients' serum PSA level and symptoms after biopsy.
Topics: Aged; Bacterial Infections; Biopsy; Humans; Leukocyte Count; Male; Middle Aged; Prostate; Prostate-Specific Antigen; Prostatitis; Rectum; Republic of Korea; Risk Factors
PubMed: 29686597
DOI: 10.3346/jkms.2018.33.e126 -
Journal of Cancer Research and... 2019The purpose of the study is to assess the clinical value of magnetic resonance imaging (MRI)-guided transperineal prostate biopsy in the diagnosis of prostate disease.
PURPOSE
The purpose of the study is to assess the clinical value of magnetic resonance imaging (MRI)-guided transperineal prostate biopsy in the diagnosis of prostate disease.
MATERIALS AND METHODS
The institutional ethics committee approved this study. MRI-guided transperineal prostate biopsy was performed on 78 patients who had presented to our hospital with a prostate-specific antigen level >4 ng/mL or with MRI scans suggesting prostate cancer between January 2015 and August 2017. Written informed consent was obtained from all patients.
RESULTS
Of the 78 patients, pathological diagnosis could not be carried out in one because insufficient prostate tissue was obtained during biopsy. Prostate adenocarcinoma was confirmed in 34 patients, small-cell neuroendocrine carcinoma in 1 patient, prostatic tuberculosis in 1 patient, and benign prostatic hyperplasia in 41 patients. These diagnoses were confirmed by surgical pathology in 31 patients, and all results were consistent with the biopsy pathology, with no false positives. Postoperative urinary tract infection occurred in one patient, and mild postoperative hemorrhage around the prostate gland was seen in 65 patients, without the need for further clinical treatment.
CONCLUSION
MRI-guided transperineal prostate biopsy is helpful in the diagnosis and treatment of prostatic disease.
Topics: Adult; Aged; Aged, 80 and over; Biomarkers, Tumor; Humans; Image-Guided Biopsy; Magnetic Resonance Imaging; Male; Middle Aged; Prostate; Prostatic Neoplasms
PubMed: 30964117
DOI: 10.4103/jcrt.JCRT_725_18 -
Danish Medical Journal Jan 2017Transrectal ultrasound-guided biopsies (TRUS-gb) are associated with both mild and serious complications. Prophylactic antibiotics reduce the risk of septicaemia and... (Review)
Review
INTRODUCTION
Transrectal ultrasound-guided biopsies (TRUS-gb) are associated with both mild and serious complications. Prophylactic antibiotics reduce the risk of septicaemia and mortality; however, no international consensus exists on the timing and duration of antibiotics, including the optimal drug strategy. We reviewed the current evidence supporting use of prophylactic antibiotics and the risk of complications following prostate biopsies.
METHODS
This review was drafted in accordance with the Prisma Guidelines. The PubMed, Embase and Cochrane databases were searched.
RESULTS
A total of 19 eligible trials were identified. One trial demonstrated a significant reduction in the risk of infection after biopsy and reported that oral ciprofloxacin as either a single-dose or a three-day regimen was superior to oral chloramphenicol and norfloxacin. Of three studies investigating the timing of the first dose of antibiotic, one study found that administration 24 h before biopsy versus administration immediately before reduced the relative risk of post-biopsy infection by 55%. Seven studies compared different durations of antibiotic prophylaxis. None showed any benefit from continuing prophylaxis beyond a single dose or a one-day regimen.
CONCLUSION
Evidence supporting a specific antibiotic regimen for TRUS-gb prophylaxis is scarce. Widespread use of fluoroquinolone prophylaxis may be associated with an increase in resistant Escherichia coli strains, posing a potentially major health issue in the future. .
Topics: Anti-Bacterial Agents; Antibiotic Prophylaxis; Bacterial Infections; Drug Administration Routes; Drug Administration Schedule; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Humans; Male; Microbial Sensitivity Tests; Prostate; Prostatic Neoplasms; Urine
PubMed: 28007054
DOI: No ID Found -
Korean Journal of Urology May 2015Infectious complications after transrectal ultrasound-guided prostate biopsy (TRUS-Bx) appear to be increasing, which reflects the high prevalence of... (Review)
Review
Infectious complications after transrectal ultrasound-guided prostate biopsy (TRUS-Bx) appear to be increasing, which reflects the high prevalence of antibiotic-resistant strains of Enterobacteriaceae. Identifying patients at high risk for antibiotic resistance with history taking is an important initial step. Targeted prophylaxis with a prebiopsy rectal swab culture or augmented antibiotic prophylaxis can be considered for patients at high risk of antibiotic resistance. If infectious complications are suspected, the presence of urosepsis should be evaluated and adequate antibiotic treatment should be started immediately.
Topics: Anti-Bacterial Agents; Antibiotic Prophylaxis; Biopsy; Drug Resistance, Bacterial; Escherichia coli Infections; Humans; Male; Prostate; Ultrasound, High-Intensity Focused, Transrectal; Urinary Tract Infections
PubMed: 25964834
DOI: 10.4111/kju.2015.56.5.346 -
Investigative and Clinical Urology Mar 2016Urosepsis is the most feared complication of transrectal prostate biopsy. The incidence may be increasing from <1% to 2%-3% in contemporary series. Historically,... (Review)
Review
PURPOSE
Urosepsis is the most feared complication of transrectal prostate biopsy. The incidence may be increasing from <1% to 2%-3% in contemporary series. Historically, fluoroquinolones have been effective antibiotic prophylaxis to prevent infective complications but antibiotic resistance is increasing. The increase in antibiotic resistance may contribute to reported increases in urosepsis and hospitalization after transrectal biopsy. This article will review other methods clinicians may employ to reduce the incidence of infective complications after prostate biopsy.
MATERIALS AND METHODS
A systematic review of the literature was conducted using literature databases PubMed and Ovid MEDLINE in August 2015 in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) criteria.
RESULTS
Effective strategies to reduce infective complications after transrectal prostate biopsy include augmented prophylaxis with other antibiotics, rectal swab culture directed antibiotic prophylaxis or a transperineal biopsy approach. Needle disinfection, minimizing the number of biopsy needles and rectal disinfectants may also be of use. These methods may be of particular utility in patients with risk factors for developing urosepsis such as recent antibiotic use and overseas travel.
CONCLUSIONS
The scientific literature describes various techniques designed to reduce infective complications caused by prostate biopsy. Clinicians should consider incorporating these novel techniques into their contemporary practice.
Topics: Antibiotic Prophylaxis; Biopsy, Needle; Cross Infection; Disinfection; Humans; Male; Needles; Prostate; Prostatic Neoplasms; Sepsis
PubMed: 26981590
DOI: 10.4111/icu.2016.57.2.94 -
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 -
Scandinavian Journal of Immunology 2007The prostate is one of the main male sex accessory glands and the target of many pathological conditions affecting men of all ages. Pathological conditions of the... (Comparative Study)
Comparative Study Review
The prostate is one of the main male sex accessory glands and the target of many pathological conditions affecting men of all ages. Pathological conditions of the prostate gland range from infections, chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) of a still unknown aetiology to benign hyperplasia and cancer. CP/CPPS is one of the most prevalent diseases in the urologic clinic and affects men younger than 50 years old. A significant advance in the understanding of CP/CPPS was made when an autoimmune response against prostate antigens was revealed in a considerable number of patients. During the last 30 years, extensive work has been done regarding the development and characterization of different rodent models of experimental autoimmune prostatitis (EAP). It has been demonstrated that tolerance to prostate antigens can be disrupted in some strains of rats and mice and cellular and humoral responses to prostate antigens are elicited. A Th1 pattern has been described and the cellular response seems to be the major pathogenic mechanism involved. Immune cells infiltrate the gland and induce prostate lesions. The genetic background and hormonal imbalance are factors that could contribute to the onset of the disease in susceptible young males. Moreover, spontaneous autoimmune prostatitis could also occur with advanced age in susceptible strains. In this review, we summarize the current knowledge regarding rodent models of EAP and the immunological alterations present in CP/CPPS patients. We also discuss the reliability of these experimental approaches as genuine tools for the study of human disease.
Topics: Animals; Autoimmune Diseases; Chronic Disease; Disease Models, Animal; Humans; Male; Prostatitis
PubMed: 17635799
DOI: 10.1111/j.1365-3083.2007.01971.x -
World Journal of Urology Sep 2022To compare infectious complications after transrectal systematic prostate biopsy (SB) and magnetic resonance imaging (MRI)-targeted biopsy (TB) in a large retrospective...
PURPOSE
To compare infectious complications after transrectal systematic prostate biopsy (SB) and magnetic resonance imaging (MRI)-targeted biopsy (TB) in a large retrospective cohort to assess whether one technique is superior to the other regarding infectious complications.
METHODS
A total of 4497 patients underwent 5288 biopsies, 2875 (54%) SB and 2413 (46%) MRI-TB only. On average, 12 SB cores and 3.7 MRI-TB cores were taken per biopsy session during the study period. Infection-related complications within 30 days were compared. The primary endpoint was a positive urine culture. Secondary endpoints were positive blood cultures, urine tests with elevated leukocytes ≥ 100 E6/L and elevated C-reactive protein (CRP) ≥ 100 mg/L. Chi-square test was used to compare the cohorts.
RESULTS
Positive urine cultures were found in 77 (2.7%) after SB and in 42 (1.7%) after MRI-TB (p = 0.022). In total, 46 (0.9%) blood culture positive infections were found, 23 (0.9%) occurred after SB and 23 (1.0%) after MRI-TB, (p = 0.848). Urine tests with elevated leukocytes ≥ 100 E6/L were found in 111 (3.9%) after SB and in 61 (2.5%) after MRI-TB (p = 0.006). Elevated CRP ≥ 100 mg/L was found in 122 (4.2%) after SB and in 72 (3.0%) after MRI-TB (p = 0.015). Blood cultures were drawn more often after SB than after MRI-TB, but the difference was not statistically significant. However, urine cultures and CRP were taken more often after SB than MRI-TB.
CONCLUSION
Blood culture positive infections were equally rare after SB and MRI-TB. However, all other infectious complications were more common after SB than MRI-TB.
Topics: Biopsy; Humans; Image-Guided Biopsy; Magnetic Resonance Imaging; Male; Prostate; Prostatic Neoplasms; Retrospective Studies; Ultrasonography, Interventional
PubMed: 35930069
DOI: 10.1007/s00345-022-04104-1