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Sonography in Male Infertility
Published in Asim Kurjak, Ultrasound and Infertility, 2020
Chronic prostatitis is marked by unusual sonographic findings. The prostate is filled with the hyperechoic areas, and exacerbation of inflammation is seen as the reappearance of small hypoechogenic areas. Such a sonographic picture denotes chronic suppurative prostatitis, and if it is caused by coliform bacteria, then it may result in decreased sperm motility. Chronic prostatitis and prostatic cancer are often indistinguishable on the basis of sonographic examination alone.2,6
Radiology of Infectious Diseases and Their Potential Mimics in the Critical Care Unit
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
Jocelyn A. Luongo, Boris Shapiro, Orlando A. Ortiz, Douglas S. Katz
Ultrasound findings are somewhat similar to abscess in that carcinoma appears as an anechoic to hypoechoic mass. The contour is classically asymmetric or triangular with the base close to the capsule, and extending centrally into the gland based on the pattern of tumor growth. While CT is an excellent means for diagnosing and following treatment of prostatic abscess, it has limited use in the diagnosis of carcinoma due to relatively poor sensitivity and specificity for detection of cancer within the gland compared with MRI. CT findings may include an enlarged gland with evidence of extracapsular extension in more advanced tumors (obliterated periprostatic fat plane, invasion of adjacent bladder or rectum) and pelvic lymphadenopathy (Figure 5.5). T2-weighted MRI demonstrates prostate cancer as a relatively low-intensity area within the gland, whereas abscess should demonstrate areas of central high signal intensity related to the fluid content [29,30]. Chronic prostatitis, which may also present with elevated PSA and non-specific urinary symptoms, is much more difficult to distinguish from prostate cancer, but it usually has a different, less defined, pattern of T2 hypointensity, and only a subtly pathologic pattern of restricted diffusion on magnetic resonance imaging (MR), as compared to prostate cancer [32,33].
Sexually Transmitted Infection and Male Infertility
Published in Botros Rizk, Ashok Agarwal, Edmund S. Sabanegh, Male Infertility in Reproductive Medicine, 2019
Kareim Khalafalla, Haitham Elbardisi, Mohamed Arafa
Prostatitis is known to cause infertility whether associated with leukocytospermia or not. This could be attributed to the increased oxidative stress due to inflammation. Chronic prostatitis is common with several STD pathogens increasing the risk of infertility. This may be due to disturbance of accessory gland secretions with disturbed seminal microenvironment. Chronic prostatitis and scarring may lead to partial or complete ejaculatory duct obstruction [15,16]. In these cases, the semen parameters of patients are characteristic showing low semen volume, acidic pH, azoospermia, and negative fructose in semen.
Safety considerations with new antibacterial approaches for chronic bacterial prostatitis
Published in Expert Opinion on Drug Safety, 2022
Gianpaolo Perletti, Alberto Trinchieri, Konstantinos Stamatiou, Vittorio Magri
2 – Reports describing therapy for CBP with some of the drugs reviewed in this article are scant in some cases. Whereas antibiotics like aminoglycosides and macrolides are recommended by international guidelines (e.g. the European Association of Urology Guidelines [22]), the evidence concerning other antibacterial agents is often anecdotal and restricted to case reports or small case series. Thus, readers should be warned of the limited published evidence concerning some of the drugs listed above. This also shows that the management of chronic prostatitis is a challenging task for clinicians, and antibiotic selection must be adapted as much as possible to current recommendations. Adequately powered comparative studies, preferably in a randomized setting, are urgently needed. In our opinion, priority should be given to studies focusing on CBP caused (i) by Gram-positive pathogens, whose prevalence is increasing in some geographic areas, and (ii) by multidrug-resistant/carbapenemase-producing Enterobacteriaceae. Unfortunately, the antibiotic pipeline is drying out due to the lack of interest of multinational pharmaceutical companies. Spontaneous research triggered by scientific interest and in the interest of patients will therefore be highly meritorious.
IL-6/STAT3 pathway is involved in the regulation of autophagy in chronic non-bacterial prostatitis cells, and may be affected by the NLRP3 inflammasome
Published in Ultrastructural Pathology, 2021
Lidong Chen, Hui Wang, Shengdong Ge, Sheng Tai
Chronic Prostatitis (CP) is a common disease in urology, characterized by high incidence, low cure rate and easy recurrence.1–3 A large and multicenter epidemiological study in China showed that the incidence of prostatitis like symptoms in men was 8.4%.3 Patients with chronic prostatitis are mainly manifested as lower abdominal discomfort, pain, perineal discomfort, scrotal moisture, urination discomfort and other related symptoms. Chronic prostatitis is often associated with male sexual dysfunction, which seriously affects the patient’s sound mind and living quality.1,2 Chronic non-bacterial prostatitis is the most common pathological type of chronic prostatitis, and it is also a difficult type of clinical prostatitis.4,5 At present, the research on the pathogenesis of CNP is not quite clear, leading to poor clinical treatment effect of CNP, which seriously affects the physical and mental health of patients and brings serious psychological impact to patients. Therefore, it is of great clinical significance to further study and explore the pathogenesis of CNP, provide new theoretical basis and strategies for the treatment and prevention of CNP.
Prolonged course of Fosfomycin-Trometamol for chronic prostatitis: an unknown good option
Published in Scandinavian Journal of Urology, 2021
Fosfomycin-Trometamol is widely used for uncomplicated urinary tract infections in women. It is, in many countries, one of the first options in guidelines. In this case, the dosage used is 3 g of Fosfomycin once, taken orally. It is also used as prophylaxis for patients who present recurrent urinary tract infections to sterilize urines once a week for example. To date, there are no recommendations for its use for pyelonephritis or prostatitis. However, Fosfomycin-Trometamol has been used for patients with chronic prostatitis. A recent review highlighted its efficacy through case reports and small case series [1]. We report here a new case that shows the interest of this molecule for the treatment of chronic prostatitis when other antibiotics failed or were not usable due to resistances.