Necrotizing Fungal Infection Following Penile Prosthesis Implantation: A Case Report

Infection is one of the most devastating complications of penile prosthesis implantation. Although the infection prevalence have decreased owing to new technologies and growing surgical experience, it is still a troublesome situation. We present a 50-year-old male patient who had necrotizing fungal infection after penile prosthesis implantation caused by Trichosporon asahii

Assessment of PSA-Age volume score in predicting positive prostate biopsy findings in Turkey

ABSTRACT Objectives: To evaluate PSA-age volume (AV) scores in predicting positive prostate biopsy findings in Turkey. Materials and Methods: PSA-AV was calculated by multiplying the patient's age by the prostate volume and dividing it by the PSA level. Sensitivities and specificities of the PSA-AV were assessed by retrospective analysis of findings from 4,717 prostate biopsies. Results: The population's average age was 63.71±7.63 years, the mean PSA level was 9.73±17.01ng/mL, the mean prostate volume was 44.46±23.88 cm3. Of the 4,717 prostate biopsies, 1,171 biopsy specimens (24.8%) were positive for prostate cancer. A PSA-AV score of 700 had a sensitivity and specificity of 95% and 15%, respectively. These values were similar to the sensitivity and specificity for a PSA cut-off of 4ng/mL (94% and 13%, respectively). Although the sensitivity of a PSA-AV cut-off of 700 in patients over 60 years was similar to the PSA cut-off of 4ng/mL and the age-adjusted PSA, in patients <60 years, its sensitivity was higher. While the sensitivities of a PSA-AV cut-off of 700 in patients with low prostate volume was higher than a PSA cut-off of 4ng/ mL, the sensitivities of both methods with moderate prostate volumes were similar. Conclusions: Considering all the biopsies, the sensitivity and specificity of a PSA-AV of 700 for predicting positive biopsy findings were similar to a PSA of 4ng/mL. We suggest the PSA-AV cut-off of 700 should only be used in patients younger than 60 with low prostate volumes (<20cm3)

Development of a quality of life scale specific for patients with benign prostatic hyperplasia

WOS: 000316333600007PubMed: 23420093The improvement of quality of life (QoL) should be the major concern in any proposed treatment modality for any disorder. The objective of this study was to develop a new easy to use benign prostatic hyperplasia (BPH)-specific QoL scale that may guide the treatment policy in BPH. A total of 118 items addressing BPH-specific QoL were produced. After an elimination process, a 20-question scale was developed. This new scale, Short Form (SF)-36 and International Prostate Symptom Score (IPSS), was then administered to 50 healthy men (control group), and 108 BPH patients who received medical or surgical treatment. Reliability assessment consisted of internal consistency evaluation by the Cronbach's alpha reliability test. In construct validity, factor analysis was performed using principal component analysis with Varimax rotation. Response to change of this new form was also evaluated. Cronbach's alpha coefficient of this scale was found to be 0.8464. Item-total correlation coefficients were between 0.3298 and 0.7886 (p < 0.0001). Factor analysis for construct validity revealed four factors. The correlation coefficients were found to be r = 0.801 (p < 0.0001) with the total IPSS, and this new QoL scale had a relatively sufficient correlation with all domains of the SF-36. Moreover, a QoL score obtained by the summation of individual grades of each item may provide valuable information just like total IPSS. The mean QoL score was 4.96 +/- A 9.58 and 20.28 +/- A 9.14 in controls and BPH patients, respectively (p < 0.0001). Moreover, QoL score significantly improved by both medical and surgical treatment. The new BPH-specific QoL was shown to be reliable and valid

Transrectal ultrasound-guided prostate rebiopsy: How many core sampling should be applied to which patient?

Background: We investigated the correlation between the sampled number of cores in rebiopsy and the cancer detection rate (CDR). Materials and Methods: Two hundred and twelve patients with normal rectal examination who had undergone rebiopsy in the past 5 years were examined retrospectively. Moreover, 68% of them had undergone 12 cores (Group 1) while 32% had undergone 20 cores (Group 2). Both groups were compared with respect to the CDR. Results: There was no difference between groups in terms of age, total prostate-specific antigen, and prostate volume (P > 0.05). Forty-one (19%) of 212 patients were diagnosed with cancer, and the CDR was significantly higher in Group 2 (30.9% vs. 13.9%, P = 0.004). This rate increased from 6.5% to 20% (P = 0.025) and from 0% to 33.3% (P = 0.023), respectively, with 12-core and 20-core rebiopsies in patients whose initial pathology indicated benign and high-grade prostatic intraepithelial neoplasia (HGPIN). Furthermore, cancer was detected in 24 (40%) of 60 patients who were diagnosed with atypical small acinar proliferation (ASAP) in the initial biopsy. However, despite being higher in 20-core biopsy group (47.6% vs. 35.9%), this was not statistically significant (P = 0.377). Conclusions: At least 20 cores should be sampled in rebiopsy, especially in the patients diagnosed with benign and HGPIN. However, we believe that standard systematic sampling will be sufficient for the patients diagnosed with ASAP

Mapping European Association of Urology Guideline Practice Across Europe: An Audit of Androgen Deprivation Therapy Use Before Prostate Cancer Surgery in 6598 Cases in 187 Hospitals Across 31 European Countries

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