[Diagnosis and treatment of prostatic abscess: Report of 11 cases and review of the literature].

OBJECTIVE: To analyze the clinical features, imaging characteristics, treatment options and prognosis of prostatic abscess (PA), and provide some new ideas for the diagnosis and treatment of the disease. METHODS: This retrospective study included 11 cases of confirmed PA treated in the Fifth Medical Center of PLA General Hospital. We analyzed the clinical data obtained from the electronic medical records, including basic demographic statistics, risk factors, clinical symptoms, laboratory results, imaging findings, treatment methods, treatment-related complications and outcomes. RESULTS: The 11 patients diagnosed with PA between May 2016 and August 2022 were aged (64.18 ± 7.19) years and all had at least 1 comorbidity, including 5 cases of diabetes mellitus (45.5%) and 8 cases of dysuria (72.8%). PA was confirmed in 3 cases by CT and in 8 cases by MRI, 6 (54.5%) multifocal and 10 (90.9%) >2 cm in diameter, with a median size of 3.84 cm. After admission, positive urine culture was found in 3 cases, positive blood culture in 1, Klebsiella pneumoniae in 2 and Enterococcus Faecalis in 1. Three of the patients were treated by intravenous administration of antibiotics alone, and the other 8 by transurethral PA unroofing in addition. Antibiotics medication lasted for a median of (12.9 ± 3.88) d and hospital stay averaged (19.18 ± 8.20) d. The patients were followed up for 3 months, which revealed the presence of PA in 2 of the cases treated with antibiotics alone, but not in any of the cases treated by surgery. CONCLUSION: PA is relatively rare and has no specific symptoms clinically. Imaging examination is very important for accurate diagnosis, and transurethral PA unroofing plus antibiotics administration could be considered as an optimal management of the disease.

An early experience of the robot-assisted laparoscopic nephroureterectomy without re-docking in a single position.

OBJECTIVE: This study aims to evaluate the execution of robot-assisted laparoscopic nephroureterectomy without repositioning the patient. METHODS: The clinical data of 9 patients who underwent robot-assisted laparoscopic nephroureterectomy between May 2017 and November 2018 were analyzed, proceeding in a single position, without repositioning the patient. This involved 5 men and 4 women, with an average age of 61.67 ± 10.37 years and an average body mass index (BMI) of 24.78 ± 3.84. We considered the duration of the intervention, the blood loss, the duration of the hospital stay, the duration of maintenance of the drainage and the follow-up on all patients, with or without complications and recurrence of the tumor. RESULTS: The intervention was completed in all 9 cases. The average duration of the intervention was 242.89 ± 13.37 minutes, the average blood loss was 166.67 ± 70.71 ml, the average hospitalization time was 2 ± 0.71 days, the average time drainage maintenance was 5.11 ± 1.05 days and the average follow-up times without complications and tumor recurrence were 12.56 ± 6.19 months. CONCLUSION: Robot-assisted laparoscopic nephroureterectomy without repositioning the patient during the procedure simplifies the procedure and shortens the duration of the procedure. It is also a safe, effective and feasible minimally invasive treatment method. KEY WORDS: Nephroureterectomy, Robot-assisted laparoscopic, Tumor recurrence, Single position, Upper tract urothelial carcinoma.