RESUMO
Transperineal prostate biopsy (TPPB) is proven to be an effective diagnostic tool for prostate cancer detection. It allows satisfactory sampling of apical and anterior areas which is not well achieved with the transrectal route, without the associated risks of urinary tract infection or sepsis. The main objective of this paper is to describe the technique utilized in our institution to perform transperineal prostate biopsy under local anesthetic in the outpatient clinic setting.
Assuntos
Próstata , Neoplasias da Próstata , Masculino , Humanos , Próstata/patologia , Anestésicos Locais , Pacientes Ambulatoriais , Biópsia/efeitos adversos , Biópsia/métodos , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/patologia , Biópsia Guiada por Imagem , Períneo/patologiaAssuntos
COVID-19 , Currículo , Corpo Clínico Hospitalar , Centro Cirúrgico Hospitalar , Cirurgia Plástica/educação , Ensino/tendências , COVID-19/epidemiologia , COVID-19/prevenção & controle , Educação/métodos , Educação/organização & administração , Educação de Pós-Graduação em Medicina/tendências , Humanos , Controle de Infecções/métodos , Corpo Clínico Hospitalar/educação , Corpo Clínico Hospitalar/psicologia , Inovação Organizacional , SARS-CoV-2 , Centro Cirúrgico Hospitalar/organização & administração , Centro Cirúrgico Hospitalar/tendências , Reino Unido/epidemiologiaRESUMO
Spinal arachnoid cysts (SAC) are rare in isolation and the exact aetiology is still debated. Primary (congenital) cysts are caused by structural abnormalities in the arachnoid layer and largely affect the thoracic region. Secondary cysts are induced by a multitude of factors, infection, trauma or iatrogenic response, and can affect any level of the spinal cord. While subarachnoid haemorrhage (SAH) is a relatively common condition with significant repercussions, it is extremely uncommonly associated with SAC. When present, it may develop in the months and years after the original bleed, giving rise to new neurological symptoms. Prompt treatment is needed to halt or reverse the worsening of symptoms and questions are still being asked about how best to approach this condition. A 42-year-old man presented with chronic back pain, severe worsening ataxia and numbness below the umbilicus, 7 months after treatment for a World Federation of Neurosurgical Societies grade five (WFNS V) SAH. Imaging revealed a SAC extending from T12 to L4 and causing thecal compression. This was treated with a L3 laminectomy andmarsupialisation. An improvement in neurological function was observed at 6 months. Aetiology of the SAC and its association with SAH are discussed and a review of the relevant literature is provided.