ABSTRACT
ABSTRACT Purpose: We evaluated the correlation between prostate calculi and hematospermia in patients undergoing prostate biopsy, and its impact on sexual activity of patients. Materials and Methods: A single-center prospective randomized study of 212 patients referred for transrectal ultrasound-guided prostate biopsy (TRUSBx) was performed. All patients were divided into two groups: Group A (GA), 106 patients with moderate/marked presence of prostatic calculi visualized by TRUS; Group B (GB), 106 patients with absence/scarce of prostatic calcifications. Patients were handed questionnaires to obtain a validated data on the duration and impact of hematospermia on sexual activity. The anxiety scores were recorded using a visual analogue scale. Results: No significant difference was noted between the two groups when comparing age, preoperative PSA level, prostate volume, and biopsy number, except for digital rectal examination (DRE) findings. Post-biopsy results of patients included in GA revealed that the complication of hematospermia was present in 65.1%, while in GB was present in 39.7% (p<0.001). On multivariate analysis for identifying significant preoperative predictors of hematospermia, which included variables of age, PSA, prostate volume, and prostate cancer were not shown to be significant predictors of hematospermia, except DRE and prostate calculi (p<0.001). The mean anxiety score was 3.7±2.8 in GA and 2.3±1.9 in GB, respectively (p<0.001). Conclusions: Prostatic calculi are an independent predictive factor of severe hematospermia after TRUSBx on the basis of multivariate analysis, but don't affect the positive rate of prostate cancer. Patients should be adequately counselled before TRUSBx to avoid undue anxiety and alterations in sexual activity.
Subject(s)
Humans , Male , Prostatic Diseases/pathology , Calculi/pathology , Hemospermia/etiology , Prostatic Diseases/complications , Prostatic Diseases/diagnostic imaging , Prostatic Neoplasms/pathology , Prostatic Neoplasms/diagnostic imaging , Biopsy/methods , Calculi/complications , Calculi/diagnostic imaging , Prospective Studies , Prostate-Specific Antigen/blood , Coitus , Endoscopic Ultrasound-Guided Fine Needle Aspiration , Image-Guided Biopsy , Middle AgedABSTRACT
PURPOSE: We evaluated the correlation between prostate calculi and hematospermia in patients undergoing prostate biopsy, and its impact on sexual activity of patients. MATERIALS AND METHODS: A single-center prospective randomized study of 212 patients referred for transrectal ultrasound-guided prostate biopsy (TRUSBx) was performed. All patients were divided into two groups: Group A (GA), 106 patients with moderate/marked presence of prostatic calculi visualized by TRUS; Group B (GB), 106 patients with absence/scarce of prostatic calcifications. Patients were handed questionnaires to obtain a validated data on the duration and impact of hematospermia on sexual activity. The anxiety scores were recorded using a visual analogue scale. RESULTS: No significant difference was noted between the two groups when comparing age, preoperative PSA level, prostate volume, and biopsy number, except for digital rectal examination (DRE) findings. Post-biopsy results of patients included in GA revealed that the complication of hematospermia was present in 65.1%, while in GB was present in 39.7% (p<0.001). On multivariate analysis for identifying significant preoperative predictors of hematospermia, which included variables of age, PSA, prostate volume, and prostate cancer were not shown to be significant predictors of hematospermia, except DRE and prostate calculi (p<0.001). The mean anxiety score was 3.7±2.8 in GA and 2.3±1.9 in GB, respectively (p<0.001). CONCLUSIONS: Prostatic calculi are an independent predictive factor of severe hematospermia after TRUSBx on the basis of multivariate analysis, but don't affect the positive rate of prostate cancer. Patients should be adequately counselled before TRUSBx to avoid undue anxiety and alterations in sexual activity.
Subject(s)
Calculi/pathology , Hemospermia/etiology , Prostatic Diseases/pathology , Biopsy/methods , Calculi/complications , Calculi/diagnostic imaging , Coitus , Endoscopic Ultrasound-Guided Fine Needle Aspiration , Humans , Image-Guided Biopsy , Male , Middle Aged , Prospective Studies , Prostate-Specific Antigen/blood , Prostatic Diseases/complications , Prostatic Diseases/diagnostic imaging , Prostatic Neoplasms/diagnostic imaging , Prostatic Neoplasms/pathologyABSTRACT
BACKGROUND: Testicular calculus is an extremely rare case with unknown etiology and pathogenesis. To our knowledge, here we report the third case of testicular calculus. A 31-year-old man was admitted to our clinic with painful solid mass in left testis. After diagnostic work-up for a possible testicular tumour, he underwent inguinal orchiectomy and histopathologic examination showed a testicular calculus. Case hypothesis: Solid testicular lesions in young adults generally correspond to testicular cancer. Differential diagnosis should be done carefully. Future implications: In young adults with painful and solid testicular mass with hyperechogenic appearance on scrotal ultrasonography, testicular calculus must be kept in mind in differential diagnosis. Further reports on this topic may let us do more clear recommendations about the etiology and treatment of this rare disease.
Subject(s)
Calculi/pathology , Rare Diseases/pathology , Testicular Diseases/pathology , Adult , Calculi/surgery , Diagnosis, Differential , Humans , Male , Orchiectomy , Rare Diseases/surgery , Testicular Diseases/surgery , Testicular Neoplasms/diagnosisABSTRACT
Testicular calculus is an extremely rare case with unknown etiology and pathogenesis. To our knowledge, here we report the third case of testicular calculus. A 31-year-old man was admitted to our clinic with painful solid mass in left testis. After diagnostic work-up for a possible testicular tumour, he underwent inguinal orchiectomy and histopathologic examination showed a testicular calculus.
Solid testicular lesions in young adults generally correspond to testicular cancer. Differential diagnosis should be done carefully.
In young adults with painful and solid testicular mass with hyperechogenic appearance on scrotal ultrasonography, testicular calculus must be kept in mind in differential diagnosis. Further reports on this topic may let us do more clear recommendations about the etiology and treatment of this rare disease.
Subject(s)
Humans , Male , Adult , Testicular Diseases/pathology , Calculi/pathology , Rare Diseases/pathology , Testicular Diseases/surgery , Testicular Neoplasms/diagnosis , Calculi/surgery , Orchiectomy , Rare Diseases/surgery , Diagnosis, DifferentialABSTRACT
Describir la técnica del uso del coledocospio en la exploración laparoscópica de la vía biliar por coledocolitisis, en el Servicio de Cirugía III, Hospital Universitario de Caracas. Se presenta caso de paciente femenina de 42 años de edad con clínica de litiasis vesicular sintomática y sospecha alta de coledocolitiasis a quien se realiza colangiopancreatografía retrograda endoscópica, siendo esta infructuosa en su intento de extraer los cálculos, por lo que se decide realizar exploración laparoscopica de la vía biliar con uso del coledocospio. Se realizó exploración de vías biliares con uso del coledocospio a través de coledocotomía longitudinal supraduodenal con extracción de múltiples cáculos de la vía biliar principal, se realizó posteriormente revisión proximal y distal sin evidencia de anomalias. La paciente evoluciona sin complicaciones, realizándose colangiografía transkehr al décimo día postoperatorio con resultados satisfactorios. El uso del coledocospio en la exploración laparoscópica de la vía biliar ayuda a alcanzar la mas altas tasas de exito y reduce al minimo la incidencia de liatiasis residual. Sin embargo, no debe olvidarse que se trata de una técnica muy compleja que requiere de una importante coordinación y trabajo en equipo, siendo fundamental la experiencia, práctica y familiarización de los cirujanos con el instrumental utilizado.
Subject(s)
Humans , Adult , Female , Choledocholithiasis/pathology , Urinary Bladder Calculi/surgery , Urinary Bladder Calculi/pathology , Laparoscopy/methods , Calculi/pathology , Abdominal Pain/diagnosis , Surgical EquipmentABSTRACT
La litiasis intrahepática es una entidad poco frecuente en el Hemisferio occidental. Su prevalencia en nuestro medio no es conocida. Estudiamos 342 pacientes con colangiografía retrógeda esdoscóspica realizada por patología litiásica de las vías biliares en el Servicio de Gastroenterología del Hospital Universitario de Caracas, desde el 6 de enero de 1993 al 7 de abril de 1995. De los 342 pacientes, 9 correspondierona litiasis intrahepática, (1,16 por ciento). Siete casos fueron pacientes de Caracas y dos fueron pacientes referidos del interior. Siete pacientes fueron del sexo femenino y dos del masculino, con edades entre 15 y 67 años. La manifestación clínica más frecuente fue el dolor abdominal. El diagnóstico se realizó por econografía y colangiografía retrógrada endoscópica en todos los casos. El tratamiento definitivo fué endoscopico en dos casos. En seis casos se requirió tratamiento quirúrgico, con dos resecciones hepáticas y 4 laparotomias biliares. Un caso egreso sin tratamiento