[Massive vesicoinguinal hernia and acute renal failure. An infrequent association]. / Hernia vesicoinguinal masiva y fracaso renal agudo. Una asociación poco frecuente.

OBJECTIVE: To report a rare complication of acute renal failure secondary to massive vesicoinguinal hernia. To our knowledge, only 4 cases have been previously reported in the literature. METHODS: Herein we describe a case of massive vesicoinguinal hernia in a patient that had presented at the emergency services with symptoms of acute renal failure. The diagnostic and therapeutic aspects of this rare complication are discussed. RESULTS: Patient evaluation showed a left inguinal hernia and benign hyperplasia of the prostate. Blood analytical findings were compatible with acute renal failure. A left massive vesicoinguinal hernia was detected on ultrasound evaluation and confirmed by retrograde cystography. Treatment was by surgical repair of the inguinal hernia, bladder repositioning and cervicoprostatotomy plus TUR of the excrescent bladder lesions to resolve the obstruction. CONCLUSIONS: Massive vesicoinguinal hernia may go undetected if the symptoms are unremarkable and may mimick those of acute renal failure.

[Bacterial content of the enucleated prostate gland]. / Contenido bacteriano de la glándula prostática enucleada.

OBJECTIVE: To determine the prevalence of prostatic colonization or infection in patients undergoing prostatic surgery for obstructive symptoms due to benign hyperplasia of the prostate (BPH), to identify and quantitate the microorganisms isolated in quantitative bacterial tissue cultures, and to determine the influence of open surgery vs endoscopy on the microbiological findings. METHODS: A prospective study was conducted on 175 patients undergoing surgery for BPH. All patients were entered into a study protocol that included quantitative bacterial cultures of prostatic tissue. Data of previously defined variables were entered into a data base for subsequent analysis comprised of redefinition of the variables and descriptive and analytical studies. RESULTS: 44 of the 175 patients (25.1%) had a positive bacterial culture of prostatic tissue. Histological lesions indicating prostatitis associated with BPH were found in 68 of the 175 patients (38.9%), regardless of the presence or absence of bacteria. Of these 68 patients with histologically demonstrated prostatic inflammation, only 19 (27.9%) had a positive prostatic tissue culture. The incidence of granulomatous prostatitis was 1.1%. CONCLUSIONS: The presence of bacteria was demonstrated in prostates of a significant number of patients (25.1%) undergoing prostatectomy for BPH. The microorganisms most frequently isolated in the quantitative bacterial cultures were, by order of frequency, coagulase negative Staphylococci, Escherichia coli and Enterococcus faecalis, which were present in concentrations of at least 10(4) CFU/Gm in prostatic tissue of 79.6% of the cases. No differences were found between the type of procedure the patient underwent and the presence or absence of prostatic infection.

[Inflammatory changes in the obstructed prostate: the correlation between the bacteriological and histological findings]. / Cambios inflamatorios en la glándula prostática obstructiva: correlación entre los hallazgos bacteriológicos e histológicos.

OBJECTIVES: To analyze the incidence and nature of the prostatic inflammatory changes, to determine the prevalence of prostatic colonization or infection in patients undergoing surgery for benign hyperplasia of the prostate (BPH) and to correlate the inflammatory lesions with the bacteriological findings. METHODS: A prospective study was conducted on 175 patients undergoing surgery for BPH. All patients were entered into a study protocol that included quantitative bacterial cultures of the prostatic tissue and histological analyses of the surgical specimens. Data of previously defined variables were entered into a data base for subsequent analysis comprised of a descriptive and an analytical study. RESULTS: 44 of the 175 patients (25.1%) had a positive bacterial culture of prostatic tissue. Histological lesions indicating prostatitis associated with BPH were found in 68 of the 175 patients (38.9%), regardless of the presence or absence of bacteria. Of these 68 patients with a histologically demonstrated inflammation of the prostate, only 19 (27.9%) had positive prostatic tissue cultures. The incidence of granulomatous prostatitis was 1.1%. CONCLUSIONS: Histological lesions indicating prostatitis associated with BPH were found in 68 of the 175 patients (38.9%). The presence of bacteria was demonstrated in the prostates of a significant number of patients (25.1%) who underwent adenomectomy for BPH. No differences were found between the patients with a positive or negative bacterial culture and histological evidence of prostatitis.

[Relationship between preoperative urine cultures and prostatic gland cultures in patients treated for benign prostatic hyperplasia]. / Relación entre los cultivos de orina preoperatorios y los cultivos de la glándula prostática en pacientes intervenidos de HBP.

OBJECTIVES: 1.--Investigate the bacteriuria preoperative in patients who will be operate on for Being Prostatic Hyperplasia (BPH). 2.--Define the prevalence of the prostatic colonization or infection. 3.--Try to correlate the bacteriological findings of urine and prostate, and find the degree of concordance between the microorganisms which can be commonly found in urine and prostatic tissue. METHOD AND MATERIALS: Prospective series of 175 patients undergoing prostatectomy for obstructive symptoms. The protocol revealed, among others variables: the preoperative urine culture; the presence or the absence of catheter; and the quantitative bacteriological culture of prostatic tissue. The information could be analised and its results could be obtained later on. The analysis stages consisted of both a descriptive and an analytic study. RESULTS AND CONCLUSIONS: 1.--Only 36 patients (20.6%) presented bacteriological increase of microorganisms (> or = 10(4) UFC/ml) in the preoperative urine culture. The Escherichia coli was the most common microorganism, followed by the Enterococcus faecalis, coagulase-negative Staphylococcus and the Pseudomona aeruginosa. A single microorganism grew in 31 out of the 36 positive cultures. 2.--The prevalence of the infection or colonization of the prostatic tissue was 25.1% (44 patients). The most common isolated microorganism was the coagulase-negative Staphylococcus followed by the Escherichia coli and the Enterococcus faecalis, in concentrations of at least 10(4) UFC/gr of tissue in the 79.6%. A single microorganism was isolated in 32 out of 44 patients. 3.--The proportion of positive prostatic cultures, in patients with positive urine culture (38.3%), was significantly higher than the one obtained in patients with negative urine cultures (16.5%) (p < 0.0001). Nevertheless, 52.3% of the 44 patients with positive prostatic cultures had negative urine culture, and only 21 (58.3%) out of the 36 patients with positive urine cultures presented a bacteriological growth in prostate. The degree of concordance (Kappa index) between the microorganisms which were found in preoperative urine and prostatic tissue is low or none for the majority of them.