Cadaveric and radiologic study of the anatomical variations of the prostatic arteries: A review of the literature and a new classification proposal with application to prostatectomy.

Development of prostatic arterial embolization (PAE) to treat benign prostatic hyperplasia (BPH) has raised interest in the variations of the prostatic arteries (PA). The aim of this study is to identify these vascular variations, to compare them with previous data, and to propose a simple classification. Ten adult male pelvis sides from embalmed cadavers were dissected, ages 69 to 92 years, and 10 PA were examined. In a retrospective analysis of 34 DSA pelvic angiographies on 28 patients aged 50 to 90 years, 48 PA were identified. A total of 58 PA were therefore analyzed. Six types are defined. Type I: PA originates from the anterior division (AD) of the internal iliac artery (IIA), 20.7%; Type II: PA emerges from the obturator artery (OA), 5.2%; type III: PA arises from the gluteal-pudendal trunk (GPT), 27.5%; Type IV: PA originates from the internal pudendal artery (IPA), 29.3%; Type V: PA comes from the middle rectal artery (MRA), 15.5%. Other origins, not observed in our sample but described in the literature, were amalgamated under Type VI. The AD/GPT/IPA stem is the main source of the PA. Analysis of the definitions of IIA branches and the associated terminology is necessary for interpreting the results reported by several authors on different samples, but in general the results fit the meta-analysis well. A new, simple, and complete classification for vascular variations of the PA is proposed. Clin. Anat. 30:71-80, 2017. © 2016 Wiley Periodicals, Inc.

Effect of intrarectal povidone-iodine in the incidence of infectious complications after transrectal prostatic biopsy.

OBJECTIVES: To assess the incidence of genitourinary infections associated with transrectal ultrasound-guided prostate biopsy (TRUS-BX) using endorectal povidone-iodine gel as a bactericidal agent. METHODS: We prospectively studied a total of 530 patients who were given 30g of 10% povidone-iodine intrarectally before TRUS-BX. Each patient received antibiotic prophylaxis with ciprofloxacin, starting the previous day (1g/day x 3 days), as well as cleansing enemas. RESULTS: One patient (0.20%) presented with an E. coli acute bacterial epididymitis after biopsy. CONCLUSIONS: In our study, the intrarectal use of 10% povidone-iodine gel in TRUS-BX is associated with a much lower rate of infectious complications compared to those described in recent literature.

El gel de yodopovidona intrarectal en la incidencia de complicaciones infecciosas tras biopsia prostática transrectal / Effect of intrarectal povidone-iodine in the incidence of infectious complications after transrectal prostatic biopsy

OBJETIVO: Evaluar la incidencia de infecciones genitourinarias asociadas a las biopsias prostáticas transrectales ecoguiadas (BPTRE) utilizando el gel de yodopovidona endorectal como agente bactericida. MÉTODOS: Se evaluaron prospectivamente un total de 530 pacientes a los que se aplicó 30 gr de yodopovidona intrarectal al 10% antes de la realización de BPTRE. En todos los pacientes se realizó profilaxis antibiótica con ciprofloxacino, iniciada el día anterior (1 gr/día/ 3/días) y enema de limpieza. RESULTADOS: Un paciente (0,2%) presentó una orquiepididimitis bacteriana aguda por E. coli después de la biopsia. CONCLUSIONES: En nuestro estudio, el uso intrarectal del gel de yodopovidona al 10% en las BPTRE se asocia a una tasa de complicaciones infecciosas muy inferior a las descritas en las series más recientes de la literatura(AU)

OBJECTIVES: To assess the incidence of genitourinary infections associated with transrectal ultrasound-guided prostate biopsy (TRUS-BX) using endorectal povidone-iodine gel as a bactericidal agent. METHODS: We prospectively studied a total of 530 patients who were given 30g of 10% povidone-iodine intrarectally before TRUS-BX. Each patient received antibiotic prophylaxis with ciprofloxacin, starteing the previous day (1g/day x 3 days), as well as cleansing enemas. RESULTS: One patient (0.20%) presented with an E. coli acute bacterial epididymitis after biopsy. CONCLUSIONS: In our study, the intarrectal use of 10% povidone-iodine gel in TRUS-BX is associated with a much lower rate of infectious complications compared to those described in recent literature(AU)

Fluorescence in situ hybridization analysis of matched primary tumour and lymph-node metastasis of D1 (pT2-3pN1M0) prostate cancer.

OBJECTIVE: To describe the chromosomal numerical changes present in primary prostate tumours and their matched lymph-node metastases, to identify a clonal cell migration process which could account for the metastatic behaviour. MATERIALS AND METHODS: Twenty-eight cases of unsuspected stage D1 (pT2-3pN1M0) prostate cancer were detected among patients who had a radical prostatectomy for clinically localized prostate cancer. Fluorescence in situ hybridization (FISH), using centromeric probes to enumerate chromosomes 7, 8, 10 and 12, was used to assess numerical chromosomal changes. FISH analysis was used on isolated nuclei obtained from matched primary tumours and their lymph node metastases. RESULTS: Of the 28 suitable cases it was possible to complete the study in 18 pairs of matched tissues; the remainder were excluded because of insufficient tissue or poor preservation of at least one of the tissues. There was cytogenetic change (aneuploidy) in 16 of the 18 primary tumours, the most common being monosomy 8, detected in 14, followed by trisomy 7, in 13 aneuploid tumours. All lymph node metastases were aneuploid by FISH. As in the primary tumours, monosomy 8 and trisomy 7 were the most common cytogenetic alterations, in 13 and 15 of the lymph node tissues. FISH analysis showed a high correlation (83%) in the cytogenetic pattern of changes between the primary tumours and their lymph node metastases. Moreover, a similar number of cells had the most common aneusomies when comparing prostate and the lymph node tissues. CONCLUSIONS: These results show a similar pattern of cytogenetic alteration in the primary tumour and its lymph node metastasis, characterized by the frequent presence of trisomy 7 and monosomy 8, suggesting that clonal cell selection is not involved in the metastatic process.