The Comparison of Imaging and Clinical Methods to Estimate Prostate Volume: A Single-Centre Retrospective Study.

BACKGROUND: Prostate volume (PV) is a useful tool in risk stratification, diagnosis, and follow-up of numerous prostatic diseases including prostate cancer and benign prostatic hypertrophy. There is currently no accepted ideal PV measurement method. OBJECTIVE: This study compares multiple means of PV estimation, including digital rectal examination (DRE), transrectal ultrasound (TRUS), and magnetic resonance imaging (MRI), and radical prostatectomy specimens to determine the best volume measurement style. METHODS: A retrospective, observational, single-site study with patients identified using an institutional database was performed. A total of 197 patients who underwent robot-assisted radical prostatectomy were considered. Data collected included age, serum PSA at the time of the prostate biopsy, clinical T stage, Gleason score, and PVs for each of the following methods: DRE, TRUS, MRI, and surgical specimen weight (SPW) and volume. RESULTS: A paired t test was performed, which reported a statistically significant difference between PV measures (DRE, TRUS, MRI ellipsoid, MRI bullet, SP ellipsoid, and SP bullet) and the actual prostate weight. Lowest differences were reported for SP ellipsoid volume (M = -2.37; standard deviation [SD] = 10.227; t[167] = -3.011; and p = 0.003), MRI ellipsoid volume (M = -4.318; SD = 9.53; t[167] = -5.87; and p = 0.000), and MRI bullet volume (M = 5.31; SD = 10.77; t[167] = 6.387; and p = 0.000). CONCLUSION: The PV obtained by MRI has proven to correlate with the PV obtained via auto-segmentation software as well as actual SPW, while also being more cost-effective and time-efficient. Therefore, demonstrating that MRI estimated the PV is an adequate method for use in clinical practice for therapeutic planning and patient follow-up.

Actinomyces odontolyticus infection 3 months post-robotic-assisted laparoscopic prostatectomy.

Actinomyces odontolyticus infection is a rare bacterial infection with only 46 cases reported from its discovery in 1958. This case highlights an immunocompetent patient who presented with an infected lymphocele and bacteraemia following a robotic-assisted laparoscopic prostatectomy and extended pelvic lymph node dissection 3 months previously. He was treated for a fever of unclear origin initially using amoxicillin, gentamicin and metronidazole. Subsequently, he was found to have an infected lymphocele, which required surgical drainage. He was discharged 19 days after admission with three times daily oral amoxicillin which is to be continued for 6-12 months. This case highlights the need for effective communication between the laboratory and medical teams, and the importance of prompt source control.