Positive urine culture prior to transrectal prostate biopsy was not associated with infectious complications development.

OBJECTIVE: Prostate cancer is one of the most common cancers worldwide. Its histological diagnosis is based on prostate biopsy. The transrectal procedure is one of the most common procedures performed by urologists. Although it is considered safe, post-biopsy infectious complications are frequently observed in practice. The aim of this study is to investigate the value of urine culture before the transrectal biopsy. Secondly, we assessed potential risk factors for infectious complications following TR-PB. METHODS: We performed a retrospective analysis of all patients who underwent urine culture tests before transrectal prostate biopsy between January 2019 and July 2020. The inclusion criteria for the study were all indications for prostate biopsy (PSA>4ng/mL or abnormal digital rectal examination). Baseline characteristics and the incidence of post-biopsy urinary tract infection were compared between patients showing positive pre-biopsy culture results and those showing negative findings. Multivariate logistic regression analyses were used to determine risk factors for infectious complications following TR-PB. RESULTS: Out of 163 patients included in our study, 19 patients (11.65%) had positive urine culture results before the biopsy. Age (P=0.068); history of hospitalization (P>0.999), history previous of quinolone use (P=0.75), history of UTI (P=0.64); median PSA level at diagnosis (P=0.267); prostate volume (P=0.78); post-void residual volume (P=0.374); percentage of patients testing positive for cancer on biopsy (P=0.81); and percentages of patients with a history of biopsy (P=0.889), diabetes mellitus (P=0.524), hypertension (P=0.714) and immunosuppressive medication use (P>0.999) were similar between the two groups. One patient in the positive urine culture group had post-biopsy prostatitis. However, 3.24% (five patients) of the negative urine culture group had the disease (P=0.789) (four patients with prostatitis and one with epididymitis). Among them, four patients were diagnosed by urine culture at the time of post-biopsy urinary tract infection. Multivariate logistic regression analysis demonstrated that history of hospitalization and history of previous quinolone use were risk factors for infection after transrectal prostate biopsy. CONCLUSION: Our study suggests that systematically performing urine cultures before transrectal prostate biopsy does not reduce the rate of infectious complications after biopsy. Positive pre-biopsy cultures were not associated with the development of post-biopsy infectious complications.

[Impact of bilateral varicocelectomy in infertile men]. / Impact de la varicocélectomie bilatérale chez l'homme hypofertile.

BACKGROUND: Although the progress in diagnosis methods revealed a high incidence of infra-clinical varicocele, the clinical signification of this pathology is controversial. We compared left unilateral varicocelectomy to bilateral surgery in patients with left clinical varicocele associated to an infra-clinical right one. PATIENTS AND METHODS: It is a retrospective study conducted between January 2007 and December 2015 concerning men followed for a varicocele related infertility (one-year or more primary infertility) with two altered sperm analysis (oligospermia and/or asthenospermia) and had a left clinical varicocele associated to right infra-clinical one detected at Doppler Ultrasound. Surgical techniques used were open surgery (sub-inguinal way), antegrade sclerotherapy and coelioscopy. All patients were reviewed with a 6 month post operatively spermogram and minimum follow up of 1 year. RESULTS: Our study included 95 men. Thirty-five patients have had a unilateral left surgery (Group I) and 60 patients have had a bilateral surgical treatment (Group II). The pre-operative spermatic parameters (concentration and progressive mobility) were comparable for the 2 groups. After the surgical treatment, an improvement of these parameters was noted in all the patients without significant difference between the two groups regarding sperm concentration (24.07±9.36×106/mL Vs 23.29±3.88×106/mL) and their progressive mobility (30.47±9.04% Vs 32.39±9.54%). The spontaneous pregnancy rate was 22.8% for patients in group I and 26.6% for those in group II without any statistically difference (p=0.68). CONCLUSION: Treatment of a right s infra-clinical varicocele, when combined with a left clinical varicocele, gave better results in terms of sperm parameters and spontaneous pregnancy than unilateral varicocelectomy but without statistically significant results. LEVEL OF EVIDENCE: 3.

A rare case of chronic penile suppuration associated with fibromatosis.

Spontaneous penile abscess is rare. Without effective treatment, penile abscesses could evolve into a chronic form with fatal consequences.A subtotal penectomy was performed for a 51-year-old man with no medical history who presented a chronic penile suppuration mimicking tumor.

[Do the nephrolithometry scoring systems predict the success of percutaneous nephrolithotomy. Comparison of 4 scores: The Guy's stone score, STONE Score, CROES nomogram and S-ReSC score]. / Les scores radiologiques peuvent-t-ils prédire le succès de la NLPC ? Étude comparative du Guy's stone score, du STONE score, du CROES nomogram, et du S-ReSc score.

INTRODUCTION: The aim of the study is to investigate the factors predictive of surgical outcomes of PCNL and to compare the predictability and accuracy of the Guy's stone score, STONE nephrolithometry, CROES nomogram and S-ReSC score. PATIENTS AND METHODS: We reviewed retrospectively the surgical outcomes recorded consecutively and imaging data of preoperative computed tomography scans of patients who underwent PCNL from 2013 to 2016. Patients with asymptomatic residual fragments<4mm were considered stone-free. Preoperative abdominopelvic computerized tomography images of the patients were reviewed and scored according The Guy's stone score, STONE nephrolithometry, CROES nomogram, S-ReSC score by one urologist. RESULTS: A total of 157 PCNLs were reviewed. The overall stone-free rate was 59% (92/157) with a complication rate of 22% (35/157). Stone Burden<542mm3 is significantly associated with stone-free rate (SFR) (P=0.001). On univariate analysis, all the scoring systems were identified as significant factors in terms of SFR. The Guy's Stone Score, the CROES score and the S-ReSC score were associated with complications (P<0.02). The multivariate logistic regression analysis showed that the CROES score was identified as a significant factor in terms of SFR and complications (P<0.01). The area under the receiver operating characteristic (ROC) curves for stone burden, the Guy's, STONE score, CROES core and S-ReSC scores showed good results (0.737/0.674/0.762/0.746/0.710) respectively. CONCLUSION: Although the four scoring systems were significantly associated with SFR, the STONE score was a significant predictive factor for SFR and complications after PCNL. LEVEL OF EVIDENCE: 3.