1/208. malacoplakia of the prostate confused with clear cell carcinoma. Primary malacoplakia of the prostate is a rare benign disease, which is frequently mistaken for carcinoma and granulomatous prostatis. The surgical and clinical course of a patient with obstructive hypertrophy of the prostate is reviewed after an initial incorrect diagnosis of clear cell carcinoma. Experience in defining the lesion during the transurethral resection is presented. The pathogenesis, morphological structure and unique microscopic appearance of malacoplakia, characterized by large mononuclear cells associated with small laminated concretions, are described and illustrated. ( info) |
2/208. Cryptococcal prostatic abscess in an immunocompromised patient: a case report and review of the literature. A case of cryptococcal prostatic abscess in a 65-year-old Chinese man with immunosuppression from treatment of myasthenia gravis is presented. The patient was diagnosed to have cryptococcaemia when he presented with fever and urinary symptoms. Further investigations confirmed cryptococcal meningitis and imaging studies showed a hypodense lesion in the prostate. This proved to be an abscess and it was deroofed transurethrally. histology of the prostatic tissue revealed the presence of cryptococcus. The prostate can be a site of persistent cryptococcal infection and may take the form of an abscess. It should be drained transurethrally to prevent relapse. ( info) |
3/208. Management of prostatic fistulas. Prostatic fistulas communicating with the rectum or perineal skin are unusual complications of a prostatic operation, pelvic trauma, prostatic abscess or other iatrogenic injury. A third of these fistulas may close spontaneously with proper urinary drainage and avoidance of fecal soilage. The many operative procedures described for the repair of these fistulas indicate that no ideal method of repair can be applied to every case. Operative management should be mandated by the size, location and duration of the fistula as well as by the surgeon's experience with the various anatomic approaches. ( info) |
4/208. Concomitant renal and prostatic aspergillosis. aspergillosis limited to the urinary tract is a rare disease seen most often in patients with altered immune status. Only 19 cases of renal aspergillosis including 3 with AIDS and 4 cases of isolated prostatic aspergillosis have been reported. We report the first case of concomitant renal and prostatic aspergillosis in a non-immunocompromised patient who presented with pyrexia of unknown origin and with dysuria. The diagnosis was based on the demonstration of characteristic hyphal elements on direct microscopy and isolation of the fungus in the culture of pus from the kidney. In view of obstructive prostatic enlargement and left non-functioning renal mass, transurethral resection of the prostate and left nephrectomy were performed in a single session with successful outcome. The aetiopathogenesis and brief review of the literature are discussed. ( info) |
5/208. A case of tuberculosis of the prostate. tuberculosis of the prostate is uncommon. However, the number of patients with tuberculosis has once again recently been gradually increasing in japan. The number of immunocompromised hosts, such as those with AIDS, is also increasing, suggesting that this rare infectious disease may increase in frequency in the near future. We present a case of tuberculosis of the prostate. ( info) |
| The advent of factor viii concentrates has made it possible for true hemophiliac patients to survive to an age when prostatic obstruction is common. Formerly, operative procedures in these patients were limited to life-threatening situations but now prostatic operations should not be feared as long as adequate serum levels of factor viii can be achieved and maintained throughout the wound healing period. Allergic reactions, hepatitis and cost are significant factors to consider when the concentrates are administered but hemophiliac patients are able to undergo treatment without a significantly increased risk to their lives. ( info) |
7/208. Prostatorectal fistula associated with tubular colorectal duplication. Tubular colonic duplications are exceedingly rare. The authors present an unusual case of a boy with a persistent prostatorectal fistula resulting from a tubular colorectal duplication. The current case is unique for 2 reasons: (1) the presence of a fistula without any concomitant genitourinary anomalies and (2) the existence of a prostatorectal fistula. ( info) |
8/208. A case of rectoprostatic fistula due to prostatic abscess visualized by barium enema. We report a rare case of rectoprostatic fistula due to spontaneous rupture of a prostatic abscess in a patient with diabetes mellitus. barium enema clearly showed rectoprostatic fistula. barium enema and colonoscopy were very useful in demonstrating the rectoprostatic fistula. ( info) |
| histoplasmosis is a common cause of systemic mycosis in areas of the united states where it is endemic. central nervous system and genitourinary histoplasmosis is rare, especially in immunocompetent hosts. We describe a case of disseminated histoplasmosis in a normal host that was associated with cerebral and prostatic histoplasmosis presenting as fever of undetermined origin, weight loss, and severe debilitating altered mental status. The patient subsequently developed acute renal failure that manifested as obstructive uropathy during antifungal therapy with amphotericin b. Transurethral resection of the prostate resulted in improved renal function during continuation of amphotericin b therapy. Pathological analysis of the prostate revealed necrotizing granulomas with intralesional fungal organisms. blood and urine cultures were positive for histoplasma capsulatum. Diagnostic issues and management are discussed. Treatment resulted in return of normal cognitive and motor function. This case is compared with the 8 previously reported cases of H. capsulatum prostatitis. ( info) |
10/208. Clinical features and management of anterior intraurethral prostatic cyst. We report on a symptomatic anterior intraurethral prostatic cyst in a 46-year-old man without clinical evidence of benign prostatic hyperplasia. The anterior location of this cyst makes it unique to all previously reported cases of prostatic cysts which are located posteriorly. Transurethral resection of the cyst with limited resection of the anterior prostatic tissue at the base of the cyst was performed with successful resolution of voiding symptoms. In the absence of lateral lobe hypertrophy, standard transurethral resection of the prostate should be avoided to ensure preservation of erectile and ejaculatory function. ( info) |