Objective: To explore the feasibility and effectiveness of "one-puncture one-needle" transrectal ultrasound (TRUS)-guided prostate biopsy in the prevention of postoperative infections. METHODS: We retrospectively analyzed the clinical data about "one-puncture one-needle" (the observation group) and "one-person one-needle" (the control group) TRUS-guided prostate biopsy performed in the Second People's Hospital of Guangdong Province from January 2005 to December 2015, and compared the incidence rates of puncture-related infection between the two strategies. By "one-puncture one-needle", one needle was used for one biopsy puncture, while by "one-person one-needle", one needle was used for all biopsy punctures in one patient and the needle was sterilized with iodophor after each puncture. RESULTS: Totally, 120 patients received 6+1-core or 12+1-core "one-person one-needle" and 466 underwent 12+1-core "one-puncture one-needle" TRUS-guided prostate biopsy. There were no statistically significant differences between the two groups of patients in age, the prostate volume, the serum PSA level, or the detection rate of prostate cancer (P >0.05). Compared with the control group, the observation group showed remarkably lower incidence rates of puncture-related urinary tract infection (7.5% vs 0.9%, P <0.05), fever (5.0% vs 1.1%, P <0.05), bacteriuria (2.5% vs 0.2%, P <0.05), and total infections (16.7% vs 2.6%, P<0.05) postoperatively. Two cases of bacteremia or sepsis were found in each of the groups, with no significant difference between the two. CONCLUSIONS "One-puncture one-needle" TRUS-guided prostate biopsy can effectively prevent puncture-related infections.
Bacteremia ; etiology ; Biopsy, Fine-Needle ; adverse effects ; instrumentation ; methods ; Case-Control Studies ; Feasibility Studies ; Humans ; Male ; Prostate ; pathology ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; blood ; pathology ; Retrospective Studies ; Sterilization ; methods ; Ultrasonography, Interventional ; Urinary Tract Infections ; prevention & control

OBJECTIVETo study the preventive effect of herbal formulation on experimental murine urinary tract infection (UTI) induced by Dr Escherichia coli 11128.

METHODSE. coli 11128 carrying Dr fimbriae was isolated from patients with chronic pyelonephritis. The minimal inhibitory concentration (MIC) value of herbal solution for E. coli 11128 was determined for further studies. Forty C3H/HeJ mice were divided into the herb-treated group (n=20, given Chinese herbs by gavage at an average dose of 20 g/kg body weight daily 3 days before inoculation), and control group (n=20, given the same amount of distilled water by gavage). Three and 6 days after infection, bacteria were counted in the urine and the kidneys of the mice. Kidney histopathologic changes were evaluated. Neutrophils infiltration and accumulation were detected.

RESULTSThe MIC value of herbal solution was 0.1 g/mL for the E. coli 11128. In herb-treated mice, there was a significant reduction in bacterial counts in urine and colonization densities of kidneys. Microscopic studies revealed signs of inflammation in kidneys. In herb-treated mice, herbal administration resulted in significantly reduced neutrophilic infiltrates (P<0.05). The semi-quantitative scores for renal lesions were significantly lower (P<0.05).

CONCLUSIONProphylactic administration of herbal formulation potentiated the effect in partially preventing experimental murine ascending UTI.

Animals ; Disease Models, Animal ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Escherichia coli ; drug effects ; Escherichia coli Infections ; drug therapy ; prevention & control ; Female ; Kidney ; drug effects ; pathology ; Mice, Inbred C3H ; Phytotherapy ; Urinary Tract Infections ; drug therapy ; microbiology ; prevention & control

OBJECTIVETo explore the correlation between single acupoints used and the recurrence rate of cystitis among cystitis-prone women receiving acupuncture as a prophylactic treatment.

METHODSIn all, 58 cystitis-prone women were included in the analysis. Customised acupuncture treatments were given twice a week, over 4 weeks. The main effect parameter was the number of cystitis episodes during the 6-month observation time. Residual urine was measured at baseline, 2, 4 and 6 months using portable ultrasound equipment. Sympathetic and vagotone nerve activities were measured by using skin conductance and respiratory sinus arrhythmia, respectively.

RESULTSThe main acupoints used for patients with Kidney (Shen) qi/yang deficiency were Shenshu (BL23), Taixi (KI3), Zhongji (CV3), Sanyinjiao (SP6) and Pangguangshu (BL28), compared with Taichong (LR3), CV3, BL28, Yinlingquan (SP9) and SP6 for Liver (Gan) qi stagnation, and SP6, CV3, BL28, Zusanli (ST36) and SP9 for Spleen (Pi) qi/yang deficiency patients. The combination BL23 and KI3 were used in 16 women, 13 of which were Kidney pattern related patients. When used, the number of symptomatic episodes were reduced to a third compared with what occurred in the 42 women where this combination was not used (3/16 vs. 28/42, P<0.05). BL23 application correlated to a significant reduction in residual urine measured a few days after treatment. Patients with the pattern of Spleen qi/yang deficiency had an initial increase in residual urine after treatments.

CONCLUSIONTreating Kidney pattern related patients with the combination of BL23 and KI3 resulted in far better outcome than other points/combination of points for other Chinese medicine diagnoses. The acupoint SP6 may be less indicated than previously assumed when treating cystitis-prone women prophylactically.

Acupuncture Points ; Acupuncture Therapy ; Cystitis ; physiopathology ; prevention & control ; therapy ; urine ; Female ; Humans ; Recurrence ; Syndrome ; Urinary Tract Infections ; physiopathology ; prevention & control ; therapy ; urine ; Vagus Nerve ; physiopathology

Infectious complications after transrectal ultrasound-guided prostate biopsy (TRUS-Bx) appear to be increasing, which reflects the high prevalence of antibiotic-resistant strains of Enterobacteriaceae. Identifying patients at high risk for antibiotic resistance with history taking is an important initial step. Targeted prophylaxis with a prebiopsy rectal swab culture or augmented antibiotic prophylaxis can be considered for patients at high risk of antibiotic resistance. If infectious complications are suspected, the presence of urosepsis should be evaluated and adequate antibiotic treatment should be started immediately.
Anti-Bacterial Agents/therapeutic use ; Antibiotic Prophylaxis ; Biopsy/*adverse effects ; Drug Resistance, Bacterial ; Escherichia coli Infections/drug therapy/*prevention & control ; Humans ; Male ; Prostate/*pathology ; *Ultrasound, High-Intensity Focused, Transrectal ; Urinary Tract Infections/*drug therapy/microbiology

PURPOSE: Complications after prostate biopsy have increased and various causes have been reported. Growing evidence of increasing quinolone resistance is of particular concern. In the current retrospective study, we evaluated the incidence of infectious complications after prostate biopsy and identified the risk factors. MATERIALS AND METHODS: The study population included 1,195 patients who underwent a prostate biopsy between January 2007 and December 2012 at Chung-Ang University Hospital. Cases of febrile UTI that occurred within 7 days were investigated. Clinical information included age, prostate-specific antigen, prostate volume, hypertension, diabetes, body mass index, and biopsy done in the quinolone-resistance era. Patients received quinolone (250 mg intravenously) before and after the procedure, and quinolone (250 mg) was orally administered twice daily for 3 days. We used univariate and multivariate analysis to investigate the predictive factors for febrile UTI. RESULTS: Febrile UTI developed in 39 cases (3.1%). Core numbers increased from 2007 (8 cores) to 2012 (12 cores) and quinolone-resistant bacteria began to appear in 2010 (quinolone-resistance era). In the univariate analysis, core number> or =12 (p=0.024), body mass index (BMI)>25 kg/m2 (p=0.004), and biopsy done in the quinolone-resistance era (p=0.014) were significant factors. However, in the multivariate analysis adjusted for core number, the results were not significant, with the exception of BMI>25 kg/m2 (p=0.011) and biopsy during the quinolone-resistance era (p=0.035), which were significantly associated with febrile UTI. CONCLUSIONS: Quinolone resistance is the main cause of postbiopsy infections in our center. We suggest that further evaluation is required to validate similar trends. Novel strategies to find alternative prophylactic agents are also necessary.
Aged ; Anti-Bacterial Agents/*therapeutic use ; Antibiotic Prophylaxis/methods ; Cross Infection/etiology/prevention & control ; *Drug Resistance, Bacterial ; Fluoroquinolones/*therapeutic use ; Humans ; Image-Guided Biopsy/*adverse effects/methods ; Incidence ; Male ; Middle Aged ; Prostatic Neoplasms/*pathology ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Ultrasonography, Interventional ; Urinary Tract Infections/epidemiology/*etiology/prevention & control

This multicenter study was undertaken to determine the efficacy of antibiotic prophylaxis and identify the risk factors for infectious complications after prostate surgery in Korean patients. A total of 424 patients who underwent surgery of the prostate were reviewed. All patients underwent urinalysis and urine culture preoperatively and postoperatively. Efficacy of antibiotic prophylaxis and risk factors for infectious complications were investigated. Infectious complications were observed in 34.9% of all patients. Factors independently associated with infectious complications were diabetes mellitus (adjusted OR, 1.99; 95% CI, 1.09-3.65, P=0.025) and operation time (adjusted OR, 1.08; 95% CI, 1.03-1.13, P=0.004). Clinicians should be aware of the high risk of infectious complications in patients with diabetes and those who undergo a prolonged operation time. Neither the type nor duration of prophylactic antibiotics resulted in differences in infectious complications.
Aged ; Anti-Bacterial Agents/pharmacology/therapeutic use ; Antibiotic Prophylaxis ; Diabetes Mellitus, Type 2/complications ; Drug Resistance, Bacterial/drug effects ; Enterococcus/drug effects/isolation & purification ; Escherichia coli/isolation & purification ; Humans ; Klebsiella pneumoniae/drug effects/isolation & purification ; Male ; Middle Aged ; Odds Ratio ; Postoperative Complications/microbiology/prevention & control ; Prospective Studies ; Prostatic Neoplasms/complications/*surgery ; Quinolones/pharmacology ; Risk Factors ; Time Factors ; Transurethral Resection of Prostate ; Urinalysis ; Urinary Tract Infections/microbiology

Increasingly accumulated results from randomized controlled trials and other clinical studies have demonstrated that male circumcision reduces the risks of acquisition and transmission of HIV, HPV, HSV-2, and other sexually transmitted infections, and thus has a potential role in preventing cervical cancer, penile cancer and prostate cancer. The prevalence of male circumcision in China is currently less than 5%. The clinical evaluation studies and randomized controlled trials of the Shang Ring device showed excellent safety profiles, extremely high acceptability, and satisfaction among the participants and service providers in Africa and China. Given the recent recommendations by the World Health Organization and the Joint United Nations Program on HIV/AIDS (UNAIDS), voluntary medical male circumcision should be promoted in China at the national level as an important alternative intervention to reduce reproductive tract infections and prevent both males and females from reproductive tract cancers. More emphasis is required on the studies of the long-term health benefits of male circumcision in uro-andrology.
China ; Circumcision, Male ; Female ; HIV Infections ; prevention & control ; Humans ; Male ; Penile Neoplasms ; prevention & control ; Prevalence ; Randomized Controlled Trials as Topic ; Sexually Transmitted Diseases ; prevention & control ; Urinary Tract Infections ; prevention & control ; Uterine Cervical Neoplasms ; prevention & control ; World Health Organization

OBJECTIVETo discuss the effect and safety of preventive administration of antibiotics to patients with benign prostatic hyperplasia (BPH) before urodynamic examination.

METHODSA total of 256 BPH patients to undergo urodynamic examination were randomly divided into a control group (n = 118) and a trial group (n = 138). The former received no pre-treatment while the latter were given cefoxitin sodium iv at 1.0 g 30 minutes before complete urodynamic examination. Then we compared the incidence rates of urinary tract infection between the two groups.

RESULTSStatistically significant differences were found in the incidence rate of urinary tract infection between the control and trial groups (20.3% [24/118] vs 7.3% [10/138], P < 0.01), as well as in those with diabetes mellitus (6.7% [3/45] vs 23.5% [8/34], P < 0.05), those with residual urine > 50 ml (5.4% [3/56] vs 18.5% [10/54], P < 0.05), and those with both diabetes mellitus and residual urine (9.5% [2/21] vs 44.4% [8/18], P < 0.05). Only 3 patients (2.2%) in the trial group had mild adverse drug reactions.

CONCLUSIONFor BPH patients, particularly those with diabetes mellitus and residual urine, preventive administration of antibiotics before urodynamic examination is safe and can effectively protect the patients against urinary tract infection.

Antibiotic Prophylaxis ; Cefoxitin ; administration & dosage ; Humans ; Male ; Prostatic Hyperplasia ; diagnosis ; Urinary Tract Infections ; prevention & control ; Urodynamics

PURPOSE: Urinary tract infection (UTI) is an ascending infection of fecal uropathogens, urogenital lactobacilli are suggested to play a role in the prevention of UTI. This study was to investigate whether lactobacillus mixture (LM) could prevent the experimental infantile UTI. MATERIALS AND METHODS: The LM were composed of three lactobacillus strains (L. gasseri, L. rhamnosus, and L. reuteri). Mother rats were grouped as lactobacillus (LB) group I (LB I, n=22), II (LB II, n=24) and control (n=20). LB I and LB II were fed with LM (1 mL/day) and control with phosphate-buffered saline (PBS) from late pregnancy through lactation. All newborn rats were breast-fed and their urine and stool were collected at the end of the 3rd week to compare lactobacillus colony. Then, infant rats from LB II were treated with intravesical instillation of LM. Infant rats from LB I and control were instilled with PBS. Twenty-four hours later, experimental UTI was introduced by intravesical instillation of standard E. coli strain. After 72 hours later, the infant rats were sacrificed for histologic examination. RESULTS: Lactobacilli colonies in urine and stool were not statistically different among the three groups. The incidence of pyelonephritis in the LB II was 16.7% (4/24), LB I 72.7% (16.22) and control 75.0% (15/20) (p=0.015). The incidence of cystitis was not significantly different among the three groups. CONCLUSION: The intravesically instilled LM significantly prevented experimental pyelonephritis in infant rats, however, LM administered orally to the pregnant and lactating mother rats did not.
Animals ; Escherichia coli Infections/*prevention & control ; *Lactobacillus ; Probiotics/*therapeutic use ; Rats ; Rats, Sprague-Dawley ; Urinary Tract Infections/*prevention & control

OBJECTIVETo analyze the relationship between the prognosis and clinical factors of primary vesicoureteral reflux (VUR) patients under the condition of non-surgical treatment.

METHODThe medical records of the patients who were diagnosed as VUR by micturating cystourethrography (MCU) from January 2000 to December 2009 in Children's Hospital of Fudan University underwent non-surgical treatment, and followed up for more than one year then had repeated MCU, were retrospectively reviewed.

RESULTA total of 73 children (30 boys, 43 girls) were included in this study. The percentage of mild reflux (grade I-II) was 19.2% (14/73), that of moderate reflux (grade III) was 53.4% (39/73), and that of severe reflux (grade IV-V) was 27.4% (20/73). Among 73 patients, 27 (37.0%) patients were found to have renal damage. The average interval of repeated MCU was (1.29 ± 0.40) years (1 - 2 years). After follow-up, it was found that the reflux grade was relieved in 41 (56.2%) patients, of whom 27 (37.0%) patients achieved complete resolution, 32 (43.8%) patients did not have remission in reflux grade, of whom 13 (17.8%) patients had worsened reflux grade. Logistic regression analysis showed that VUR patients with renal damage at initial diagnosis was an important clinical factor to affect reflux remission (P = 0.000), complete resolving (P = 0.008) and result in worsening (P = 0.002).

CONCLUSIONA certain proportion of primary VUR patients could get reflux grade self-resolution, it was also quite common in severe VUR patients. VUR patients with renal damage at initial diagnosis was an important clinical factor affecting the reflux grade prognosis. Mild and moderate VUR patients with renal damage were at risk of worsening. VUR patients with high reflux grade had normal renal status could still get remission or even disappearance of VUR. But severe VUR patients with renal damage were still recommended to receive surgical therapy.

Anti-Bacterial Agents ; administration & dosage ; therapeutic use ; Child ; Child, Preschool ; Cicatrix ; Female ; Humans ; Infant ; Kidney Diseases ; epidemiology ; etiology ; pathology ; Male ; Prognosis ; Retrospective Studies ; Risk Factors ; Severity of Illness Index ; Survival Rate ; Urinary Tract Infections ; epidemiology ; etiology ; prevention & control ; Urography ; Vesico-Ureteral Reflux ; complications ; drug therapy ; pathology