minocycline and Prostatic-Diseases

The patient was an 81-year-old man who visited a clinic for fever and lower abdominal pain. He was subsequently diagnosed with prostatitis based on computed tomography (CT) findings that showed swelling of the prostate. Despite treatment with antibacterial therapy, his symptoms did not improve significantly. Since the patient also had myelodysplastic syndrome, he was transferred to our hospital and subsequently diagnosed with prostate abscess based on findings on magnetic resonance imaging (MRI). The abscess had spread widely from the dorsal side of the trigone of the bladder to anterior wall of the rectum. Transperineal drainage was performed to preserve the urethral mucosa of the prostatic urethra. Considering the shape of the abscess cavity, one pigtail catheter was placed in the prostate and another was placed transperineally on the dorsal side of the trigone of the bladder. Cystostomy was performed at the same time. Culture of the abscess revealed the presence of Staphylococcus aureus. As there was little exudate from the abscess 9 days after drainage, the pigtail catheter on the dorsal side of the trigone of the bladder was removed following an injection of minocycline into the abscess. CT showed shrinkage of the abscess 4 days later, and the remaining intraprostatic pigtail catheter was removed after an injection of minocycline. The cystostomy pigtail catheter was subsequently removed since the patient was able to urinate smoothly after clamping. MRI confirmed the disappearance of the abscess cavity 2 months later.

Topics: Abscess; Aged, 80 and over; Drainage; Humans; Male; Minocycline; Prostate; Prostatic Diseases

We treated three patients who had symptomatic prostatic cysts by transrectal ultrasound-guided puncture, drainage, and sclerotherapy. The procedure and the results are described in this report.. The patients were 60, 73, and 78 years old and complained of difficult voiding. With local anesthesia, transrectal ultrasound-guided puncture and drainage were performed, and then 100 mg of minocycline hydrochloride was infused into the cavity of the cyst. We evaluated the International Prostate Symptom Score (IPSS), urodynamic data, volume of residual urine, complications, and recurrence.. There were no complications, and improvements of voiding symptoms were experienced without any recurrences within the 2 years or more of follow-up.. This minimally invasive treatment by transrectal ultrasound-guided puncture, drainage, and minocycline hydrochloride sclerotherapy is suggested to be promising for the symptomatic prostatic cyst.

Topics: Aged; Combined Modality Therapy; Cysts; Drainage; Endosonography; Follow-Up Studies; Humans; Male; Middle Aged; Minocycline; Prostatic Diseases; Punctures; Rectum; Sampling Studies; Sclerotherapy; Severity of Illness Index; Treatment Outcome; Urodynamics

In 6 patients, ranging in age from 26 to 71 years, we analyzed aspirated fluid and histologically studied cystic lesions located at the midline of the prostate.. Digital rectal examination, ultrasonography, magnetic resonance imaging, and aspiration of cystic fluid were performed to evaluate size, contents, and location of the cystic lesion. A 22-gauge needle was inserted into the cystic lesion perineally under ultrasound guidance. After extracting fluid for cytology and measurement of prostate-specific antigen (PSA) and prostatic acid phosphatase (PAP), a specimen from the prostate involving the cystic wall was collected. Hematoxylin-eosin staining and immunohistochemical staining for PSA were performed.. All aspirated fluid specimens were yellowish and clear without any sperm or malignant cells. The PSA levels in the fluid ranged between 90 and 670 x 10(4) ng/ml, while the PAP levels were between 168 and 4,000 ng/ml. These levels of PSA and PAP were significantly higher as compared with those in the serum. The cystic wall was lined with cuboidal or columnar epithelium. Some epithelial cells from the cystic wall showed positive immunostaining for PSA.. Not all cystic lesions located at the midline of the prostate are müllerian duct cysts, and there is a high probability that the lesion could be a cystadenoma or a simple cyst of the prostate.

Topics: Acid Phosphatase; Adult; Aged; Anti-Bacterial Agents; Biopsy, Needle; Body Fluids; Cysts; Endosonography; Follow-Up Studies; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Minocycline; Mullerian Ducts; Prostate; Prostate-Specific Antigen; Prostatic Diseases; Retrospective Studies

Ureaplasma urealyticum has been considered to be a pathogen of nongonococcal urethritis. To elucidate the pathogenicity of this microorganism in chronic prostatitis, U. urealyticum was isolated from patients with chronic prostatitis and prostatodynia. Using the Taylor-Robinson's method, U. urealyticum was detected in expressed prostatic secretion (EPS) or urine voided after prostatic massage (VB3) in 40 (41.2%) out of 97 patients with chronic prostatitis and 6 (20.0%) out of 30 patients with prostatodynia. Seventeen patients with U. urealyticum-positive chronic prostatitis, 13 of whom had failed to respond to the treatment by other antimicrobial agents, were treated with minocycline. In 16 (94.1%) of the 17 patients, U. urealyticum was eradicated and in 14 patients (82.4%), the elevated white blood cell count was markedly lowered in EPS or VB3. U. urealyticum may prove to be an etiological microorganism of chronic prostatitis.

Topics: Chronic Disease; Humans; Male; Minocycline; Pain; Prostatic Diseases; Prostatitis; Ureaplasma