■美国国立卫生研究院(NIH)II类前列腺炎对抗生素治疗具有挑战性。我们介绍了一系列经过各种手术治疗的男性病例的结果。此外,我们对慢性细菌性前列腺炎(CBP)手术治疗患者的特点和结局进行了范围综述.
■这是克利夫兰诊所Glickman泌尿外科和肾脏研究所的成人患者的单中心回顾性病例系列,治疗难治性NIHII类前列腺炎,并进行手术干预。查询PubMed,并分析所有所得文章的相关性和平行研究设计。
■12名受试者接受了内镜手术。12名受试者中有2名(16.7%)在12个月和60个月时出现大肠杆菌CBP复发;两名患者最初都有前列腺结石。一名CBP复发患者出现尿道狭窄。七名受试者接受了保留神经的机器人根治性前列腺切除术治疗,其中两名患有前列腺癌。三个受试者有前列腺结石,其中两个延伸到手术囊之外。大肠杆菌是6名患者的分离病原体,其中2名是多重耐药(MDR)大肠杆菌。尽管进行了手术,该组中的一名患者仍经历了复发性尿路感染(UTI)。对现有文章的范围审查始终没有提及在手术干预之前使用前列腺分泌培养物甚至尿液培养物进行CBP的明确诊断,也没有发现有关手术干预的治疗结果的研究。
■我们的研究提供了首个单中心回顾性病例系列之一,该系列病例包括抗生素难治性NIHII类CBP患者,并进行手术干预。总的来说,所有手术方式的治愈率为84%(n=16).当疾病局限于手术包膜时,内镜治疗可能就足够了.与内窥镜干预相比,根治性前列腺切除术有望增加术后勃起功能障碍和压力性尿失禁的发生率。然而,在患有包膜外疾病和/或伴随前列腺癌的患者中,先前的内窥镜治疗,或危及生命的UTI,根治性前列腺切除术可能是合理的。
UNASSIGNED: National Institutes of Health (NIH) category II
prostatitis refractory to antibiotic therapy can be challenging to treat. We present the outcomes from a
case series of men who have undergone various surgical therapies to treat this condition. Additionally, we performed a scoping review of studies describing the characteristics and outcomes of patients surgically treated for chronic bacterial prostatitis (CBP).
UNASSIGNED: This is a single-center retrospective
case series of adult patients at Cleveland Clinic Glickman Urological and Kidney Institute with refractory NIH category II
prostatitis managed with surgical intervention. PubMed was queried and all resulting articles were analyzed for relevance and parallel study designs.
UNASSIGNED: Twelve subjects underwent endoscopic procedures. Two of 12 (16.7%) subjects had CBP recurrence with E. Coli at 12 and 60 months; both patients initially had prostatic stones. One patient with CBP recurrence developed a urethral stricture. Seven subjects were treated with nerve-sparing robotic radical prostatectomy of whom two had concomitant prostate cancer. Three subjects had prostate stones, two of which extended beyond the surgical capsule. E. coli was the isolated pathogen for six patients with two of these being multi-drug resistant (MDR) E. coli. One patient in this group experienced recurrent urinary tract infections (UTIs) despite the surgery. Scoping review of available articles consistently failed to mention definitive diagnosis of CBP with prostatic secretion cultures or even urine cultures prior to surgical intervention and no studies were found on the curative outcomes of surgical intervention.
UNASSIGNED: Our study provides one of the first single-center retrospective
case series of patients with antibiotic refractory NIH category II CBP managed with surgical intervention. Overall, rate of cure between all surgical modalities was 84% (n=16). When disease is confined to the surgical capsule, endoscopic management is likely sufficient. Radical prostatectomy expectedly increased rates of postoperative erectile dysfunction and stress urinary incontinence compared to endoscopic intervention. However, in patients with disease beyond the capsule and/or concomitant prostate cancer, prior endoscopic treatment, or life-threatening UTI, radical prostatectomy may be justified.