Efficacy of chemotherapy for prostatic tuberculosis-a clinical and histologic follow-up study.
OBJECTIVE
To characterize the clinical features of prostatic tuberculosis and to evaluate the short and long-term results of antituberculous chemotherapy.


METHODS
Eighteen patients (mean age 66.7 +/- 10.2 years) with prostatic tuberculosis were included in this study. The median pretreatment prostate-specific antigen (PSA) level was 2.7 ng/mL (range 0.3 to 31). The PSA level was greater than 4.0 ng/mL in 6 patients (33.3%). Eight patients (44.4%) received a triple-drug regimen of rifampin, ethambutol, and isoniazid for more than 6 months. The mean duration of chemotherapy was 7.6 months (range 6 to 12). Of the 8 patients, 3 underwent chemotherapy longer because of concurrent tuberculosis of other organs. Follow-up studies included digital rectal examination, total PSA determination, and transrectal prostate biopsy.


RESULTS
Ten patients were eligible for regular follow-up. All the patients were symptom free during follow-up. The median length of follow-up was 3.4 years (range 1 to 9). The average number of follow-up transrectal prostate biopsies was 2.4 (range 2 to 3). The follow-up histologic findings showed nodular hyperplasia in 7 patients and chronic inflammatory cell infiltration in 3 patients. No acid-fast bacillus was found in any follow-up specimen. Similarly, subsequent transrectal biopsy showed no relapse after a median length of 3.4 years of follow-up. Of the 6 patients with elevated PSA levels, the post-treatment PSA returned to normal in 3 patients.


CONCLUSIONS
Our results suggest that a triple-drug regimen of 6 months' duration can successfully control prostatic tuberculosis. Histologic follow-up is a good method for monitoring the efficacy of treatment. Transrectal prostate biopsy is an important tool for the diagnosis and follow-up of prostatic tuberculosis.
Lee
Y
Y
Department ofSurgery, Veterans General Hospital-Kaohsiung and National Yang Ming University School of Medicine, Republic of, Taiwan, China.
Huang
W
W
Huang
J
J
Wang
J
J
Yu
C
C
Jiaan
B
B
Huang
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use*; D001706:Biopsy; D004977:Ethambutol / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010173:Palpation / Q000706:statistics & numerical data; D017430:Prostate-Specific Antigen / Q000097:blood; D011469:Prostatic Diseases / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D012293:Rifampin / Q000627:therapeutic use; D016896:Treatment Outcome; D014389:Tuberculosis, Male Genital / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology
D000995:Antitubercular Agents; D004977:Ethambutol; D017430:Prostate-Specific Antigen; D007538:Isoniazid; D012293:Rifampin