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Urinary Tract Infections and prostate cancer

Urinary Tract Infections

In considering urinary tract infections we must remember that “pus” is a sign of underlying disease, and is not a disease itself. In the presence of normal anatomic relationships of the organs of the urinary tract with normal function and adequate drainage, a urinary tract infection is a self limited disease. Sulfa drugs and antibiotics therefore merely hasten the recovery. If there is poor drainage, if there is any abnormal anatomic relationship, if there are pathologic changes such as the presence of stone, tumor, etc., sulfa drugs or antibiotics may aid in overcoming the acute phase of an infection, but will not cure the disease. Presistence in using these antibacterial agents will therefore do more harm than good.

Frequently this results in the overgrowth of a mutant antibiotic resistant strain of bacteria, leaving the patient with a serious chronic disease. It becomes important therefore to do a complete and thorough urologic study of any patient who does not respond promptly and adequately to medication.

Cancer of the Prostate

There is no substitute for the index finger in making a presumptive diagnosis of cancer of the prostate. When suspicion of cancer is raised on routine rectal examination, corroborative biopsy is imperative before instituting treatment. Needle biopsy through the perineum or biopsy through a perinea! exposure of the prostate are both satisfactory methods. Transurethral biopsy is the least satisfactory because so often the carcinoma is in the posterior lobe of the prostate and, although transrectal biopsies have been recently recommended, I can not feel that I am justified in exposing my patient to this Hazard.

It should be remembered that cancer of the prostate in the great majority of cases arises in the posterior lobe of the organ and may be asymptomatic until comparatively late in its course. Hence early cancer may be detected only by routine rectal examination. There is no substitute for the educated finger. Methods of obtaining adequate biopsy specimens are our only new advances in diagnosis, and a biopsy has become essential.

Posted in General Health