Actualidad en manejo de abcesos prostáticos: a propósito de un caso

Frago, P. Serrano; Losa, C. Allepuz; Alonso, A. Fantova; Valdenebro, A. Marco; López, M. Allué; Sanz, Libia

doi:10.4321/s0210-48062006000700012

Cited by 2 publications

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“…Initially, some prostate microabscesses can appear if they do not respond adequately to antibiotic treatment or no treatment is started, which can lead to the onset of a prostate abscess of different dimensions. The germs most frequently isolated are Gram-negative bacilli, E. coli being the most common and isolated in 60-80% of the cases [1][2][3][4][5] . There are not that many references about this pathology in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…1 ). Blood tests showed leukocytosis (23,580/mm 3 with a shift to the left), thrombocytopenia 102,000/mm 3 , mild coagulopathy, creatinine 3.1 mg/dl, and plasma creatinine 26-75 mg/ dl. A vesical catheter was placed, urine culture and hemoculture extracted, and antibiotic treatment started with meropenem 1 g/ 24 h for the renal failure.…”

Section: Percutaneous Drainage Of Prostatic Abscessmentioning

confidence: 99%

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Percutaneous Drainage of Prostatic Abscess: Case Report and Literature Review

2011

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The incidence of prostatic abscess is 0.5% in relation to all prostate pathologies and usually occurs in patients with diabetes or with some degree of immunosuppression. The case of a male patient, 84 years old, with a history of arterial hypertension and mild renal failure, presenting high fever, prostate syndrome, genital edema and constipation is reported. He was diagnosed with prostate abscess via transrectal ultrasonography (TRUS). Treatment was started with empirical meropenem and a puncture of the abscess was performed transperineally under TRUS guidance placing an 8-Fr nephrostomy tube for 36 h. The patient was discharged 48 h after the puncture with a good prognosis. TRUS-guided transperineal drainage is a safe, adequate and effective treatment for prostate abscess, and allows the placement of drainage for several hours thereby avoiding the communication between the abscessed cavity and the urethra or rectum. Therefore, after having reviewed the literature, we consider this approach suitable for drainage.

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Section: Discussionmentioning

confidence: 99%

Section: Percutaneous Drainage Of Prostatic Abscessmentioning

confidence: 99%

Percutaneous Drainage of Prostatic Abscess: Case Report and Literature Review

2011

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“…T A B L E 1 A list of the case reports and case studies in which transperineal drainage of prostate abscesses was performed. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]…”

Section: Technique Descriptionmentioning

confidence: 99%

Transperineal drainage of prostate abscesses: A minimally invasive, low‐risk management strategy that yields satisfactory results

Scholtz,

Hooshyari,

Vermeulen

et al. 2023

BJUI Compass

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ObjectivesIn this narrative review, we aim to present two cases of transperineal drainage of prostate abscesses with a good clinical outcome. Furthermore, we reviewed the literature on this treatment approach and aim to propose a minimally invasive protocol for managing this rare condition.Patients and MethodsOur patients are 33‐ and 61‐year‐old males who both underwent uncomplicated transperineal drainage of prostate abscess with the use of a Precision Point device with rapid clinical improvement and complete resolution of the abscess within the follow‐up period. We used PubMed to conduct a literature search and included and evaluated 16 relevant case reports and case series in which the authors utilized transperineal drainage techniques for prostatic abscesses.ResultsOur first patient was young and very unwell with sepsis and a pulmonary embolism. He had a complex abscess extending through the prostate to the left pelvic side wall. Trans‐gluteal drainage of the pelvic side‐wall collection was required in addition to transperineal drainage of the prostate abscess. After drainage and a prolonged course of antibiotics, he achieved resolution of the abscess by 7 weeks with ejaculatory function intact. Our second patient who was very keen on the preservation of ejaculatory function had multiple small abscesses and underwent transperineal drainage. He had significant interval improvement of his abscess burden at the 4‐week follow‐up and complete resolution at the 6‐month follow‐up. The total number of cases in the literature on our review is 22, with considerable variability in how the authors managed the prostate abscesses that underwent transperineal drainage, including variability in their follow‐up time frame, choice of imaging modality, duration of antibiotic treatment, drain placement, and use of irrigation solutions (including antibiotics) into the abscess cavity. Furthermore, the sizes of the prostate abscesses were not consistently reported. Given the small sample size and variability in management from different authors, it was not possible to draw any statistical analysis.ConclusionTransperineal prostate abscess drainage combined with prolonged antibiotic therapy provides a less invasive alternative to treating prostate abscesses for those who which to preserve ejaculatory function and avoid the other adverse events of transurethral de‐roofing. In itself, it can achieve complete resolution of abscess. It provides the benefit of drainage under real‐time imaging; for percutaneous drain placement; prevents urethral injury; retrograde ejaculation; and can be done under local anaesthetic which is preferable for the unstable patient. The utility of the procedure may be limited by the complexity of the abscess or whether it has extended beyond the prostate. The patient should always be informed that further drainage via percutaneous methods or transurethral methods may be necessary if their clinical condition does not improve. We recommend this procedure be offered as an alternative to transurethral methods in younger patients and those who would like to preserve ejaculatory function. Furthermore, we highly encourage a prolonged course of antibiotic therapy and interval follow‐up with clinical review of symptoms and imaging to confirm resolution.

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Actualidad en manejo de abcesos prostáticos: a propósito de un caso

Cited by 2 publications

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Percutaneous Drainage of Prostatic Abscess: Case Report and Literature Review

Percutaneous Drainage of Prostatic Abscess: Case Report and Literature Review

Transperineal drainage of prostate abscesses: A minimally invasive, low‐risk management strategy that yields satisfactory results

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