Minimally-invasive management of prostatic abscess: The role of transrectal ultrasound

Abstract

Context and Aim:Prostatic abscess is an unusual condition. The prevalence of prostatic abscess is about 0.5% of all prostatic diseases. The purpose of the study is to present and discuss the role of transrectal ultrasound (TRUS) in the management of prostatic abscess. Settings and Design: Retrospective study. Materials and Methods:We retrospectively reviewed the medical records of all eight patients diagnosed and treated for prostatic abscess in the last threeyears. TRUS was used for diagnosis in all cases. Four patients had TRUS guided aspiration for management of prostatic abscess. Data collected regarding etiology, clinical features, investigations and treatment was compared with the available literature. Results: The age of patients ranged from 18-65 yrs (mean 47.12 yrs). Out of the eight patients, six were diabetics. TRUS revealed one or more hypoechoic areas within the prostate in all the patients. Successful treatment of prostatic abscess with TRUS guided needle aspiration was done in all fourpatients in whom it was used. Mean hospitalization time was 9.4 days, and most frequent bacterial agent was S. aureus. Conclusions: TRUS is useful in diagnosis as well as in guidance for aspiration of such abscesses. TRUS guided needle aspiration is an effective method for treating prostatic abscess. Most of the patients are diabetics and usually grow Staphaureus. So an antibiotic with staphylococcal coverage should be used empirically. Abstract Minimally-invasive management of prostatic abscess:The role of transrectal ultrasound

Transrectal ultrasound-guided aspiration versus transurethral deroofing of prostatic abscess: A prospective randomized study

“…In the other three patients no culture was done of retrieved pus. [ 14 ] Elwagdy et al . 2015 reported E. coli in about 78% of their 18 patients with prostatic abscess by pus culture.…”

Transurethral Resection of Prostate Abscess: Is It Different from Conventional Transurethral Resection for Benign Prostatic Hyperplasia?

“…However, the technique of transurethral drainage of prostatic abscess is not clear. The available options include limited interventional techniques (TUI and TUD) [5, 6, 8, 9] and the “more” invasive method like TURP [1, 8, 9]. Although all these methods have been described to be effective for draining prostate abscess, frequent complications encountered include septicemia, hemorrhage, residual abscess, retrograde ejaculation, and urinary incontinence.…”

“…Although all these methods have been described to be effective for draining prostate abscess, frequent complications encountered include septicemia, hemorrhage, residual abscess, retrograde ejaculation, and urinary incontinence. The techniques of TUI and TUD have the advantages of minimal invasion with a disease-specific treatment approach and less chances of complications [3, 6]. However, the major disadvantage of these methods is the risk of incomplete drainage of abscess.…”

“…The diagnosis and localization of prostatic abscess have been facilitated with the advent of TRUS and axial imaging [4–6, 13, 14]. These modalities can exactly define the location, size, and number of abscess cavities and help in the management.…”

Prostatic abscess

“…We read the interesting article "Minimally-invasive management of prostatic abscess: The role of transrectal ultrasound"[ 1 ]. Authors have emphasized that TRUS (transrectal ultrasound) guided needle aspiration is an effective method for treating prostatic abscess.…”