PROSTATIC ABSCESS| A report of 25 Cases1

Dajani, A. M.; O'flynn, J. Dermot

doi:10.1111/j.1464-410x.1968.tb11875.x

Cited by 44 publications

(13 citation statements)

References 6 publications

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“…Surgical drainage should be performed for multifocal abscesses greater than 1 cm in diameter, septic shock, recurrent abscess, or in patients responding poorly to antibiotics for 3 days or longer. Traditionally, open perineal incision or transurethral resection was recommended as the method of choice [5,6]. …”

Section: Discussionmentioning

confidence: 99%

Treatment of Prostatic Abscess: Case Collection and Comparison of Treatment Methods

Jang

Lee

et al. 2012

Korean J Urol

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PurposeProstatic abscess is an uncommon urologic disease but has a high mortality rate if not treated properly. Furthermore, diagnosis and proper treatment of prostatic abscesses remains a challenge for physicians. Therefore, we compared data on conservative treatments, transurethral resection of prostatic abscess, and transrectal ultrasound (TRUS)-guided needle aspiration in 52 cases over a 10-year period.Materials and MethodsThe records of 52 patients diagnosed with prostatic abscess by computed tomography at Gangnam Severance Hospital between January 2000 and September 2010 were retrospectively reviewed. All patients were discharged when their leukocytosis had normalized and they had been free of fever for 2 days. Multivariate regression analysis was done to determine independent risk factors for the length of hospitalization.ResultsAt the time of diagnosis, the average age of the 52 patients was 61.3 years (range, 33 to 81 years), the average volume of the prostate was 56.3 ml (range, 21 to 223 ml), the average prostate-specific antigen was 18.54 ng/ml (range, 2.0 to 57.0 ng/ml), and the average abscess size was 3.8 cm (range, 2.1 to 5.5 cm). All patients were treated with parenteral antibiotics during their hospital stay with intravenous antibiotics (fluoroquinolone monotherapy or 3rd-generation cephalosporin in combination with an aminoglycoside). Of 52 patients, 22 had diabetes mellitus (42.3%), 19 had hypertension (36.5%), and 7 (13.5%) had paraplegia due to spinal cord injury. The most common symptoms were fever (47, 90.4%), perineal discomfort (43, 82.7%), dysuria (40, 76.9%), and urinary retention (29, 55.8%). Prostatic abscesses were treated by conservative treatment (11 cases), transurethral resection of prostatic abscess (23 cases), and TRUS-guided needle aspiration (18 cases). The average hospitalization stay was 17.5 days (range, 6 to 39 days); that of conservative treatment patients was 19.1 days (range, 9 to 39 days). Patients treated by transurethral resection of prostatic abscess and TRUS-guided needle aspiration stayed 10.2 days (range, 6 to 15 days) and 23.25 days (range, 18 to 34 days), respectively. Of the 18 cases who underwent needle aspiration, prostatic abscesses recurred in 4 cases (22.2%) within 1 month after patient discharge. The 2 patients subjected to conservative treatment died due to sepsis. We found no independent factors that affected the average hospitalization period.ConclusionsPatients with prostatic abscess treated by transurethral resection of the prostate had a significantly shorter hospitalization length compared with needle aspiration.

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Section: Discussionmentioning

confidence: 99%

Treatment of Prostatic Abscess: Case Collection and Comparison of Treatment Methods

Jang

Lee

et al. 2012

Korean J Urol

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“…Although this technique sounds practical, it involves additional trained manpower and extra equipment and is cumbersome to perform. Secondly, many elderly men with prolonged history of lower urinary tract symptoms (LUTS) have a component of benign prostatic hyperplasia (BPH), which may not respond to limited drainage or may require another surgical intervention (in the form of TURP) in the lifetime [3, 12]. …”

Section: Discussionmentioning

confidence: 99%

“…In major published studies, up to one third of the patients suffering from prostatic abscess ultimately required TURP [8, 9, 12]. In one of the largest series of 25-patients by Dajani and O'Flynn, two patients underwent TURP as the primary procedure because of associated prostate enlargement.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2013

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Purpose. To present our experience of prostate abscess management by modified transurethral resection (TUR) technique. Methods. Seventeen men with prostate abscess undergoing TUR between 2003 and 2011 were retrospectively analyzed. Details of demography, surgical procedures, complications, and followup were noted. Results. With a mean age of 61.53 ± 8.58 years, all patients had multifocal abscess cavities. Initially, 6 men underwent classical TUR similar to the technique used for benign prostatic enlargement (group 1). Next, 11 men underwent modified TUR (group 2) in which bladder neck and anterior zone were not resected. The abscess cavities resolved completely, and no patient required a second intervention. One patient in group 1 and three in group 2 had postoperative fever requiring parenteral antibiotics (P = 0.916). Three patients in group 1 had transient urinary incontinence, whereas none of the patients in group 2 had this complication (P = 0.055). Four and five men in group 1 and 2 reported retrograde ejaculation, respectively (P = 0.740). Conclusion. The modified technique of prostate resection edges over conventional TURP in the form of reduced morbidity but maintains its high success rate for complete abscess drainage. It alleviates the need for secondary procedures, having an apparent advantage over limited drainage techniques. Use of this technique is emphasized in cases associated with BPH and lack of proper preoperative imaging.

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“…Although a long-term indwelling foley catheter could potentially obstruct urethral ducts, short-term (<12 h) indwelling foley catheter insertion or in-and-out catheterization are appropriate [75,76]. Suprapubic cystotomy is also a viable option and avoids obstruction of the urethral ducts [77].…”

Section: Catheterization and Surgical Treatmentmentioning

confidence: 99%

Prostatitis and chronic prostatitis/chronic pelvic pain syndrome

Bergman

Zeitlin

2007

Expert Review of Neurotherapeutics

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The prevalence of prostatitis is extremely high, with up to 16% of men diagnosed with prostatitis at some point throughout their lifetime. However, the etiology appears to be multifactorial and standard treatment regimens have been altered significantly in recent years. The purpose of this review is to examine the changing scientific views on the causes and treatment of prostatitis, chronic prostaitis and chronic pelvic pain syndrome. We review the infectious and noninfectious etiology of the disease, examining the role of antimicrobial treatment in eradicating infection as well as ameliorating symptoms. Current NIH classifications, which stratify prostatitis into four categories, are discussed, as is the NIH Chronic Prostatitis Symptom Index, the primary tool used to assess symptomatology. Diagnostic examinations are studying the need for the four-glass test and its practical replacement by the two-glass test. Multimodal treatment therapy is then discussed, including recent data on biofeedback and evaluation of the role of pelvic floor dysfunction in prostatitis.

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PROSTATIC ABSCESS| A report of 25 Cases1

Cited by 44 publications

References 6 publications

Treatment of Prostatic Abscess: Case Collection and Comparison of Treatment Methods

Treatment of Prostatic Abscess: Case Collection and Comparison of Treatment Methods

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

Prostatitis and chronic prostatitis/chronic pelvic pain syndrome

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