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Elmogassabi A, Gul T, Tallai B, Alrayashi M, Abdelkareem M, Ibrahim M, Baker A, Ebrahim M, Alnawasra H, Alhabash S, Salah M. Successful management of emphysematous prostatic abscess and concurrent liver abscess: A rare case report. Urol Case Rep 2023; 51:102571. [PMID: 37818411 PMCID: PMC10561036 DOI: 10.1016/j.eucr.2023.102571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/14/2023] [Accepted: 09/20/2023] [Indexed: 10/12/2023] Open
Abstract
Emphysematous prostatic abscess (EPA) is a rare condition characterized by gas and abscess accumulation in the prostate. In this case report we report a successfully treated EPA with liver abscess due to Klebsiella pneumoniae in a 49-year-old man. He was admitted with abdominal pain and fever. Physical examination revealed tender, palpable resonance urinary bladder, and prostatic tenderness on rectal digital examination. High inflammatory markers were found. Abdominal computer tomography (CT) confirmed EPA. The patient was treated with broad-spectrum antibiotics, strict blood glucose control, suprapubic catheterization, and transurethral deroofing of the prostatic abscess. After three weeks patient discharged in good condition.
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Affiliation(s)
- Abdoulhafid Elmogassabi
- Urology Section, Surgery Department, Hazm Mebaireek General Hospital, Hamad Medical Corporation, Qatar
| | - Tawiz Gul
- Urology Section, Surgery Department, Hazm Mebaireek General Hospital, Hamad Medical Corporation, Qatar
- College of Medicine, Qatar University, Doha, Qatar
| | - Bela Tallai
- Urology Section, Surgery Department, Hazm Mebaireek General Hospital, Hamad Medical Corporation, Qatar
| | - Maged Alrayashi
- Urology Section, Surgery Department, Hazm Mebaireek General Hospital, Hamad Medical Corporation, Qatar
| | - Mohamed Abdelkareem
- Urology Section, Surgery Department, Hazm Mebaireek General Hospital, Hamad Medical Corporation, Qatar
| | - Mohammed Ibrahim
- Urology Section, Surgery Department, Hazm Mebaireek General Hospital, Hamad Medical Corporation, Qatar
| | - Abu Baker
- Urology Section, Surgery Department, Hazm Mebaireek General Hospital, Hamad Medical Corporation, Qatar
| | - Mohammed Ebrahim
- Urology Section, Surgery Department, Hazm Mebaireek General Hospital, Hamad Medical Corporation, Qatar
| | - Hossameldin Alnawasra
- Urology Section, Surgery Department, Hazm Mebaireek General Hospital, Hamad Medical Corporation, Qatar
| | - Salvan Alhabash
- Urology Section, Surgery Department, Hazm Mebaireek General Hospital, Hamad Medical Corporation, Qatar
| | - Morshed Salah
- Urology Section, Surgery Department, Hazm Mebaireek General Hospital, Hamad Medical Corporation, Qatar
- College of Medicine, Qatar University, Doha, Qatar
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Tariq A, Stewart AG, Desai DJ, Britton S, Dunglison N, Esler R, Roberts MJ. Periurethral abscess etiology, risk factors, treatment options, and outcomes: A systematic review. Curr Urol 2023; 17:100-108. [PMID: 37691985 PMCID: PMC10489258 DOI: 10.1097/cu9.0000000000000159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 05/23/2022] [Indexed: 11/06/2022] Open
Abstract
Objectives This study aimed to describe patterns of presentation, etiology, risk factors, management, and treatment outcomes of periurethral abscesses using a systematic review framework. Materials and methods After prospective registration on the PROSPERO database (CRD42020193063), a systematic review of Web of Science, Embase, PubMed, and Cochrane scientific databases was performed. Articles published between 1900 and 2021 were considered. Extracted data included symptoms, etiology, medical history, investigations, treatment, and outcomes. Collated data were analyzed using univariate methods. Results Sixty articles met the inclusion criteria reporting on 270 patients (211 male, 59 female) with periurethral abscess. The most common clinical features were pain (41.5%), pyuria (41.5%), dysuria (38.5%), urinary frequency (32.3%), fever (25%), and a palpable mass (23%). Predisposing risk factors included the presence of a sexually transmitted infection or urinary tract infection (55.0%), urethral strictures (39.6%), and recent urethral instrumentation (18.7%). Management approaches included open incision and drainage (64.3%), conservative management with antibiotics (29.8%), and minimally invasive techniques (needle aspiration, endoscopic drainage). Time trend analysis of etiology revealed a decreased incidence of infection (sexually transmitted infection/urinary tract infection, human immunodeficiency virus) and higher incidence of diabetes mellitus and periurethral bulking injections in recent years. Conclusions Periurethral abscesses may display a wide range of clinical features. Presentation, risk factors and underlying etiology vary with sex. The optimal management technique is guided by abscess size. Open incision and drainage combined with antibiotics continues to be the mainstay of management. However, minimally invasive techniques are gaining favor. To the authors' knowledge, this is the first systematic appraisal and management algorithm for periurethral abscess.
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Affiliation(s)
- Arsalan Tariq
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Adam G. Stewart
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Department of Infectious Diseases, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
- Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia
| | - Devang J. Desai
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Department of Urology, Toowoomba Base Hospital, Toowoomba, QLD, Australia
| | - Sumudu Britton
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Department of Infectious Diseases, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Nigel Dunglison
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Rachel Esler
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Matthew J. Roberts
- Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
- Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
- Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia
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Hwang JH, Hwang JH, Lee SY, Lee J. Prostatic Abscess Caused by Klebsiella pneumoniae: A 6-Year Single-Center Study. J Clin Med 2022; 11:jcm11092521. [PMID: 35566647 PMCID: PMC9099488 DOI: 10.3390/jcm11092521] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 02/04/2023] Open
Abstract
Hypervirulent Klebsiella pneumoniae (hvKp) is an important strain that can cause multiple organ infections. Although hvKp infection cases are increasing, there is limited information on the prostatic abscesses caused by K. pneumoniae. Furthermore, the clinical significance of hvKp associated with K1 or K2 capsular types or virulence genes in prostatic abscesses remains unclear. Therefore, we aimed to elucidate the clinical and microbiological characteristics of prostatic abscesses caused by K. pneumoniae in relation to various virulence genes. A retrospective study was performed at a 1200-bed tertiary hospital between January 2014 and December 2019. Patients diagnosed with prostatic abscesses with K. pneumoniae isolated from blood, urine, pus, or tissue cultures were enrolled in this study. Our results demonstrate that 30.3% (10/33) of the prostatic abscesses were caused by K. pneumoniae. All strains isolated from patients with prostatic abscesses due to K. pneumoniae were the K1 capsular type, and eight patients (80.0%) carried rmpA and iutA genes that identified hvKp. These findings suggest that hvKp is an important pathogen in prostatic abscesses. Therefore, when treating patients with K. pneumoniae prostatic abscesses, attention should be paid to the characteristics of hvKp, such as bacteremia, multiorgan abscess formation, and metastatic spread.
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Affiliation(s)
- Joo-Hee Hwang
- Department of Internal Medicine, Jeonbuk National University Medical School and Hospital, Jeonju 54907, Korea; (J.-H.H.); (J.-H.H.)
- Research Institute of Clinical Medicine of Jeonbuk National University—Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju 54907, Korea;
| | - Jeong-Hwan Hwang
- Department of Internal Medicine, Jeonbuk National University Medical School and Hospital, Jeonju 54907, Korea; (J.-H.H.); (J.-H.H.)
- Research Institute of Clinical Medicine of Jeonbuk National University—Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju 54907, Korea;
| | - Seung Yeob Lee
- Research Institute of Clinical Medicine of Jeonbuk National University—Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju 54907, Korea;
- Department of Laboratory Medicine, Jeonbuk National University Medical School and Hospital, Jeonju 54907, Korea
| | - Jaehyeon Lee
- Research Institute of Clinical Medicine of Jeonbuk National University—Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju 54907, Korea;
- Department of Laboratory Medicine, Jeonbuk National University Medical School and Hospital, Jeonju 54907, Korea
- Correspondence: ; Tel.: +82-63-250-2693
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Pathak A, Shrestha M, Khanna S, Nanavati J, Prasad O, Gupta A, Mistry T. Contemporary management of prostatic abscess: Our experience. Urol Ann 2022; 14:135-140. [PMID: 35711491 PMCID: PMC9197006 DOI: 10.4103/ua.ua_161_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 04/28/2021] [Indexed: 12/02/2022] Open
Abstract
Introduction: Prostatic abscess is a serious urological problem that needs immediate attention due to its high morbidity and mortality in absence of appropriate treatment. The objective of our study is to evaluate the efficacy and safety of various modalities of management of prostatic abscess: medical management (MM), transrectal ultrasound-guided aspiration (TRUS-GA), and transurethral deroofing (TU-DR Methods: This retrospective study was done in a tertiary care center after taking approval from the institutional review board. Conservative management was done by oral or parenteral medications. Transrectal ultrasound GAs were performed under local anesthesia with an 18-gauge two-part needle. Collapse of cavity was seen in “real time” on TRUS. TU-DR of the prostate was done by 26 French continuous irrigation monopolar resectoscopes. The aspirated pus was sent for microbiological investigation. Results: TRUS-guided aspiration was performed in 20 patients, TU-DR in five patients, and conservative management in 15 patients. The mean volume of abscess aspirated by TRUS guidance was 13 cc (range 8–50 cc) with single-time aspiration in 85% of cases. Re-aspiration was done in 3 patients. The mean volume of abscess was 33.2 cc (range: 25–40 cc) in TU-DR group and 1.2 cc (range 0.5–2.0 cc) in the MM group. The predominant organism isolated was Escherichia coli (48%). Clinical improvement was seen in 97.5% of cases. Conclusion: We suggest TRUS-GA for symptomatic patients with abscess size more than 2 cc and TU-DR if TRUS-GA fails or is contraindicated.
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Shakur A, Hames K, O'Shea A, Harisinghani MG. Prostatitis: imaging appearances and diagnostic considerations. Clin Radiol 2021; 76:416-426. [PMID: 33632522 DOI: 10.1016/j.crad.2021.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 01/14/2021] [Indexed: 02/07/2023]
Abstract
Acute and chronic inflammation of the prostate gland can be attributed to several underlying aetiologies, including but not limited to, bacterial prostatitis, granulomatous prostatitis, and Immunoglobulin G4-related prostatitis. In this review, we provide an overview of the general imaging appearances of the different types of prostatitis, their distinguishing features and characteristic appearances at cross-sectional imaging. Common imaging pitfalls are presented and illustrated with examples.
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Affiliation(s)
- A Shakur
- Department of Radiology, Division of Abdominal Imaging, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.
| | - K Hames
- Department of Radiology, Hamilton General Hospital, 237 Barton Street E, Hamilton, Ontario, L8L 2X2, Canada
| | - A O'Shea
- Department of Radiology, Division of Abdominal Imaging, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
| | - M G Harisinghani
- Department of Radiology, Division of Abdominal Imaging, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA
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Alnadhari I, Sampige VRP, Abdeljaleel O, El Ansari W, Ali O, Salah M, Shamsodini A. Presentation, diagnosis, management, and outcomes of prostatic abscess: comparison of three treatment modalities. Ther Adv Urol 2020; 12:1756287220930627. [PMID: 32550860 PMCID: PMC7278333 DOI: 10.1177/1756287220930627] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 05/10/2020] [Indexed: 11/17/2022] Open
Abstract
Purpose The lack of available guidelines for the management of prostatic abscess (PA) results in inconsistencies in its management. The most commonly used management modalities were conservative treatment with parenteral antibiotics alone, transrectal ultrasound-guided (TRUS) needle aspiration, or transurethral deroofing (TUD).The current study is a retrospective study and examines prostatic abscess cases treated by either one or more of the different modalities. We assess and compare presentation, diagnosis, management, and outcomes of prostatic abscess and we compare the outcomes of the three management modalities. Methods We retrieved the records of all patients (n = 23) admitted to the Urology department at Al Wakra hospital with the computed tomography (CT) diagnosis of prostatic abscess from January 2013 to March 2018. Data collected included demographic, clinical, laboratory, and imaging findings, as well as management modality, duration of hospital stay, duration of follow up, outcome, and recurrence. Results A total of nine (39.1%) patients had conservative treatment only; eight (34.8%) had TUD, and six (26.1%) had TRUS needle aspiration. The mean age was 52.7 years. Lower urinary tract symptoms and fever were the most common presentations (95.7% and 82.6%, respectively). CT scan of the abdomen and pelvis with contrast was undertaken for all patients and it showed that multiple abscesses were observed in 14 (60.9%) cases.The overall mean hospital stay was 8.45 days (range 2-21 days). We observed no recurrences for patients treated conservatively or those who undertook TUD, but three patient (50%) recurrences were noted in TRUS aspiration patients. There was no mortality across the sample. Conclusion Early diagnosis of prostatic abscess and prompt management may have decreased the morbidity and mortality. Conservative management can succeed in subcentimeter abscesses but TUD is the definite therapy for large and multiloculated abscess. TRUS aspiration does have a role in treatment, but it has higher recurrence and longer hospital stay.
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Affiliation(s)
- Ibrahim Alnadhari
- Department of Urology, Al Wakra Hospital, Hamad Medical Corporation, Doha, Qatar
| | | | - Osama Abdeljaleel
- Department of Urology, Al Wakra Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Walid El Ansari
- Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Omar Ali
- Department of Urology, Al Wakra Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Morshed Salah
- Department of Urology, Al Wakra Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ahmad Shamsodini
- Department of Urology, Al Wakra Hospital, Hamad Medical Corporation, Doha, Qatar
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Staphylococcus aureus Prostatic Abscess in the Setting of Prolonged S. aureus Bacteremia. Case Rep Infect Dis 2020; 2020:7213838. [PMID: 32518699 PMCID: PMC7256736 DOI: 10.1155/2020/7213838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 03/28/2020] [Accepted: 05/06/2020] [Indexed: 11/17/2022] Open
Abstract
Staphylococcus aureus rarely causes prostatic abscess. We report five cases of S. aureus prostatic abscess in the setting of bacteremia at our institution that occurred between 12/2018 and 05/2019. Three of the cases were caused by MRSA, and four of the patients underwent drainage of the prostatic abscess. All five patients received a minimum of six weeks of antibiotic therapy. One of the five patients died during the course of their infection. S. aureus prostatic abscess with bacteremia is an uncommon but serious disease. Treatment should consist of a combination of prolonged antibiotic therapy and surgical drainage when feasible.
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Extensive Prostatic Abscess in an Elderly Patient Requiring Multidisciplinary Drainage. Case Rep Urol 2020; 2020:4398561. [PMID: 32566352 PMCID: PMC7298311 DOI: 10.1155/2020/4398561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 04/20/2020] [Accepted: 05/22/2020] [Indexed: 12/03/2022] Open
Abstract
Background. Prostatic abscess is rare and mainly affects immunocompromised individuals, classically presenting with both systemic and lower urinary tract symptoms. Our case is unique as the patient presented with an exceptionally long duration of symptoms prior to seeing a health-care provider, had no systemic symptoms, and was managed via a multidisciplinary approach. Case Presentation. We present a case of a 70-year-old man with type-two diabetes who endured two months of lower urinary tract symptoms and constipation without systemic symptoms prior to seeking medical attention. He had a positive urinalysis and culture and was initially thought to have a urinary tract infection; however, computed tomography scan revealed a large, complex, and multiloculated prostatic abscess. Multidisciplinary drainage of the abscess was performed by interventional radiology and urology. A postoperative Foley catheter was left in place, and the patient recovered without complications. Discussion. Prostatic abscess is uncommon and presents almost exclusively in patients with immunocompromising conditions such as diabetes. Prior to the advent of antibiotics, the major causes were gonorrheal and Staphylococcus aureus infections, but with the advent of antibiotics, microbial culprits have shifted to gram-negative organisms. Patients typically present with lower urinary tract symptoms, perineal or lower back pain, and systemic symptoms. Management often consists of intravenous antibiotics and surgical drainage either by transrectal ultrasound-guided needle aspiration, or transurethral deroofing of the prostate. Our case highlights the following: (a) the importance of a high index of suspicion for a prostatic abscess in an immunocompromised patient with persistent leukocytosis and perineal pain after treatment with antibiotics and (b) the potential for an early multidisciplinary approach to draining extensive, loculated prostatic abscesses.
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Khudhur H, Brunckhorst O, Muir G, Jalil R, Khan A, Ahmed K. Prostatic abscess: A systematic review of current diagnostic methods, treatment modalities and outcomes. Turk J Urol 2020; 46:tud.2020.19273. [PMID: 32479256 PMCID: PMC7360156 DOI: 10.5152/tud.2020.19273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 04/26/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Prostatic abscesses (PAs) are an uncommon urologic presentation with widely varying approaches in their diagnoses and management. This study, therefore, aims to systematically review the literature of PAs to identify common clinical presentations, evaluate currently utilized diagnostic and treatment modalities, and assess their outcomes. MATERIAL AND METHODS A systematic review of the literature was performed using the MEDLINE and EMBASE databases, from January 1968 to June 2019. Outcome measures extracted from identified articles included age, the underlying disease, identified pathogens, diagnostic tool utilized, treatment used, and various subsequent clinical outcomes. RESULTS The literature search yielded 683 articles, with a final twelve included in the review, representing a total of 210 patients. Transrectal ultrasonography (TRUS) was the most commonly used imaging tool used to identify PAs in all twelve studies. The PAs were treated with conservative antibiotic treatment in seven studies. Transurethral resection of the prostatic abscess (TURP) was utilized in eight studies with an average abscess size of 3.87 cm (3.0-4.0 cm) and with an average hospital stay of 10.22 days in those undergoing TURP. Transperineal aspiration was seen in five studies and offered a less invasive treatment modality. Finally, TRUS-guided needle aspiration was seen in seven studies with an average hospital stay of 23.25 days. This was the longest of any identified modalities with an additional high rate of abscess recurrence. CONCLUSION Diagnosis and treatment practices of PAs remain widely varied in the literature due to a lack of clear guidelines. Based on the current evidence, we provide recommendations of treatment based on abscess size, patient age, and clinical condition. While smaller abscesses may be suited to antibiotic or TRUS-guided aspiration, transurethral approaches should be considered for larger and more complex abscesses. However, the current evidence remains poor with further research required to determine the optimum treatment modalities for patients.
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Affiliation(s)
- Hasan Khudhur
- Department of Urology, King’s College Hospital, London, UK
| | - Oliver Brunckhorst
- MRC Centre for Transplantation, Guy’s Hospital Campus, King’s College London, King’s Health Partners, London, UK
| | - Gordon Muir
- Department of Urology, King’s College Hospital, London, UK
| | - Rozh Jalil
- Department of Urology, King’s College Hospital, London, UK
| | - Azhar Khan
- Department of Urology, King’s College Hospital, London, UK
| | - Kamran Ahmed
- Department of Urology, King’s College Hospital, London, UK
- MRC Centre for Transplantation, Guy’s Hospital Campus, King’s College London, King’s Health Partners, London, UK
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Walker B, Heidel E, Shorman M. Clinical Characteristics and Outcome of Staphylococcus aureus Prostate Abscess, Ten-Year Experience at a Tertiary Care Center. Open Forum Infect Dis 2019; 6:5552345. [PMID: 31430373 PMCID: PMC6767969 DOI: 10.1093/ofid/ofz372] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Prostatic abscess (PA) is an uncommon infection that is generally secondary to Escherichia coli and other members of the Enterobacteriaceae family. In recent years, although rare, more reports of Staphylococcus aureus (S. aureus) PA have been reported, especially with increasing reports of bacteremia associated with injection drug use (IDU). METHODS This was a retrospective review of adult patients admitted to a tertiary care hospital between 2008 and 2018 and who had a diagnosis of S. aureus PA. RESULTS Twenty-one patients were included. Average age was 46 years. Fourteen (67%) presented with genitourinary concerns. Main risk factors included concurrent skin or soft tissue infections in 52%, history of genitourinary disease or instrumentation in 48%, IDU in 38%, and diabetes mellitus in 38%. Methicillin-resistant staphylococcus aureus (MRSA) was identified in 57% and concomitant bacteremia in 81% of patients. Surgical or a radiologically guided drainage was performed in 81% of patients. Antibiotic treatment duration ranged from 3 to 8 weeks. Six patients were lost to follow-up. Clinical resolution was observed in the remaining 15 (81%) patients who had follow-up. CONCLUSIONS S. aureus prostate abscess (PA) continues to be a rare complication of S.aureus infections. MRSA is the culprit in most published reports. In high risk patients with persistent bacteremia physicians need to consider the prostate as a site of infection.
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Affiliation(s)
- Bryan Walker
- University of Tennessee, Graduate School of Medicine
| | - Eric Heidel
- University of Tennessee, Graduate School of Medicine
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Schattner A, Finn T, Glick Y, Dubin I. Prostate Abscesses and Staphylococcus aureus Bacteremia. Am J Med 2018; 131:e417-e418. [PMID: 29928861 DOI: 10.1016/j.amjmed.2018.05.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 05/24/2018] [Indexed: 11/16/2022]
Affiliation(s)
- Ami Schattner
- Department of Medicine, Laniado Hospital-Sanz Medical Center, Netanya, Israel; Faculty of Medicine, Hebrew University-Hadassah Medical School, Jerusalem, Israel.
| | - Talya Finn
- Department of Infectious Diseases, Laniado Hospital-Sanz Medical Center, Netanya, Israel
| | - Yair Glick
- Department of Imaging, Laniado Hospital-Sanz Medical Center, Netanya, Israel
| | - Ina Dubin
- Department of Medicine, Laniado Hospital-Sanz Medical Center, Netanya, Israel; Faculty of Medicine, Hebrew University-Hadassah Medical School, Jerusalem, Israel
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Selem M, Desoky E, Eliwa A, Fawzi A, Elkady E, Ali MM, Ragab A, Sakr A, Omran M, Kamel M. Transrectal ultrasound-guided aspiration versus transurethral deroofing of prostatic abscess: A prospective randomized study. Urol Ann 2018; 10:291-295. [PMID: 30089988 PMCID: PMC6060608 DOI: 10.4103/ua.ua_41_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Aims The aim of this study is to compare between transrectal ultrasound (TRUS)-guided aspiration and transurethral (TU) deroofing in the treatment of prostatic abscess regarding safety and efficacy. Settings and Design This prospective randomized study was done during the period between April 2009 and March 2015 and included 32 patients with prostatic abscess. Subjects and Methods All patients were enrolled in the study after obtaining a written informed consent and approval of the local ethical committee. The patients were randomly allocated into two groups; Group A treated by TRUS-guided aspiration, saline wash, and local injection of antibiotics and Group B treated by TU deroofing of the abscess. All patients received broad-spectrum antibiotics during the period of treatment, and the follow-up was done on the 5th day by TRUS to ensure complete resolution of the abscess. Statistical Analysis Used Statistical analysis was done using online social science statistical calculators http://www.socscistatistics.com/Default.aspx using t-test for two independent means, Chi-square test, and Mann-Whitney U-test with P < 0.05 considered statistically significant. Results The mean age was 59 ± 11.46 and 60 ± 13.65 years for Groups A and B, respectively. Diabetes mellitus was detected in 9 (56.25%) and 6 (37.5%) patients in Groups A and B, respectively, hypertension in 7 (43.75%) and 6 (37.5%) patients in Groups A and B, respectively, and two patients (12.5%) with liver cirrhosis in each group. The mean size of the abscess was 3.36 ± 0.86 and 3.04 ± 0.86 cm in Groups A and B, respectively (P = 0.29). The abscess recurred in five patients (31.25%) and one patient (6.25%) in Groups A and B, respectively (P = 0.08). TRUS-guided aspiration was done for all recurrent cases except for two patients (12.5%) in Group A required trans urethral deroofing of the recurrent abscess. The mean hospital stay was 12.9 ± 4.05 and 7.25 ± 2.40 days for Groups A and B, respectively (P = 0.000). In Group A, one patient (6.25%) was complicated by urethrorectal fistula, whereas in Group B, one patient (6.25%) was complicated by septic shock, three patients (13.75%) with epididymo-orchitis and two patients (12.5%) with urethral stricture. Conclusion Patients with prostatic abscess treated with TRUS-guided aspiration show less morbidity, higher recurrence rate, and longer hospital stay than those treated with TU deroofing.
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Affiliation(s)
- Mohammed Selem
- Department of Urology, Zagazig University, Zagazig, Egypt
| | - Esam Desoky
- Department of Urology, Zagazig University, Zagazig, Egypt
| | - Ahmed Eliwa
- Department of Urology, Zagazig University, Zagazig, Egypt
| | - Amr Fawzi
- Department of Urology, Zagazig University, Zagazig, Egypt
| | - Ehab Elkady
- Department of Urology, Zagazig University, Zagazig, Egypt
| | - Maged M Ali
- Department of Urology, Zagazig University, Zagazig, Egypt
| | - Ahmed Ragab
- Department of Urology, Zagazig University, Zagazig, Egypt
| | - Ahmed Sakr
- Department of Urology, Zagazig University, Zagazig, Egypt
| | - Mohamed Omran
- Department of Urology, Zagazig University, Zagazig, Egypt
| | - Mostafa Kamel
- Department of Urology, Zagazig University, Zagazig, Egypt
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[FOUR CASES OF THE PROSTATIC ABSCESS IN WHICH DRAINAGE WAS EFFECTIVE]. Nihon Hinyokika Gakkai Zasshi 2018; 109:122-126. [PMID: 31006742 DOI: 10.5980/jpnjurol.109.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
We encountered four prostatic abscess patients. Although antimicrobial therapies were ineffective, drainage was effective in all cases. Patient 1 had lung cancer and diabetes mellitus (DM), and patient 2 developed acute prostatitis after transrectal prostatic biopsy. Culture of the urine and blood revealed extended-spectrum beta lactamase (ESBL) -producing Escherichia coli (E.coli). Patient 3 had previously sustained spinal cord injury, and urinated by self-catheterization. Patient 4 had untreated, severe DM. Patient 1, 2 and 3 had been treated by transurethral resection of the prostate (TURP). Patient 2 complained of ejaculatory incompetence after the surgery, and the symptom caused mental distress. Patient 4 was a 43-year-old man who had undergone transperineal needle aspiration under ultrasound guidance to avoid ejaculatory incompetence. The prostatic abscess disappeared in all cases after drainage without recurrence.
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Abdelmoteleb H, Rashed F, Hawary A. Management of prostate abscess in the absence of guidelines. Int Braz J Urol 2017; 43:835-840. [PMID: 28379661 PMCID: PMC5678513 DOI: 10.1590/s1677-5538.ibju.2016.0472] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 11/27/2016] [Indexed: 02/07/2023] Open
Abstract
In contemporary practice, the number of patients presenting with prostatic abscess have significantly declined due to the widespread use of antibiotics. However, when faced with the pathology, prostatic abscess tends to pose a challenge to clinicians due to the difficulty of diagnosis and lack of guidelines for treatment. Treatment consists of an array of measures including parenteral broad-spectrum antibiotic administration and abscess drainage.
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Affiliation(s)
| | | | - Amr Hawary
- Great Western Hospital, Swindon, United Kingdom
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15
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Ackerman AL, Parameshwar PS, Anger JT. Diagnosis and treatment of patients with prostatic abscess in the post-antibiotic era. Int J Urol 2017; 25:103-110. [DOI: 10.1111/iju.13451] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 08/14/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Anne Lenore Ackerman
- Division of Urology; Department of Surgery; Cedars-Sinai Medical Center; Los Angeles California USA
| | - Pooja S Parameshwar
- Division of Urology; Department of Surgery; Cedars-Sinai Medical Center; Los Angeles California USA
| | - Jennifer T Anger
- Division of Urology; Department of Surgery; Cedars-Sinai Medical Center; Los Angeles California USA
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Barua SK, Bora SJ, Bagchi PK, Sarma D, Phukan M, Baruah SJ, Rajeev TP. Emphysematous infections of the urinary tract - an audit of 20 patients with review of literature. Int J Adolesc Med Health 2017; 31:/j/ijamh.ahead-of-print/ijamh-2017-0045/ijamh-2017-0045.xml. [PMID: 28820731 DOI: 10.1515/ijamh-2017-0045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Accepted: 06/04/2017] [Indexed: 12/23/2022]
Abstract
Emphysematous infection of the urinary tract is a rapidly progressive, necrotizing infection which results into collection of gas and subsequent destruction of the tissues. Although very rare among general population, such necrotizing infection is common, particularly among those with compromised immune status. With the rising trend of people afflicted with diabetes mellitus globally, this fulminating infection may pose a serious threat to the medical fraternity. A high index of suspicion and abdominal CT scan usually helps to establish the diagnosis at an early stage and thereby facilitating aggressive antimicrobial therapy and percutaneous drainage where indicated. Although, extirpation of infected renal unit was the treatment of choice earlier, with the advent of modern imaging, endourological procedures and broad spectrum antibiotics, majority of such patients can be treated with minimal morbidity and mortality even with salvaging of the renal units. We present here the outcome of management of 20 cases with varied spectrum of emphysematous infection.
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Affiliation(s)
- Sasanka Kumar Barua
- Department of Urology, Gauhati Medical College Hospital, Guwahati781032, Assam,India, Phone: +91 9864096583
| | - Somor Jyoti Bora
- Department of Urology, Gauhati Medical College Hospital, Guwahati781032, Assam,India
| | - Puskal Kumar Bagchi
- Department of Urology, Gauhati Medical College Hospital, Guwahati781032, Assam,India
| | - Debanga Sarma
- Department of Urology, Gauhati Medical College Hospital, Guwahati781032, Assam,India
| | - Mandeep Phukan
- Department of Urology, Gauhati Medical College Hospital, Guwahati781032, Assam,India
| | - Saumar Jyoti Baruah
- Department of Urology, Gauhati Medical College Hospital, Guwahati781032, Assam,India
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Choudhry M, Pellino G, Simillis C, Qiu S, Kontovounisios C. Prostatic abscesses. A case report and review of the literature on current treatment approaches. Cent European J Urol 2017; 70:118-122. [PMID: 28462000 PMCID: PMC5407335 DOI: 10.5173/ceju.2016.934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Revised: 01/09/2017] [Accepted: 01/09/2017] [Indexed: 11/22/2022] Open
Abstract
Prostatic abscess (PA) is a rare clinical entity due to a variety of causative organisms including gram-negative bacilli, anaerobic and fungal agents. We report on a 55-year-old, HIV+ patient presenting with a 2-week history of urethral discharge and a large PA. He was successfully treated with a combination of radiological-guided transperineal drainage plus antibiotics. Treatment decisions in patients with PA are multifactorial and should be made with all diagnostic information available from the most current modes of medical imaging. In the case of PA several factors should be assessed, including size of the prostate, size, location and frequency of abscesses, previous pelvic surgery, relevant co-morbidities and risk factors, and patient preference.
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Affiliation(s)
- Mariam Choudhry
- Department of Colorectal Surgery, Chelsea and Westminster Hospital, Chelsea, United Kingdom
| | - Gianluca Pellino
- Department of Colorectal Surgery, Chelsea and Westminster Hospital, Chelsea, United Kingdom
| | - Constantinos Simillis
- Department of Colorectal Surgery, Chelsea and Westminster Hospital, Chelsea, United Kingdom
| | - Shengyang Qiu
- Department of Colorectal Surgery, Chelsea and Westminster Hospital, Chelsea, United Kingdom
| | - Christos Kontovounisios
- Department of Colorectal Surgery, Chelsea and Westminster Hospital, Chelsea, United Kingdom.,Department of Surgery and Cancer, Imperial College, London, United Kingdom
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18
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Prostatic abscess caused by Mycobacterium tuberculosis and Escherichia coli in a patient with acquired immunodeficiency syndrome. Am J Med Sci 2015; 350:153-4. [PMID: 26230573 DOI: 10.1097/maj.0000000000000469] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Elwagdy S, Abdelkhalek M, El-Kheshen A, Aun AA, Mostafa A. Role of transrectal sectional sonography (TRSS) in management of prostatic abscesses. Urol Ann 2015; 7:334-8. [PMID: 26229321 PMCID: PMC4518370 DOI: 10.4103/0974-7796.158505] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Accepted: 06/24/2014] [Indexed: 12/03/2022] Open
Abstract
Aim: The aim of this study was to assess the effectiveness of transrectal sectional sonography (TRSS) in the diagnosis and treatment of prostatic abscess. Materials and Methods: Eighteen patients with prostatic abscesEs were the material of the present study. The criteria of abscess collection within the prostate gland and the periprostatic tissues were confirmed by TRSS, which guided the aspiration in all patients. Results: Diagnosis and transperineal needle aspiration of prostatic abscesses were successful in all cases. After the second puncture procedure, recurrence noted in 2 (11.1%) out of 18 patients, who were further subjected to transurethral deroofing under TRSS vision. The amount of pus drained ranged between 3.6 and 29.3 mL (mean: 15.1 mLSD ± 1.5), compatible with the estimated volume by virtual organ computer-aided analysis three-dimensional measurements. The most frequently involved organism was Escherichia coli. All patients received intravenous antibiotics (third generation cephalosporin) after the midstream urine analysis and further proper antibiotics, according to the aspirated pus culture and sensitivity. Conclusions: Transrectal sectional sonography could be a more reliable method in the diagnosis of prostatic abscesses. It can provide precise needle-guides into the best drainage location of the abscess cavity and justify transurethral unroofing if persistent recurrence is there.
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Affiliation(s)
- Salah Elwagdy
- Department of Radiology, Alazhar University, Cairo, Egypt
| | | | | | - Abdel Aziz Aun
- Department of Radiology, Alazhar University, Cairo, Egypt
| | - Amr Mostafa
- Department of Radiology, Alazhar University, Cairo, Egypt
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20
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Patel A, Bishburg E, Nagarakanti S. Pseudomonas aeruginosa prostatic abscess: case report and review of the literature. JMM Case Rep 2015. [DOI: 10.1099/jmmcr.0.000035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Ami Patel
- Newark Beth Israel Medical Center, Newark, NJ, 07112, USA
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Jiménez-Pacheco A, Jiménez-Pacheco A, Verdú-Martínez M, López-Luque A. Drenaje transperineal ecodirigido de un absceso prostático. A propósito de un caso y revisión de la literatura. Rev Int Androl 2015. [DOI: 10.1016/j.androl.2014.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Zheng X, Wang X, Zhou J, Xiang J, Xie L. Diagnosis and treatment of community-associated methicillin-resistant Staphylococcus aureus prostatic abscess involving the seminal vesicle: A case report. Exp Ther Med 2014; 9:835-838. [PMID: 25667637 PMCID: PMC4316977 DOI: 10.3892/etm.2014.2147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Accepted: 12/15/2014] [Indexed: 01/26/2023] Open
Abstract
Prostatic abscess involving the seminal vesicle is a rare disease due to the widespread use of broad-spectrum antibiotics in patients with lower urinary tract symptoms. With the elevated risk of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA), a great emphasis on its pathogenicity in prostatic abscesses is required. To the best of our knowledge, this is the first study to describe the use of ultrasound perfusion imaging and traditional computed tomography to diagnose a patient with CA-MRSA prostate abscess involving the seminal vesicle. In the present case, the patient was successfully treated via adjuvant antibiotics and transrectal ultrasonography (TRUS)-guided prostate needle aspiration. Prostatic abscess involving the seminal vesicle is an uncommon disease with a potential risk of mortality if the appropriate treatment is not provided, and thus deserves particular attention. Ultrasound perfusion imaging plays an important role in the diagnosis of prostatic abscess involving the seminal vesicle. In the present case, early treatment with adjuvant antibiotics and TRUS-guided needle aspiration of the prostatic abscess resulted in a shorter hospital stay, and lower risk of local recurrence and mortality.
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Affiliation(s)
- Xiangyi Zheng
- Department of Urology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, P.R. China
| | - Xiao Wang
- Department of Urology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, P.R. China
| | - Jin Zhou
- Department of Urology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, P.R. China
| | - Jianjian Xiang
- Department of Ultrasound, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, P.R. China
| | - Liping Xie
- Department of Urology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310003, P.R. China
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Kim JH, Yang WJ, Kim TH. Klebsiella pneumonia-induced prostate abscess: How to work it up? Can Urol Assoc J 2014; 8:E841-4. [PMID: 25485013 DOI: 10.5489/cuaj.2155] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTON Klebsiella pneumonia (KP) is related to a metastatic phenomenon from the originally affected primary organ. About 28% of patients with pyogenic liver abscess arising from KP suffer from metastatic complications. This study was done to define the clinical features of KP-induced prostate abscess. METHODS A total of 14 patients were diagnosed with prostate abscess based on clinical, laboratory examination and abdominopelvic computed tomography (CT) scan from 2007 to 2013. RESULTS Among these 14 patients, KP was the dominant causative microorganism in 6 patients (42.9%), followed by Esherchia coli in 2, Pseudomonas aeroginosa in 1, methicillin-resistant Staphyolcoccus aureus in 1, and no growth in either the urine or blood culture in 4. Four (66.7%) of the 6 KP induced-prostate abscess had other concurrent abscess sites besides the prostate: liver in 3, kidney in 1, and perianal area with endogenous endophthalmitis that ended in loss of vision in 1 patient. CONCLUSIONS We report on the clinical features of KP-induced prostate abscess based on a small number of patients, which is the main limitation of our study. We believe that if the causative organism of a prostate abscess was KP, more workup would be needed to rule out the presence of an abscess in other organs, especially in the liver. Abdominopelvic CT scan would be a proper imaging modality.
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Affiliation(s)
- Jae Hoen Kim
- Department of Urology, Soonchunhyang University, College of Medicine, Seoul, South Korea
| | - Won Jae Yang
- Department of Urology, Soonchunhyang University, College of Medicine, Seoul, South Korea
| | - Tae Hyong Kim
- Infection Urology, Soonchunhyang University, College of Medicine, Seoul, South Korea
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Dubos M, Barraud O, Fedou AL, Fredon F, Laurent F, Brakbi Y, Cypierre A, François B. Prostatic abscesses and severe sepsis due to methicillin-susceptible Staphylococcus aureus producing Panton-Valentine leukocidin. BMC Infect Dis 2014; 14:466. [PMID: 25158781 PMCID: PMC4156639 DOI: 10.1186/1471-2334-14-466] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 08/19/2014] [Indexed: 12/26/2022] Open
Abstract
Background Prostatic abscesses are an uncommon disease usually caused by enterobacteria. They mostly occur in immunodeficient patients. It is thus extremely rare to have a Staphylococcal prostatic abscess in a young immunocompetent patient. Case presentation A 20-year-old patient was treated with ofloxacin for a suspicion of prostatitis. An ultrasonography was performed because of persisting symptoms and showed acute urinary retention and prostatic abscesses. So the empirical antibiotic therapy was modified with ceftriaxone/amikacin. The disease worsened to severe sepsis and the patient was admitted in ICU. CT-scan and MRI confirmed three abscesses with perirectal infiltration and the bacteriological samples (abscesses and blood cultures) were positive to methicillin-susceptible Staphylococcus aureus producing Panton-Valentine leukocidine. The treatment was changed with fosfomycin/ofloxacin which resulted in a general improvement and the regression of the abscesses. Conclusion Staphyloccocus aureus producing Panton-Valentine leukocidin are most commonly responsible for skin and soft tissue infections. To this day, no other case of prostatic abscess due to this strain but susceptible to methicillin has been described. Electronic supplementary material The online version of this article (doi:10.1186/1471-2334-14-466) contains supplementary material, which is available to authorized users.
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Jang K, Lee DH, Lee SH, Chung BH. Treatment of prostatic abscess: case collection and comparison of treatment methods. Korean J Urol 2012; 53:860-4. [PMID: 23301131 PMCID: PMC3531640 DOI: 10.4111/kju.2012.53.12.860] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2011] [Accepted: 10/11/2011] [Indexed: 11/18/2022] Open
Abstract
Purpose Prostatic 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 Methods The 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. Results At 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. Conclusions Patients with prostatic abscess treated by transurethral resection of the prostate had a significantly shorter hospitalization length compared with needle aspiration.
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Affiliation(s)
- Kidon Jang
- Department of Urology, Gangnam Severance Hospital, Seoul, Korea
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Abstract
BACKGROUND Improvements in outcome after surgery for elective pilonidal sinus disease have yet to be matched for those presenting with acute disease. Traditional approaches to the management of acute pilonidal abscess have been associated with slow healing and significant loss of working time. OBJECTIVE The aim of this study was to report our approach in which a temporizing intervention allows subsequent definitive treatment with low morbidity. DESIGN This article presents a prospective cohort study. SETTING This study was performed in acute admissions to the Surgical Unit in York Teaching Hospital. PATIENTS Patients presenting with acute pilonidal abscess, not septic, immune-compromised, or diabetic, and without skin necrosis, underwent aspiration on the surgical ward. INTERVENTION Aspiration of pilonidal abscess under local anesthetic was performed with the use of a wide-bore needle. The abscess cavity was drained to dryness, samples were sent to the laboratory for microbiology, and empirical oral antibiotics were commenced, covering anaerobes and aerobes. Review was arranged for within 7 days to plan elective excision and primary closure of the underlying pilonidal sinus. MAIN OUTCOME MEASURES The primary outcomes measured were the number of days required to return to normal activities, response to treatment, and any residual inflammation. RESULTS Fifty-six patients were referred with acute pilonidal abscess. Forty patients met the criteria for aspiration and empirical antibiotic treatment. All were allowed to go home the same day and were reviewed within a median of 5 days. Thirty-eight (38/40) patients demonstrated complete resolution of acute inflammation and were back to normal activities the following day. Fifteen patients subsequently underwent day-case excision and primary closure at a median of 9 weeks. Another 13 are awaiting surgery, and 10 patients have declined further treatment. Two (2/40) patients did not respond, one of whom did not receive the appropriate antibiotics. Both were managed with incision and drainage. CONCLUSIONS Aspiration and antibiotic management of pilonidal abscess is effective in 95% of acute cases in preventing the need for emergent laying open and allows for subsequent elective surgery.
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Emphysematous prostatic abscess: case series study and review. Int J Infect Dis 2012; 16:e344-9. [DOI: 10.1016/j.ijid.2012.01.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2011] [Revised: 12/30/2011] [Accepted: 01/03/2012] [Indexed: 12/20/2022] Open
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Arrabal-Polo MA, Jimenez-Pacheco A, Arrabal-Martin M. Percutaneous drainage of prostatic abscess: case report and literature review. Urol Int 2011; 88:118-20. [PMID: 21934282 DOI: 10.1159/000330934] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2011] [Accepted: 07/11/2011] [Indexed: 11/19/2022]
Abstract
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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Successful percutaneous transperineal drainage of a large prostatic abscess. Urology 2010; 76:1369-70. [PMID: 20350761 DOI: 10.1016/j.urology.2009.12.067] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2009] [Revised: 11/26/2009] [Accepted: 12/29/2009] [Indexed: 11/21/2022]
Abstract
We present a case of an 83-year-old man with septic shock secondary to an extremely large prostatic abscess. Antibiotics and transperineal percutaneous drainage with a suprapubic-type Malecot catheter successfully treated the abscess. Follow-up images reveal resolution of the abscess. Broad-spectrum antibiotics and drainage permitted a full recovery.
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31
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Puri R, Jain P, Sud R, Kumar M, Hussain S, Basnotra A, Eloubeidi MA. EUS-guided drainage of an isolated primary tubercular prostatic abscess. Gastrointest Endosc 2010; 71:425-8. [PMID: 19879570 DOI: 10.1016/j.gie.2009.07.032] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2008] [Accepted: 07/19/2009] [Indexed: 02/08/2023]
Affiliation(s)
- Rajesh Puri
- Department of Gastroenterology, Sir Ganga Ram Hospital, New Delhi, India
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El Harrech Y, Chafiki J, Janane A, Ghadouane M, Ameur A, Abbar M. [US-guided transrectal drainage of prostatic abscesses]. JOURNAL DE RADIOLOGIE 2010; 91:227-229. [PMID: 20389270 DOI: 10.1016/s0221-0363(10)70028-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Prostatic abscess is rare and most commonly occurs as a complication of acute prostatitis. Because of the wider use of antibiotics, the clinical presentation is becoming less typical. Diagnosis is useful for diagnosis. Based on a review of 3 cases, the authors report their experience with US-guided transrectal drainage of prostatic abscesses and review other therapeutic options.
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Affiliation(s)
- Y El Harrech
- Service d'urologie, Hôpital Militaire Universitaire Mohammed V, Rabat, Maroc.
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Vandover JC, Patel N, Dalawari P. Prostatic abscess. J Emerg Med 2009; 40:e83-5. [PMID: 19157756 DOI: 10.1016/j.jemermed.2008.08.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2007] [Revised: 07/14/2008] [Accepted: 08/06/2008] [Indexed: 11/15/2022]
Affiliation(s)
- John C Vandover
- Division of Emergency Medicine, Saint Louis University School of Medicine, St. Louis, Missouri 63110, USA
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Machida H, Ueno E, Nakazawa H, Fujimura M, Ito F. Spermatic cord abscess with concurrent prostatic abscess involving the seminal vesicle. ACTA ACUST UNITED AC 2008; 26:81-3. [PMID: 18301983 DOI: 10.1007/s11604-007-0193-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2007] [Accepted: 10/02/2007] [Indexed: 01/27/2023]
Abstract
Prostatic abscess involving the seminal vesicle has become rare following the development of effective antibiotic treatments. To our knowledge, we report the first case in the English-language literature of a patient with a spermatic cord abscess and a concurrent prostatic abscess. We examined an 81-year-old man for swelling and pain in the left inguinal region and performed computed tomography (CT) that later confirmed the suspected diagnosis of left inguinal hernial strangulation. We performed urgent surgical drainage of a left spermatic cord abscess; and under the correct diagnosis by CT, he was successfully treated further with antibiotics and transperineal drainage of a prostatic abscess extending to the seminal vesicle. We highlight that familiarity with such a rare condition is overwhelmingly essential for patient management and that CT is the most valuable imaging procedure for diagnosing such cases.
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Affiliation(s)
- Haruhiko Machida
- Department of Radiology, Tokyo Women's Medical University, Medical Center East, 2-1-10 Nishiogu, Tokyo, 116-8567, Japan.
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35
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Prostatic Abscess Due to Community-Acquired Methicillin-Resistant Staphylococcus aureus. Am J Med Sci 2008; 335:154-6. [DOI: 10.1097/maj.0b013e3180caac4b] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Juan YS, Huang CH, Chang K, Wang CJ, Chuang SM, Shen JT, Wu WJ. Emphysematous prostatic abscess due to candidiasis: a case report. Kaohsiung J Med Sci 2008; 24:99-102. [PMID: 18281227 DOI: 10.1016/s1607-551x(08)70104-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Prostatic abscess is an uncommon condition and clinical diagnosis is difficult. The classical symptoms and signs of prostatic abscess are variable and nonspecific. Here, we report a rare case of emphysematous prostatic abscess due to candidiasis in a 68-year-old man with diabetes and liver cirrhosis. The diagnosis was confirmed by pelvic computed tomography (CT) and successfully treated by antibiotics and CT-guided percutaneous abscess drainage. This case highlights the importance of early and accurate diagnosis of emphysematous prostatic abscess followed by appropriate treatment.
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Affiliation(s)
- Yung-Shun Juan
- Department of Urology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan
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37
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Cabrera Meirás F, Sanchís Bonet A, Blanco Carballo O, Martín Parada A, Duque Ruiz G, Leiva Galvis O. [Staphylococcus aureus prostatic abscess and subdural empyema: a case report]. Actas Urol Esp 2007; 31:548-52. [PMID: 17711175 DOI: 10.1016/s0210-4806(07)73680-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION AND OBJECTIVES To report one case of prostatic abscess and subdural empyema by Staphylococcus aureus. METHODS We describe the case of a 51 year old male patient who was diagnosed of prostatic abscess and subdural empyema by Staphilococcus aureus. We use clinical presentation and physical exploration based on rectal digital examination, as diagnostic approach method. And computerized axial tomography and transrectal ultrasonography, which allows the guided needle drainage of the abscess, as diagnostic confirmation methods. RESULTS The clinical picture resolved with the transrectal ultrasonography guided needle aspiration of the abscess and conservative treatment with antibiotics and urinary diversion. CONCLUSIONS Prostatic abscess is an uncommon entity nowadays. Provided the great variety of symptoms, a great degree of clinical suspicion is needed for the diagnosis, and once it is got it, immediate aggressive treatment must be initiated. Transrectal ultrasonography allows not only the diagnosis, but also the drainage of the abscess. The culture of the obtained material identifies the etiological agent and the most specific antibiotic therapy.
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Affiliation(s)
- F Cabrera Meirás
- Servicio de Urología, Hospital Universitario 12 de Octubre, Madrid.
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38
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Langer JE, Cornud F. Inflammatory disorders of the prostate and the distal genital tract. Radiol Clin North Am 2006; 44:665-77, vii. [PMID: 17030219 DOI: 10.1016/j.rcl.2006.07.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Inflammatory disease of the prostate and distal genital tract is emerging as a major health problem because it is estimated that up to 15% of adult men may be affected at some point in their lives. Clinically, the diagnosis of "prostatitis" refers to multiple disorders that cause pelvic pain and discomfort, ranging from acute bacterial infection to complex conditions that may not necessarily be caused by prostatic inflammation. Because the traditional etiology-based classification system did not always correlate with symptoms and therapeutic efficacy, a new classification of prostatitis has been suggested by the National Institutes of Health. New imaging techniques such as high-resolution transrectal ultrasonography (TRUS) and MR imaging provide exquisite anatomic detail and often play a crucial role in the evaluation of these patients.
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Affiliation(s)
- Jill E Langer
- Department of Radiology, Hospital of the University of Pennsylvania, University of Pennsylvania Medical Center, 3400 Spruce Street, Philadelphia, PA 19104, USA.
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Serrano Frago P, Allepuz Losa C, Fantova Alonso A, Marco Valdenebro A, Allué López M, Rioja Sanz LA. Actualidad en manejo de abcesos prostáticos: a propósito de un caso. Actas Urol Esp 2006; 30:720-2. [PMID: 17058619 DOI: 10.1016/s0210-4806(06)73524-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The existence of prostate abscess as bad evolution of an acute protatitis is not very frequent due to the correct handling of the urinary infections by means of suitable antibiotics, in spite of the presence of inmunosupresion situations that can favor their appearance. It is our intention to review the performance in these situations because of a case that by means of minimal invasive therapy by transperineal percutaneous puncture obtained complete improvement.
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Affiliation(s)
- P Serrano Frago
- Servicio de Urología, Hospital Universitario Miguel Server, Zaragoza.
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40
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Bastide C, Carcenac A, Arroua F, Arrova F, Rossi D. Prostatic abscess due to Candida tropicalis. Prostate Cancer Prostatic Dis 2005; 8:296-7. [PMID: 15953933 DOI: 10.1038/sj.pcan.4500809] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Fungal urinary tract infection represents a high-risk event in severely ill patients. We report a case of a prostatic abscess due to Candida tropicalis with no systemic manifestations. In first time, a conservative treatment with antifungal treatment and transrectal ultrasound-guided drainage was performed without success. Transurethral resection was required for drainage with a favourable course.
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Affiliation(s)
- C Bastide
- Department of Urology, Hopital Nord, Chemin des Bourrelly, Marseille, France.
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41
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Bosquet Sanz M, Gimeno Argente V, Palmero Martí JL, Bonillo García MA, Salom Fuster JV, Jiménez Cruz JF. Absceso prostático: revisión de la literatura y presentación de un caso. Actas Urol Esp 2005; 29:100-4. [PMID: 15786772 DOI: 10.1016/s0210-4806(05)73206-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Prostatic abscess is an uncommon entity nowadays due to widely use of antibiotics, however, in some patients, because of the seriousness, a quick diagnosis and interventionist treatment is required. We report a case of a 78 year-old male patient who had a torpid evolution and needed an urgent prostatectomy. We review ethiopathogenic factors, clinical findings, diagnosis and treatment of this uncommon entity.
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Affiliation(s)
- M Bosquet Sanz
- Servicio de Urología, Hospital Universitario La Fe, Valencia
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Göğüş C, Ozden E, Karaboğa R, Yağci C. The value of transrectal ultrasound guided needle aspiration in treatment of prostatic abscess. Eur J Radiol 2004; 52:94-8. [PMID: 15380852 DOI: 10.1016/s0720-048x(03)00231-6] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2003] [Revised: 07/15/2003] [Accepted: 07/21/2003] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Prostatic abscess (PA) is a very uncommon disorder. The value of transrectal ultrasound (TRUS) guided aspiration in the treatment of PA has not been clearly defined. We present our experience with six such patients. MATERIALS AND METHODS Between July 1997 and December 2002, six patients with PA were diagnosed by TRUS and treated by TRUS guided needle aspiration in our department. PA was defined as hypoechoic, inhomogeneous, thick walled fluid collection. TRUS guided needle aspiration of the abscess was performed transrectally in all patients with a 20-cm long 18 gauge Chiba needle. Successful treatment criteria were defined as clinical improvement in symptoms and decrease of more than half of the estimated abscess volume on follow up TRUS control. Patients with continuing clinical symptoms were defined as treatment failures. RESULTS The most common TRUS finding was detection of a hypoechoic area with inhomogeneous structures, which was determined in all patients (100%). In some patients irregular contour and heterogeneous areas were additionally described. TRUS guided needle aspiration treatment of PA was successful in five of six patients (83.3%). In one patient treatment failed and the abscess recurred 3 weeks after the procedure. As this patient had additionally a bladder outflow obstruction, transurethral resection of the prostate was performed instead of a repeat procedure. There were no complications associated with the procedure. CONCLUSIONS In conclusion, TRUS has an important value in diagnosis and treatment of PA. TRUS guided aspiration is an effective and minimally invasive treatment modality for PA which causes no serious complications.
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Affiliation(s)
- Cağatay Göğüş
- Department of Urology, Ankara University, School of Medicine, Ankara, Turkey.
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43
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Chou YH, Tiu CM, Liu JY, Chen JD, Chiou HJ, Chiou SY, Wang JH, Yu C. Prostatic abscess: transrectal color Doppler ultrasonic diagnosis and minimally invasive therapeutic management. ULTRASOUND IN MEDICINE & BIOLOGY 2004; 30:719-724. [PMID: 15219951 DOI: 10.1016/j.ultrasmedbio.2004.03.014] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2003] [Revised: 03/19/2004] [Accepted: 03/25/2004] [Indexed: 05/24/2023]
Abstract
The purpose of this study was to analyze the transrectal ultrasound (US), or TRUS, and color Doppler ultrasonography (CDU) findings and therapeutic strategies with TRUS-guided procedures in 13 patients with prostatic abscess. Over a period of 6 years, 18 prostatic abscesses were diagnosed in 13 patients (mean age: 59 years). Diagnostic workup included TRUS, analysis of midstream urine, and analysis and culture of abscess fluid for leukocytes and pathogens. These patients were treated either conservatively (for abscess cavities < 1 cm in diameter), or by aspiration or draining procedures (cavities > or = 1 cm). The transrectal CDU findings were correlated to the treatment effects. The predisposing factors were also reviewed. In the 13 patients, the most common clinical symptom and sign were urinary frequency (77%) and pus cell in the midstream urine (92%). Predisposing factors were found in 11 men, with diabetes in 5 of them. In 10 patients, the definitive preinterventional diagnosis was based on the TRUS findings. TRUS with probe palpation demonstrated tiny floating echogenic speckles in the abscess cavity in 4 patients. CDU demonstrated increased color-flow signals at the margin and surrounding tissue of the abscess pockets. Abscesses with poorly defined boundaries had more prominent surrounding color-flow signals and achieved, with relative difficulty, a satisfactory aspiration procedure. Aspiration was done for all 11 abscesses between 1 and 3 cm. A total of 4 larger abscesses (> 3.0 cm) were treated with aspiration or drainage using a 5-French pigtail catheter. No surgical drainage was performed. Transrectal CDU may help in the evaluation of maturity of an abscess pocket. US-guided aspiration with an 18-gauge needle or drainage with a 5-French pigtail catheter significantly shortened the hospital stay.
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Affiliation(s)
- Yi-Hong Chou
- Department of Radiology, Veterans General Hospital-Taipei and National Yang-Ming University School of Medicine, Taipei, Taiwan.
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45
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Somuncu I, Sağlam M, Yağci S, Tahmaz L, Taşar M, Ors F. Multiloculated prostate abscess: treatment with transrectal ultrasound guided transrectal needle aspiration and lavage with the saline and antibiotic. Clin Imaging 2003; 27:251-5. [PMID: 12823920 DOI: 10.1016/s0899-7071(02)00546-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Prostatic abscess is a rare but nevertheless serious disease. It should be diagnosed at an early stage by the combination of clinical examination and transrectal ultrasound, and drained. We treated a 79-year-old case with multiple prostate abscesses (PAs) by using lavage of the saline and antibiotic (cefoxitin) after transrectal ultrasound-guided transrectal puncture and aspiration. We are presenting the transrectal ultrasound images of pre- and postmedication, where we achieved complete success and no relapse was seen in follow-up of 1 year.
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Affiliation(s)
- Ibrahim Somuncu
- Department of Radiology, Gülhane Military Medical Academy, 06018 Etlik-Ankara, Turkey
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46
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Boland LE, Hardie RJ, Gregory SP, Lamb CR. Ultrasound-guided percutaneous drainage as the primary treatment for prostatic abscesses and cysts in dogs. J Am Anim Hosp Assoc 2003; 39:151-9. [PMID: 12617543 DOI: 10.5326/0390151] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Thirteen dogs with prostatic abscesses and cysts were treated using percutaneous ultrasound-guided drainage. Eight dogs were diagnosed with prostatic abscesses and five with cysts on the basis of cytopathological examination and bacterial culture of the prostatic fluid. Antibiotic therapy, based on culture and sensitivity results, was administered for a minimum of 4 weeks. Intact dogs were castrated after initial drainage. Repeat ultrasonography of the prostate was performed every 1 to 6 weeks, and any residual cavitary lesions were drained and fluid analysis repeated. The median number of drainage procedures required to completely resolve the lesions was two (range, one to four). No complications were observed after drainage, and clinical signs resolved in all dogs. None of the dogs developed clinical signs of recurrent abscesses or cysts in the follow-up period (median, 36 months; range, 10 to 50 months). Ultrasound-guided, percutaneous drainage of prostatic abscesses and cysts appears to be a useful alternative to surgical treatment in select dogs.
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Affiliation(s)
- Lori E Boland
- Department of Small Animal Medicine and Surgery, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Hertfordshire, AL9 7TA, United Kingdom
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47
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Ribes P, Blanc P, Legrand E, Marc J. Current clinical presentation of prostatic abscesses; two case reports. Med Mal Infect 2001. [DOI: 10.1016/s0399-077x(01)00214-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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48
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Symptomatologie actuelle des abcès de la prostate : deux observations. Med Mal Infect 2001. [DOI: 10.1016/s0399-077x(01)00213-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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