Adult UrologyUltrasound-guided needle aspiration in prostatic abscess
Section snippets
Material and methods
Between October 1984 and November 1997, prostatic abscess was diagnosed in 31 patients. The average age was 60 years (range 29 to 79). Abscess was diagnosed either at the emergency care unit or as an incidental finding in a control ultrasound examination. After obtaining the patient’s history and making a physical examination, blood analysis, urine culture, and prostate ultrasound were performed. For diagnostic purposes, a 5-mHz real time convex probe was used for the hypogastric approach and a
Results
It is of note that 9 patients (29%) were diabetic and 15 (48%) had a previous history of urinary tract infection (orchitis, cystitis, prostatitis). Thirteen patients (42%) had bladder outlet obstruction (4 were carrying an indwelling bladder catheter, 4 had had acute urine retention, 3 had been diagnosed with urethral stenosis, and in 2, uroflowmetry data were consistent with bladder outlet obstruction according to Siroky’s nomogram). Six patients had neither had a significant urologic disease
Comment
Prostatic abscess is a rare condition, with an incidence of about 0.5% of all prostatic diseases.4 Its incidence has decreased remarkably since the introduction of broad-spectrum antibiotics.1 This decrease is associated with a change in the frequencies of causal microorganisms.5 A study by Sargent and Irwin6 from 1931 showed that Neisseria gonorrhoaea was responsible for 75% of prostatic abscesses, followed in frequency by Staphylococcus aureus.7 At present, major pathogenic microorganisms are
Conclusions
Because of the difficulty involved in clinically distinguishing between acute prostatitis and prostatic abscess, a high degree of suspicion is needed to diagnose the latter. However, making the distinction is important, since the treatment varies depending on the diagnosis. The performance of transrectal ultrasound is thus indicated in those patients with a suspicious digital rectal examination or in those who do not respond to intravenous antibiotic therapy within 48 hours. This procedure does
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2021, Clinical RadiologyCitation Excerpt :The TRUS-guided approach confers many advantages over the other methods described including a lower risk of retrograde ejaculation and incontinence, which are all potential risks with a transurethral approach.25,27 The success rate of TRUS-guided aspirations range from 84–86%25,28 and for TRUS-guided drainage is reported to be 83.3%.29,30 The main disadvantage of this approach is the inability to adequately allow for complete drainage of multi-loculate abscesses in which case, a transurethral approach may have a role.31
Prostate Abscesses and Staphylococcus aureus Bacteremia
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