Prostatic abscess: transrectal color Doppler ultrasonic diagnosis and minimally invasive therapeutic management

Chou, Yi‐Hong; Tiu, Chui‐Mei; Liu, Jen-Yi; Chen, Jen-Dar; Chiou, Hong‐Jen; Chiou, See-Ying; Wang, Jia-Hwia; Cheng, Yu

doi:10.1016/j.ultrasmedbio.2004.03.014

Cited by 53 publications

(35 citation statements)

References 20 publications

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“…Complete ultrasound normalization of the prostate bed usually occurs about 30 days after the drainage. Chou et al [7] published a series of 13 patients with prostatic abscess, and in 4 subjects with an abscess 1 3 cm, they performed transperineal drainage and placed a 5-Fr catheter under TRUS guidance. Drainage collection reduces both the improvement and hospital admission time.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Drainage of Prostatic Abscess: Case Report and Literature Review

2011

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

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Section: Discussionmentioning

confidence: 99%

Percutaneous Drainage of Prostatic Abscess: Case Report and Literature Review

2011

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“…17 In these cases, the best imaging modality is a CT of the abdomen and pelvic area, which can detect extraprostatic penetration, the extent of the pelvic inflammatory process and other possible infectious sources. 18 Prompt medical and surgical management of prostatic abscess is crucial to prevent progression to sepsis and death. 19 The management options include transrectal ultrasonography-guided aspiration, transurethral incision over the abscess, transurethral deroofing of the abscess cavity, or formal transurethral resection of prostate.…”

Section: Discussionmentioning

confidence: 99%

Klebsiella pneumonia-induced prostate abscess: How to work it up?

Kim

Yang

Kim

2014

CUAJ

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Cite as: Can Urol Assoc J 2014;8(11-12):e841-4. http://dx.doi.org/10.5489/cuaj.2155 Published online November 24, 2014. AbstractIntroduction: 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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“…7 Aphinives et al 8 reviewed the results of TRUS, CT, and magnetic resonance imaging in 12 patients with prostatic abscesses and found that most of the lesions were located in or around the central gland. Chou et al 9 reported that color Doppler ultrasonography demonstrated increased color-flow signals at the margin and surrounding tissue of abscess pockets. They suggested that these signals may help in the evaluation of the maturity of an abscess pocket.…”

Section: Discussionmentioning

confidence: 99%

“…Many studies have suggested that TRUS-guided needle aspiration is a feasible, safe, and effective alternative to transurethral drainage. 4,7,9 The role of TURP in the treatment of prostatic abscess is not clear. The major disadvantage is the risk of incomplete drainage.…”

Section: Discussionmentioning

confidence: 99%

Advanced prostate cancer presenting as a huge abscess

Wang

Hsieh

2014

Urological Science

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Keywords:prostate cancer prostatic abscess transrectal ultrasonography transurethral resection of prostate a b s t r a c t Prostatic abscess is a rare urological disease. It is not easily diagnosed based on the history, physical examination, laboratory data, and imaging studies. Patients with prostatic abscess and those with prostate cancer can have similar presenting signs and symptoms, such as lymphadenopathy and abnormal prostate-specific antigen values. A 67-year-old man without any underlying diseases presented with acute prostatitis. Transrectal ultrasonography was performed 14 days after initiation of antibiotic therapy revealed a fluid-containing irregular mass. Doppler ultrasonography showed high vascularity around the margin of the mass. Advanced prostate cancer with necrosis was found in tissue from transurethral resection of the prostate (TURP). His symptoms improved a lot after TURP and he accepted androgen deprivation therapy in the outpatient clinic. Although ultrasound-guided needle aspiration remains the mainstream treatment for prostatic abscess, TURP should be considered in patients with complicated prostate abscess or suspected prostatic carcinoma.

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Prostatic abscess: transrectal color Doppler ultrasonic diagnosis and minimally invasive therapeutic management

Cited by 53 publications

References 20 publications

Percutaneous Drainage of Prostatic Abscess: Case Report and Literature Review

Percutaneous Drainage of Prostatic Abscess: Case Report and Literature Review

Klebsiella pneumonia-induced prostate abscess: How to work it up?

Advanced prostate cancer presenting as a huge abscess

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