Tuberculous Prostatic Abscess with Prostatorectal Fistula after Intravesical Bacillus Calmette-Guérin Immunotherapy

Eom, Jeong Ho; Yoon, Jin‐Kook; Lee, Seok Won; Kim, Hyo Sun; Park, Tae Young; Bang, Chang Seok; Baik, Gwang Ho; Kim, Dong Joon

doi:10.5946/ce.2015.145

Cited by 7 publications

(7 citation statements)

References 11 publications

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“…Novel gland‐conserving therapies directed at prostate cancer, such as cryotherapy and brachytherapy, are also associated with rare complications of PA; several reports also detail PA after intravesical BCG for bladder cancer . This complication must be considered in patients presenting with suspicious symptoms after urological instrumentation.…”

Section: Etiology and Natural Historymentioning

confidence: 99%

Diagnosis and treatment of patients with prostatic abscess in the post‐antibiotic era

2017

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We reviewed the pathogenesis, clinical presentation, treatment options and outcomes of prostatic abscess in the post-antibiotic era, focusing on how patient risk factors and the emergence of multidrug-resistant organisms influence management of the condition. A MEDLINE search for "prostate abscess" or "prostatic abscess" was carried out. Prostate abscess is no longer considered a consequence of untreated urinary infection; now, men with prostatic abscess are typically debilitated or immunologically compromised, with >50% of patients having diabetes. In younger men, prostatic abscess can be the initial presentation of such chronic conditions. In older men, prostatic abscess is increasingly a complication of benign prostatic hyperplasia or prostate biopsy. Diagnosis is based on a physical examination, leukocytosis, leukocyturia and transrectal ultrasound, with magnetic resonance imaging serving as the preferred confirmatory imaging modality. Treatment of prostatic abscess is changing as a result of the emergence of atypical and drug-resistant organisms, such as extended-spectrum blactamase-producing enterobacteriaceae and methicillin-resistant Staphylococcus aureus. As many as 75% of infections are resistant to first-generation antibiotics, necessitating aggressive therapy with broad-spectrum parenteral antibiotics, such as third-generation cephalosporins, aztreonam or antibiotic combinations. A total of 80% of patients require early surgical drainage, frequently through a transurethral approach. In the postantibiotic era, prostatic abscess is evolving from an uncommon complication of urinary infection to a consequence of immunodeficiency, growing antibiotic resistance and urological manipulation. This condition, primarily affecting patients with chronic medical conditions rendering them susceptible to atypical, drug-resistant organisms, requires prompt aggressive intervention with contemporary antibiotic therapy and surgical drainage.

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Section: Etiology and Natural Historymentioning

confidence: 99%

Diagnosis and treatment of patients with prostatic abscess in the post‐antibiotic era

2017

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“…Furthermore, there are only a few reports on the formation of an RPF caused by a PA, indicating that it is rare. It has been reported as a complication of intravesical Bacillus Calmette‐Guérin therapy for bladder cancer 1 . Additionally, RPF formation has been reported in xanthogranulomatous prostatitis 2 .…”

Section: Discussionmentioning

confidence: 99%

A case of perforation of the prostatic abscess into the rectum resulting in a rectoprostatic fistula

Sugiyama,

Fujikawa,

Yokokawa

2023

IJU Case Reports

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IntroductionA rectoprostatic fistula complicating a prostatic abscess is extremely rare, and there are many uncertainties regarding its treatment and prognosis.Case presentationWe present the case of a 68‐year‐old male who presented with rectal bleeding. Computed tomography reveals a prostatic abscess in contact with the rectum. As conservative treatment with antibiotics resulted in the aggravation of symptoms, we placed a transperineal catheter placement in the prostate, followed by drainage of the abscess through the catheter. The abscess communicated with the rectum, forming a rectoprostatic fistula. Subsequently, a transverse colostomy was performed. The abscess resolved, and no recurrence was observed even after 6 months of drainage. However, the rectal ulceration that resulted in the formation of the fistula persisted, and stoma closure was not achieved.ConclusionIn cases of prostatic abscess complicated by rectoprostatic fistula, drainage of the abscess along with colostomy seems essential for a curative approach.

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“…Adjuvant intra-vesical immunotherapy with BCG for bladder transitional cell carcinoma can lead to a rare complication of tuberculous infection in the prostate via haematogenous spread and direct extension which can cause a prostate abscess [ 17 ].…”

Section: Prostate and Periprostatic Regionmentioning

confidence: 99%

Incidental findings in and around the prostate on prostate MRI: a pictorial review

2021

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Prostate MRI has seen rapid growth in use in recent years as an advanced diagnostic modality to detect focal areas of clinically significant prostate cancer, to identify an area for targeted biopsy and to guide management and surveillance. The increase in use has also led to increased diagnosis of incidental lesions arising from structures around the prostate. These incidental findings may be related to the genitourinary system or non- genitourinary system and may have a benign aetiology which needs no additional follow-up, or it may require surveillance and management. The field of view in a multiparametric prostate MRI includes other pelvic organs, neurovascular bundles, bowel, lymph nodes and bones. Being familiar with standard MRI characteristics and a sound knowledge of anatomy of the prostate and surrounding structures can help in distinguishing normal anatomy from pathology. Given that patients undertaking a prostate MRI are usually a cohort with increased anxiety from their known or suspicion of prostate cancer, it is important that radiologists are familiar with these common incidental findings to minimise anxiety to the patient, have a well-informed discussion with the referring clinician and reduce costs associated with unnecessary further testing and follow-up of benign incidental findings. Additionally, being able to diagnose more serious incidental pathologies early can be life-saving and potentially significantly alter patient management.

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Tuberculous Prostatic Abscess with Prostatorectal Fistula after Intravesical Bacillus Calmette-Guérin Immunotherapy

Cited by 7 publications

References 11 publications

Diagnosis and treatment of patients with prostatic abscess in the post‐antibiotic era

Diagnosis and treatment of patients with prostatic abscess in the post‐antibiotic era

A case of perforation of the prostatic abscess into the rectum resulting in a rectoprostatic fistula

Incidental findings in and around the prostate on prostate MRI: a pictorial review

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