Use of Transrectal Ultrasonography in the Manasgemnent of Prostatic Abscess

Abstract

Prostatic abscess is a potentially life-threatening condition. Effective treatment requires intensive anthmicrobial therapy and drainage of the abscess. Transrectal ultrasound now plays an important role in the management of this condition. Transrectal ultrassund is an effective and readily available method the establishing the diagnosis of prostatic abscess. In addition, intraoperative transrectal ultrasonography can be of great help in localizing an abscess cavity so that it can be unroofed and the contents drained. Case ReportA 40-year-old insulin-dependent diabetic man presented with a 2-day history of left scrotal swelling and pain. Physical examination revealed left scrotal erythema and tenderness of the left testis and epididymis. Scrotal ultrasound demonstrated increased arterial flow in the left epididymis consistent with epididymitis. No evidence of intrascrotal abscess was identified. Urine culture obtained on admission was positive for Escherichia coli. The patient was admitted and antimicrobial treatment was started, which consisted of administration of ampicillin, gentamicin, and Flagyl (Searle, Chicago, IL). The patient's condition improved steadily, and he was discharged 2 days later taking oral ofloxacin.The patient was re-admitted 24 hours later with tachypnia, tachycardia, and hypotension. He was intubated and transferred to the intensive care unit on a dopamine drip. Examination of the scrotal contents demonstrated a fluctuant mass in the left