Ultrasound-guided transrectal placement of a drainage tube as therapeutic management of patients with prostatic abscess.
OBJECTIVE
A novel approach for continuous drainage of prostatic abscesses is presented and discussed.


METHODS
We present seven cases diagnosed with prostatic abscess during 2001-2007. The diagnosis was based on either clinical or transrectal ultrasound (TRUS) findings. All patients were initially treated as prostatitis cases by intravenous antibiotics, a1 blockers, and a suprapubic catheter. Those diagnosed with an abscess had a drainage tube placed transrectally under TRUS guidance, and it was left in place for 24-36 hours.


RESULTS
Past medical history most often included previous urinary infection (n = 4), bladder outlet obstruction (n = 1), and diabetes mellitus (n = 4). In all patients, prostatic abscess was greater than 1.5 cm, and in two patients the abscess was multifocal. All abscesses were completely resolved by transrectal continuous drainage, and the average hospitalization period was 10 days. No patient required a second intervention. All patients received antibiotics for 1 month following the procedure.


CONCLUSIONS
Although rare, prostatic abscess is a serious condition that needs quick diagnosis and treatment. In our experience, TRUS-guided transrectal placement of a drainage tube is a feasible and safe treatment alternative for prostatic abscess; it is also easy to perform and well tolerated by the patients.
Aravantinos
Evangelos
E
Department of Urology, University of Thessaly, School of Medicine, Larissa, Greece.
Kalogeras
Nikolaos
N
Zygoulakis
Nikolaos
N
Kakkas
Gregory
G
Anagnostou
Theodore
T
Melekos
Michael
M
D000038:Abscess / Q000000981:diagnostic imaging* / Q000628:therapy*; D000368:Aged; D004322:Drainage / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011469:Prostatic Diseases / Q000000981:diagnostic imaging* / Q000628:therapy*; D012007:Rectum / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography