Minimally-invasive management of prostatic abscess: The role of transrectal ultrasound

Context and Aim: Prostatic abscess is an unusual condition. The prevalence of prostatic abscess is about 0.5% of all prostatic diseases. The purpose of the study is to present and discuss the role of transrectal ultrasound (TRUS) in the management of prostatic abscess. Settings and Design: Retrospective study. Materials and Methods: We retrospectively reviewed the medical records of all eight patients diagnosed and treated for prostatic abscess in the last threeyears. TRUS was used for diagnosis in all cases. Four patients had TRUS guided aspiration for management of prostatic abscess. Data collected regarding etiology, clinical features, investigations and treatment was compared with the available literature. Results: The age of patients ranged from 18-65 yrs (mean 47.12 yrs). Out of the eight patients, six were diabetics. TRUS revealed one or more hypoechoic areas within the prostate in all the patients. Successful treatment of prostatic abscess with TRUS guided needle aspiration was done in all fourpatients in whom it was used. Mean hospitalization time was 9.4 days, and most frequent bacterial agent was S. aureus. Conclusions: TRUS is useful in diagnosis as well as in guidance for aspiration of such abscesses. TRUS guided needle aspiration is an effective method for treating prostatic abscess. Most of the patients are diabetics and usually grow Staphaureus. So an antibiotic with staphylococcal coverage should be used empirically.