Prostatic abscesses: radiographic findings and treatment.

OBJECTIVE To analyze the medical images and therapeutic strategies in patients with prostatic abscesses. METHOD From April 1999 to August 2002, 12 patients with prostatic abscesses at Srinagarind Hospital, Khon Kaen, Thailand were reviewed The average age was 47 years (range 29 to 75). Diagnostic procedures included analysis of midstream urine, abscess fluid for pathogens and medical imaging with TRUS, CT and MRI. Therapeutic options were transrectal ultrasound-guided drainage or conservative medical treatment. RESULTS Almost all patients had predisposing diseases. All patients showed hypo-echoic masses, plus internal septation in 5 cases. Most lesions were located at the central gland. Their sizes ranged from 0.5 to 2.75 cm (average 1.51 cm) in diameter. The main pathogen was B. pseudomallei. On TRUS imaging, patients with melioidosis had one or more hypo-echoic areas with internal septation, thickened wall and surrounding multiple small daughter abscesses. All abscesses resolved within 4 weeks, with no difference in the duration of treatment, despite different sizes or pathogens. CONCLUSIONS Transrectal ultrasonography is useful in the diagnosis of prostatic abscess as well as in the guidance for aspiration and the drainage of such abscesses. Our data showed sonographic patterns in prostatic abscess, especially with melioidosis.

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