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[Prostatic abscesses: percutaneous treatment]
J Vesa Llanes1, C Lladó Carbonell, O Arango Toro
1Servicio de Urología, Hospital Universitario del Mar, Universidad Autónoma de Barcelona, España.
Abstract:
Three cases of prostatic abscess diagnosed in our service in the past year are reported. The current treatment of this disease entity and the changes observed relative to the pathogenic flora of prostatic abscess in certain groups at risk today are discussed. All three cases underwent percutaneous transperineal debridement of the purulent collection. An 8 Fr silicone catheter was left indwelling in the residual cavity of the abscess to permit lavage with povidone-iodine solution during the first 3 or 4 days post-operatively. At one week, the abscess had completely resolved in all of the cases as evidenced by the ultrasound control. E. coli was isolated in two patients with diabetes and Staph. aureus was isolated in an HIV-positive intravenous drug addict who also had renal abscess from Candida albicans.
Insights
This study reports three prostatic abscess cases treated with percutaneous transperineal debridement and povidone-iodine lavage, achieving complete resolution. Pathogen analysis revealed E. coli in diabetic patients and Staph. aureus in an HIV-positive individual.
Area of Science:
- Urology
- Infectious Diseases
- Medical Imaging
Background:
- Prostatic abscess is a serious condition requiring effective treatment.
- Understanding the evolving microbial flora in at-risk populations is crucial.
Purpose of the Study:
- To report three cases of prostatic abscess.
- To discuss current treatment modalities and observed pathogenic flora.
- To evaluate a minimally invasive treatment approach.
Main Methods:
- Percutaneous transperineal debridement of purulent collections.
- Indwelling silicone catheter placement for povidone-iodine lavage.
- Ultrasound for post-operative monitoring and resolution assessment.
Main Results:
- Complete abscess resolution within one week in all three cases.
- E. coli identified in two diabetic patients.
- Staphylococcus aureus isolated in an HIV-positive intravenous drug user with coexisting renal abscess.
Conclusions:
- Percutaneous transperineal debridement with catheter lavage is an effective treatment for prostatic abscess.
- Treatment led to rapid resolution, confirmed by ultrasound.
- Pathogenic flora varies in at-risk groups, including E. coli and Staph. aureus.