Prostatic suppuration and destruction in patients with myelodysplasia: a newly recognized entity

Area of Science:

• Urology
• Pediatric Urology
• Infectious Diseases

Background:

• Prostatic abscess is rare, particularly in the context of modern antibiotic use.
• Adolescents with myelomeningocele often have neurogenic bladders managed with intermittent catheterization.
• Chronic urinary tract infections are common in this patient population.

Observation:

• Five adolescent patients with myelomeningocele presented with a previously unreported condition: chronic prostatic abscess.
• Voiding cystourethrography revealed contrast material extravasation at the prostate borders in all patients.
• Two patients underwent transurethral resection, finding prostatic parenchyma entirely replaced by suppuration.

Findings:

• Transurethral resection provided limited clinical improvement in patients with advanced prostatic abscess.
• The study discusses potential etiological factors contributing to chronic prostatic abscess in myelomeningocele patients.
• Diagnostic challenges and therapeutic options for this rare condition were explored.

Implications:

• This research underscores the need for heightened awareness of prostatic abscess in adolescents with myelomeningocele and neurogenic bladders.
• It suggests that standard treatments may be insufficient for advanced cases, necessitating further investigation into optimal therapeutic strategies.
• The findings contribute to understanding and managing a rare but significant complication in pediatric urology.