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Presentation, diagnosis, management, and outcomes of prostatic abscess: comparison of three treatment modalities
Department of Urology, Al Wakra Hospital, Hamad Medical Corporation, Doha, Qatar.
Department of Urology, Al Wakra Hospital, Hamad Medical Corporation, Doha, Qatar.
Department of Urology, Al Wakra Hospital, Hamad Medical Corporation, Doha, Qatar.
University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Surgery, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar / College of Medicine, Qatar University, Doha, Qatar. (Individ och samhälle VIDSOC, Individual and Society)ORCID iD: 0000-0003-0961-1302
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2020 (English)In: Therapeutic advances in urology, ISSN 1756-2872, Vol. 12, p. 1-8, article id 1756287220930627Article in journal (Refereed) Published
Abstract [en]

Purpose:

The lack of available guidelines for the management of prostatic abscess (PA) results in inconsistencies in its management. The most commonly used management modalities were conservative treatment with parenteral antibiotics alone, transrectal ultrasound-guided (TRUS) needle aspiration, or transurethral deroofing (TUD).

The current study is a retrospective study and examines prostatic abscess cases treated by either one or more of the different modalities. We assess and compare presentation, diagnosis, management, and outcomes of prostatic abscess and we compare the outcomes of the three management modalities.

Methods:

We retrieved the records of all patients (n = 23) admitted to the Urology department at Al Wakra hospital with the computed tomography (CT) diagnosis of prostatic abscess from January 2013 to March 2018. Data collected included demographic, clinical, laboratory, and imaging findings, as well as management modality, duration of hospital stay, duration of follow up, outcome, and recurrence.

Results:

A total of nine (39.1%) patients had conservative treatment only; eight (34.8%) had TUD, and six (26.1%) had TRUS needle aspiration. The mean age was 52.7 years. Lower urinary tract symptoms and fever were the most common presentations (95.7% and 82.6%, respectively). CT scan of the abdomen and pelvis with contrast was undertaken for all patients and it showed that multiple abscesses were observed in 14 (60.9%) cases.

The overall mean hospital stay was 8.45 days (range 2–21 days). We observed no recurrences for patients treated conservatively or those who undertook TUD, but three patient (50%) recurrences were noted in TRUS aspiration patients. There was no mortality across the sample.

Conclusion:

Early diagnosis of prostatic abscess and prompt management may have decreased the morbidity and mortality. Conservative management can succeed in subcentimeter abscesses but TUD is the definite therapy for large and multiloculated abscess. TRUS aspiration does have a role in treatment, but it has higher recurrence and longer hospital stay.

Place, publisher, year, edition, pages
Sage Publications, 2020. Vol. 12, p. 1-8, article id 1756287220930627
Keywords [en]
prostatic abscess, transrectal aspiration, transurethral deroofing
National Category
Surgery Infectious Medicine Urology and Nephrology
Research subject
Individual and Society VIDSOC
Identifiers
URN: urn:nbn:se:his:diva-18675DOI: 10.1177/1756287220930627ISI: 000539996300001PubMedID: 32550860Scopus ID: 2-s2.0-85085974767OAI: oai:DiVA.org:his-18675DiVA, id: diva2:1448802
Available from: 2020-06-29 Created: 2020-06-29 Last updated: 2020-08-27Bibliographically approved

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El Ansari, Walid

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