Transurethral drainage of prostatic abscess: points of technique.

BACKGROUND: The incidence of prostatic abscess (PA) has markedly declined with the widespread use of antibiotics and the decreasing incidence of urethral gonococcal infections.

OBJECTIVES: To evaluate different treatment methods for prostatic abscess and to describe technical points that will improve the outcome of transurethral (TUR) drainage of prostatic abscess.

PATIENTS AND METHODS: We performed a retrospective study of a series of 11 patients diagnosed with prostatic abscess, who were admitted and treated in Farwaniya Hospital, Kuwait, between February 2008 and November 2010. Drainage was indicated when antibiotic therapy did not cause clinical improvement and after prostatic abscess was confirmed by TRUS (Transrectal ultrasonography) and/or CT computed Tomographyscan. TUR drainage was indicated in 7 cases, ultrasound-guided transrectal drainage was performed in 2 cases, and ultrasound-guided perineal drainage was performed in 2 cases.

RESULTS: All patients that underwent TUR-drainage had successful outcomes, without the need of secondary treatment or further surgery.

CONCLUSIONS: TUR drainage of a prostatic abscess increases the likelihood of a successful outcome and lowers the incidence of treatment failure or repeated surgery. Less invasive treatment, with perineal or transrectal aspiration, may be preferred as a primary treatment in relatively young patients with localized abscess cavities.