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The incidence of prostatic Prostata-Drainage PA has markedly declined with the widespread use of antibiotics and the decreasing incidence of urethral gonococcal infections. To evaluate different treatment methods Prostata-Drainage prostatic abscess and to describe technical points that will improve Prostata-Drainage outcome of transurethral TUR drainage of prostatic abscess. We performed a retrospective study of a series of Prostata-Drainage patients diagnosed Prostata-Drainage prostatic abscess, who were admitted and treated in Farwaniya Hospital, Kuwait, between February and November TUR drainage was indicated in 7 cases, ultrasound-guided transrectal drainage was performed in 2 cases, and Prostata-Drainage perineal drainage was performed in 2 cases.

All patients that underwent TUR-drainage had successful outcomes, Prostata-Drainage the need of secondary treatment Prostata-Drainage further surgery. 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 Prostata-Drainage treatment in relatively young patients with localized abscess cavities.

The incidence of prostatic abscess PA has declined markedly with the widespread use of Prostata-Drainage and the decreasing incidence of urethral gonococcal infections. Predisposing factors for PA include an indwelling catheter, instrumentation of the lower urinary tract, bladder outlet obstruction, acute and chronic Prostata-Drainage prostatitis, chronic renal failure, hemodialysis, diabetes mellitus, cirrhosis, and, more recently, acquired immunodeficiency syndrome AIDS 1 - 3.

Evidence from the literature indicates that prostatic Prostata-Drainage is diagnosed in only 0. To evaluate different treatment methods for prostatic abscess and to describe technical points that will improve the outcome of TUR drainage of prostatic abscess. We retrospectively Prostata-Drainage a series of 11 patients diagnosed with prostatic abscess, who were admitted and treated in Farwaniya Hospital, Kuwait, between February and Novemberusing data collected from medical records.

The ages of the patients ranged from 43 to 67 years old mean age, 51 Table 1. All patients had risk factors. Nine patients had diabetes Prostata-Drainage 2 were receiving hemodialysis.

All Prostata-Drainage initially treated Prostata-Drainage parenteral antibiotics. Prostata-Drainage was indicated after there was no clinical improvement with antibiotic therapy and after the diagnosis of prostatic abscess was confirmed. In this article, we Prostata-Drainage some technical points of TUR drainage of prostatic abscess that will help to accurately identify the site Prostata-Drainage abscess cavity, minimize unneeded resection TURPand improve the drainage.

To prevent septicemia, TUR drainage is performed Prostata-Drainage preoperative systemic parenteral antibiotic administration and after injection of Prostata-Drainage doses of cephalosporin and metronidazole. During TUR drainage of prostatic abscess, the site of the abscess is not easy to detect, as it is usually deep-seated in the transitional zone. The site of the abscess cavity can be pre-operatively anticipated with the findings from digital rectal examination, transrectal ultrasonography, Prostata-Drainage CT scans.

Additionally, the release of pus to the prostatic urethra, by Prostata-Drainage prostatic massage, can indicate the site of the abscess. Another method is to induce pus release to the prostatic urethra by creating several incisions with a Collings knife in the expected site of the abscess, thus avoiding Prostata-Drainage resection of prostatic tissues.

In some cases, to ensure complete drainage of the abscess, the thick pus must Prostata-Drainage milked out by prostatic massage. Prostata-Drainage patients had fever, which was accompanied by urine retention in Prostata-Drainage cases of our series. Three patients presented with severe lower urinary tract symptoms. Six patients had perianal or perineal pain. Ten patients had leukocytosis, while Prostata-Drainage immunocompromised patient Prostata-Drainage hemodialysis showed a normal Prostata-Drainage count.

In 10 patients, the prostatic abscess was detected by transrectal ultrasound Figure 1. One Prostata-Drainage, who could not tolerate the transrectal Prostata-Drainage, was diagnosed by abdominal ultrasonography. Computed tomography CT scans confirmed the abscess in 7 patients Figure 2. CT scans of our series detected 2 cases with an Prostata-Drainage extension to ischiorectal fossa and in 1 case, detected emphysematous prostatitis, a rare condition 8.

All Prostata-Drainage were initially Prostata-Drainage with empiric parenteral antibiotics during their hospital Prostata-Drainage, with 4.

The 2 patients on hemodialysis were prescribed 1 gram ceftriaxone od, Prostata-Drainage it is safe with renal failure. Seven patients received TUR drainage of their abscesses 4 received it as primary treatment and 3 as secondary treatment after failed aspiration. The abscesses of 2 patients were perineally drained, Prostata-Drainage to the periprostatic extension of Prostata-Drainage abscess to the ischiorectal fossa and Prostata-Drainage.

Two patients Prostata-Drainage transrectal drainage due to posterior abscess bulging into the space between the prostate and the rectum. The most frequently identified Prostata-Drainage was Escherichia coli, which was found in 6 cases, followed by Staphylococcus aureus in 3 cases and Klebsiella pneumoniae in 2 cases. There were no tuberculosis cases in this series. All patients were negative for human immunodeficiency virus HIV. In 5 out of the 7 patients who underwent TUR drainage, the abscess cavity was located on the Prostata-Drainage part of the prostate, close to the verumontenum.

In late follow-up Prostata-Drainage the 7 patients that received TUR drainage, only 2 of the patients had retrograde ejaculation. Successful drainage was achieved in all TUR drainage cases, without the need of secondary treatment or further surgery. Prostatic abscess is an infrequent clinical occurrence that can be difficult to diagnose, due to its presentation with non-specific Prostata-Drainage. Symptoms and clinical findings of prostatic abscess are extremely variable.

Fever and painful and frequent micturition are common with acute prostatitis. A prostatic abscess may progress to spontaneous fistulization into the urinary Prostata-Drainage, prostatic urethra, Prostata-Drainage, or perineum.

In some cases, it can lead to sepsis and death 9 - Thus, both an accurate diagnosis and an efficient treatment are required. Most published data regarding prostatic abscesses are case reports, and there is no standardization of the diagnostic and Prostata-Drainage routines. In review articles, the summary of several individual experiences permits delineating some lines of action for prostatic abscess 1Prostata-Drainage.

The diagnostic method of choice, which assists in the treatment and follow-up of patients with prostatic abscess, is transrectal ultrasonography of the prostate. The most common finding is the presence of 1 or Prostata-Drainage hypoechoic areas, which contain thick pus primarily in the transition zone and in the central zone of the prostate, and which are permeated by hyperechogenic areas and distortion of the Prostata-Drainage of the gland 9.

This finding, observed in all cases in Prostata-Drainage study for which the examination was performed, supports the use of transrectal ultrasonography for the diagnosis of prostatic abscess, for detection of extraprostatic Prostata-Drainage, and to detect gas in the fluid emphysematous prostatitis 9. Transrectal Prostata-Drainage usually underestimates the real periglandular extension of the abscess 9 - Detecting periprostatic extension, particularly to the ischiorectal fossa and perineum, is important, as Prostata-Drainage drainage is easier and expected to be Prostata-Drainage successful than the TUR Prostata-Drainage, which we observed in case number 5.

Prostata-Drainage of prostatic abscess is implied in parenteral broad-spectrum antibiotic administration and abscess drainage. All methods have been reported to be safe and Prostata-Drainage. Recent findings suggest that less invasive treatment Prostata-Drainage ultrasound-guided percutaneous or transrectal drainage is preferred to TUR drainage because it can be performed under local anesthesia or sedation and repeated if necessary. Less invasive methods also have a lower risk of complications, in particular, Prostata-Drainage retrograde ejaculation after TUR drainage Prostata-Drainage relatively young Prostata-Drainage 13 - TUR drainage should be reserved for cases with multiple and diffuse prostatic abscesses or when aspiration does not show complete resolution Prostata-Drainage the Prostata-Drainage collection 9.

In this series, 7 patients Using Prostata-Drainage procedural points, which have been described in the Materials and Methods section, to accurately localize the abscess cavity during Prostata-Drainage drainage is very important, particularly Prostata-Drainage young patients, in order to limit TUR drainage to the abscess cavity, and thus avoid Prostata-Drainage occurrence of retrograde ejaculation after complete TURP.

Prostatic abscess should be suspected in patients presenting with fever and persistent lower urinary tract symptoms that do not respond to antibiotics. Less invasive treatments, such as perineal or transrectal aspiration, Prostata-Drainage preferred as the primary treatment in relatively young patients with localized abscess cavities. TUR drainage is recommended in cases with diffuse, large abscess cavities or after failed aspiration. Several techniques, which we have described above, are very helpful during TUR drainage in minimizing resection and avoiding retrograde ejaculation in relatively young patients.

TUR drainage of prostatic abscesses has a high Prostata-Drainage of success and a low incidence of treatment failure or further surgery. Nephro-Urol Mon. DOI: Prostata-Drainage Disclosure: Drs. National Center for Biotechnology InformationU.

Journal List Nephrourol Mon v. Nephrourol Mon. Published online Mar 1. Author information Article notes Copyright and License information Disclaimer. Prostata-Drainage ; Jahra,Kuwait. This is an open-access article distributed under the terms Prostata-Drainage the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly Prostata-Drainage.

This article has been cited by other articles in PMC. Abstract Background The incidence of prostatic abscess PA has markedly declined with Prostata-Drainage widespread Prostata-Drainage of antibiotics and the decreasing Prostata-Drainage of urethral gonococcal Prostata-Drainage.

Objectives To evaluate different treatment methods for prostatic abscess and to describe technical points that will improve the outcome of Prostata-Drainage TUR drainage of prostatic abscess. Patients and Methods We Prostata-Drainage a retrospective study of a series of 11 patients diagnosed with prostatic abscess, who were admitted and Prostata-Drainage in Farwaniya Hospital, Prostata-Drainage, between February and November Results All Prostata-Drainage that underwent TUR-drainage had successful outcomes, without the need of secondary treatment or further surgery.

Conclusions Prostata-Drainage drainage of a prostatic abscess increases the likelihood Prostata-Drainage a successful outcome and lowers the incidence of treatment failure or repeated surgery. Keywords: Prostate, Transurethral, Drainage, Methods.

Background The incidence of prostatic abscess PA has declined markedly with the widespread Prostata-Drainage 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 TUR drainage of prostatic abscess. Patients and Methods We retrospectively studied a series of Prostata-Drainage patients diagnosed with prostatic abscess, who were admitted and treated in Farwaniya Hospital, Kuwait, between February and Novemberusing data collected from medical records.

Table 1 Demographics and Operative Data. Open in a separate window. Technique To prevent septicemia, TUR drainage is performed during preoperative systemic parenteral antibiotic administration and after injection of single doses of cephalosporin and metronidazole.

Results All patients had fever, which was Prostata-Drainage by urine Prostata-Drainage in 8 cases of our Prostata-Drainage. Figure 1. Figure 2. Discussion Prostatic abscess is an infrequent clinical occurrence that can be difficult to diagnose, due to its presentation with non-specific symptoms. Acknowledgments There is no grant or funding source for this study. References 1. Prostata-Drainage abscesses in sub-Saharan Africa: Prostata-Drainage hospital-based experience from Cameroon. Eur Urol.