Prostatic abscess
Updates to Article Attributes
A prostatic abscesses can be a rare complication of prostatitis.
Epidemiology
It has become relaitvely uncommon in clinical practice due to antibiotic therapy in those with prostatitis. It tends to affect diabetic and immunosuppressed patients. Most patients tend to present in the 5th to 6th decade 7.
Clinical presentation
Common presenting features are dysuria, fever, suprapubic pain +/ - urinary retention. Urine examination usually reveals pus cells. Clincal presentation can sometimes be similar to acute bectarial prostatitis without asbcess formation 8.
Pathology
The prostate is a relatively uncommon gland for abscess formation.
The organisms usually involved include
- Escherichia coli
- Staphylococcus spp
- Gonococcus spp - rare
Radiographic features
Ultrasound
Transrectal sonography (TRUS) is considered very reliable imaging method to diagnose a prostatic abscess 1-2. It usually demonstrates ill-defined hypoechoic areas within an enlarged and / or distorted prostate gland. They may be inhomogenous echoes within 8-9.
CT
- tends to show well defined areas of low attenuation 3
- the prostate gland can either be symmetrically or assymetrically enlarged
MRI
MRI signal characteristics of an abscess include 2
- T1 : hypointense
- T2 : hyperintense
- C+ (Gd) : tends to show peripheral contrast enhancement.
-
DWI :
- limited studies only 2
- tends to show restriction of diffusion corresponding to hypoechoic lesions on ultraousnd
-
ADC :
- limited studies only 2
- mean ADC values within the abscesses have been reported to be very low
Treatment and prognosis
Percutaneous transperineal or transrectal drainage is often considered the first choice for therapy due of the lower risk of complication compared with surgery. A TRUS guided aspiration is also reported to be an effective and minimally invasive treatment modality.
More content required
Differential diagnosis
Imaging differential considerations include
- cavitatory prostatitis from chronic prostatitis
- cystic prostatic carcinoma
See also
-<p>A <strong>prostatic abscesses</strong> can be a rare complication of <a title="Prostatitis" href="/articles/prostatitis">prostatitis</a>. </p><h4>Epidemiology</h4><p>It has become relaitvely uncommon in clinical practice due to antibiotic therapy in those with prostatitis. It tends to affect diabetic and immunosuppressed patients. Most patients tend to present in the 5<sup>th</sup> to 6<sup>th</sup> decade <sup>7</sup>.</p><h4>Clinical presentation </h4><p>Common presenting features are dysuria, fever, suprapubic pain +/ - urinary retention. Urine examination usually reveals pus cells. Clincal presentation can sometimes be similar to acute bectarial prostatitis without asbcess formation <sup>8</sup>.</p><h4>Pathology</h4><p>The prostate is a relatively uncommon gland for abscess formation.</p><p>The organisms usually involved include</p><ul>- +<p>A <strong>prostatic abscesses</strong> can be a rare complication of <a href="/articles/prostatitis">prostatitis</a>. </p><h4>Epidemiology</h4><p>It has become relaitvely uncommon in clinical practice due to antibiotic therapy in those with prostatitis. It tends to affect diabetic and immunosuppressed patients. Most patients tend to present in the 5<sup>th</sup> to 6<sup>th</sup> decade <sup>7</sup>.</p><h4>Clinical presentation </h4><p>Common presenting features are dysuria, fever, suprapubic pain +/ - urinary retention. Urine examination usually reveals pus cells. Clincal presentation can sometimes be similar to acute bectarial prostatitis without asbcess formation <sup>8</sup>.</p><h4>Pathology</h4><p>The prostate is a relatively uncommon gland for abscess formation.</p><p>The organisms usually involved include</p><ul>
-</ul><h4>Radiographic features</h4><h5>Ultrasound </h5><p>Transrectal sonography (TRUS) is considered very reliable imaging method to diagnose a prostatic abscess <sup>1-2</sup>. It usually demonstrates ill-defined hypoechoic areas within an enlarged and / or distorted prostate gland. They may be inhomogenous echoes within <sup>8-9</sup>.</p><h5>CT</h5><ul>- +</ul><h4>Radiographic features</h4><h5>Ultrasound</h5><p>Transrectal sonography (TRUS) is considered very reliable imaging method to diagnose a prostatic abscess <sup>1-2</sup>. It usually demonstrates ill-defined hypoechoic areas within an enlarged and / or distorted prostate gland. They may be inhomogenous echoes within <sup>8-9</sup>.</p><h5>CT</h5><ul>
-<strong>DWI </strong>:-<ul>- +<strong>DWI </strong>: <ul>
-<strong>ADC </strong>:-<ul>- +<strong>ADC </strong>: <ul>
-</ul><h4>Treatment and prognosis</h4><p>Percutaneous transperineal or transrectal drainage is often considered the first choice for therapy due of the lower risk of complication compared with surgery. A TRUS guided aspiration is also reported to be an effective and minimally invasive treatment modality. </p><p>More content required</p><h4>Differential diagnosis</h4><p>Imaging differential considerations include</p><ul>- +</ul><h4>Treatment and prognosis</h4><p>Percutaneous transperineal or transrectal drainage is often considered the first choice for therapy due of the lower risk of complication compared with surgery. A TRUS guided aspiration is also reported to be an effective and minimally invasive treatment modality.</p><p>More content required</p><h4>Differential diagnosis</h4><p>Imaging differential considerations include</p><ul>
-<a title="cavitatory prostatitis" href="/articles/cavitatory-prostatitis">cavitatory prostatitis</a> from chronic prostatitis</li>-<li>cystic <a title="Prostatic carcinoma" href="/articles/prostatic-carcinoma-1">prostatic carcinoma</a> </li>-</ul><h4>See also</h4><ul><li><a title="cystic lesions of the prostate" href="/articles/cystic-lesions-of-the-prostate">cystic lesions of the prostate</a></li></ul>- +<a href="/articles/cavitatory-prostatitis">cavitatory prostatitis</a> from chronic prostatitis</li>
- +<li>cystic <a href="/articles/prostatic-carcinoma-1">prostatic carcinoma</a>
- +</li>
- +</ul><h4>See also</h4><ul><li><a href="/articles/cystic-lesions-of-the-prostate">cystic lesions of the prostate</a></li></ul>
Image 6 MRI (Dynamic post contrast ) ( create )
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