Purpose of the study:
A prostatic abscess is a peculiar genitourinary infection often posing a diagnostic and therapeutic challenge. Many studies have reported newly emerging at-risk populations presenting with a wide range of clinical features further adding to the diagnostic difficulty. In this review, we aim to study epidemiology, risk factors, clinical presentation, microbiota, and outcome of PA patients presented to our tertiary care academic centre.
Material and methods:
We retrospectively studied the patients who presented to our centre with a diagnosis of a prostatic abscess (PA) from 2007 to 2021. We reviewed their medical record and obtained relevant information which includes demographic details, clinical presentation, associated comorbidities, physical examination findings, laboratory investigations, imaging details, treatment, and outcome.
Results:
A total of 38 patients was included in the study. The mean age was 49.47 (S.D ±14.01) years. 58% of patients were younger than 50 years. 73% of patients presented with both focal and systemic symptoms. Uncontrolled DM and voiding dysfunction was the most common risk factors. Six patients were diagnosed as diabetic on admission. E. coli was the most common organism in urine and prostatic pus culture. 10% of E. coli were ESBL resistant. Antibiotics, transurethral drainage and TURP were the most common management options. Out of 38 patients, 2 patients died due to septic shock.
Conclusion:
In our study, PA is more common in younger males, and it can be a tell-tale sign of underlying comorbidities like diabetes mellitus. Knowledge of various causative microorganisms and local antibiograms is vital for selecting appropriate empirical antibiotics and avoiding antibiotic resistance. Pus culture of the procedural specimen is important for identification of microorganisms & proper antimicrobial selection. In the absence of standard guidelines, we propose that treatment should be individualized taking into consideration clinical features of the patient, abscess characteristics and potential complications.
Key words: Prostate, abscess, Genitourinary infection, Transrectal ultrasound, Transurethral drainage, Transrectal aspiration
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