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What’s the Risk of Prostatic Abscess in Prostatitis

Anti-Inflammatory Drugs for Prostatitis

Men who have been experiencing symptoms of prostatitis for an extended period of time are at increased risk of having a prostatic abscess and should undergo imaging to make that determination, according to new research published in BMC Urology. It’s important to identify a prostatic abscess early because it can be treated effectively more easily.

What is a prostatic abscess?

Occasionally, a prostatic abscess can form in the prostate itself in cases of bacterial prostatitis. Such abscesses can have a high mortality rate if they are not treated properly and promptly.

Prostatic abscesses smaller than 20 millimeters are usually easy to treat while larger ones may require surgical intervention. Before treatment can be initiated, physicians usually take a fluid sample from the abscess utilizing ultrasound to help them locate the formation. Once the type of bacteria is identified, the appropriate antibiotics can be prescribed.

In some men, the abscess needs to be drained, in which case an instrument is passed through the penis to the abscess. A minute cut is made, the abscess is allowed to drain, and antibiotics are then usually prescribed. Catheterization also may be required because of swelling associated with the procedure.

What did the new study reveal about prostatic abscess and prostatitis?

An expert team from The Catholic University of Korea retrospectively reviewed 31 prostatic abscesses that were identified in 142 men who had acute prostatitis. Overall, the investigators found that having urinary voiding problems and symptoms of prostatitis for an extended period of time were associated with a significantly greater risk of developing a prostatic abscess. In addition:

  • Men with diabetes had an increased risk of prostatic abscess
  • The length of antibiotic treatment was generally longer among men with an abscess than those without one
  • Men who had an abscess smaller than 20 mm did not need to undergo surgery and were cured without complications
  • Men with an abscess larger than 20 mm who underwent transurethral resection required antibiotics for a shorter time than did men who did not have surgery
  • Prostatic abscesses were often discovered in men who did not improve after undergoing initial treatment

Overall, the authors concluded that “Routine imaging studies such as CT [computed tomography] or TRUS [transrectal ultrasonography] should be considered in cases of acute prostatitis…especially in patients with long-term symptom duration and voiding disturbances.” Imaging will allow doctors to be prepared for the presence of an abscess, which should be treated immediately and may need to be drained.

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