Treatment of prostatic abscess: Value of transrectal ultrasonographically guided needle aspiration

The purpose of this study was to assess the effectiveness of transrectal ul trasonographically guided needle aspiration in the treatment of prostatic a bscess. Fourteen patients with prostatic abscess were evaluated with this t echnique and treated with sonographically guided needle aspiration. Using t his technique, all cases (100%) had one or more hypoechoic areas within the prostate that contained inhomogeneous materials; in 10 patients (71.0%), t he lesion showed internal septa or solid portion. The margins of the hypoec hoic area were well defined and thick in 11 patients (79.0%) and poorly def ined in 3 patients (21.0%). The estimated volume of the prostatic abscess r anged between 2 and 28 ml (mean, 12.0 ml). The presence of a pus collection within the prostate was confirmed by transrectal ultrasonographically guid ed aspiration in all patients. However, successful treatment of prostatic a bscess with transrectal needle aspiration was done in 12 (86.0%) of 14 pati ents; the treatment failed in 2 (14.0%) of 14 patients. One patient was tre ated with perineal incision and drainage and the other with transurethral r esection. The amount of pus drained ranged between 1 and 39 ml (mean, 12.0 ml). On follow-up transrectal ultrasonographic examination, no remaining ab scess pocket was found within the prostate in any of the cases. One year la ter, the prostatic abscess recurred in one case. In conclusion, transrectal ultrasonographic guidance is useful in the diagnosis of prostatic abscess as well as in the guidance for aspiration and the drainage of such abscesse s. Transrectal ultrasonographically guided needle aspiration could be an ef fective method for treating prostatic abscess.