Prostatic Abscesses: Radiographic Findings and Treatment
Chalida Aphinives MD*, Kajit Pacheerat MD**, Jitjaroen Chaiyakum MD*, Vallop Laopaiboon MD*, Potchavit Aphinives MD**, Warinthorn Phuttharak MD*
Affiliation : * Department of Radiology, Faculty of Medicine, Khon Kaen University ** Department of Surgery, Faculty of Medicine, Khon Kaen University
Objective : To analyze the medical images and therapeutic strategies in patients with prostatic abscesses.
Method : From April 1999 to August 2002, 12 patients with prostatic abscesses at Srinagarind Hospital,
Khon Kaen, Thailand were reviewed. The average age was 47 years (range 29 to 75). Diagnostic procedures
included analysis of midstream urine, abscess fluid for pathogens and medical imaging with TRUS, CT and
MRI. Therapeutic options were transrectal ultrasound-guided drainage or conservative medical treatment.
Results : Almost all patients had predisposing diseases. All patients showed hypo-echoic masses, plus internal
septation in 5 cases. Most lesions were located at the central gland. Their sizes ranged from 0.5 to 2.75 cm
(average 1.51 cm) in diameter. The main pathogen was B. pseudomallei. On TRUS imaging, patients with
melioidosis had one or more hypo-echoic areas with internal septation, thickened wall and surrounding
multiple small daughter abscesses. All abscesses resolved within 4 weeks, with no difference in the duration
of treatment, despite different sizes or pathogens.
Conclusions : Transrectal ultrasonography is useful in the diagnosis of prostatic abscess as well as in the
guidance for aspiration and the drainage of such abscesses. Our data showed sonographic patterns in
prostatic abscess, especially with melioidosis.
Keywords : Prostatic abscess, Melioidosis
