Management of prostatic abscess in patients with human immunodeficiency syndrome

doi:10.1016/0090-4295(94)90176-7

Urology

Volume 43, Issue 5, May 1994, Pages 629-633

https://doi.org/10.1016/0090-4295(94)90176-7 Get rights and content

Abstract

Objective. To review and assess the management and evaluation of prostatic abscess in patients with the acquired immunodeficiency syndrome (human immunodeficiency virus [HIV)).

Methods. Retrospectively reviewed 7 cases of prostattc abscess in HIV-positive patients treated at our institution.

Results. All 7 patients presented with fever and irritative voiding symptoms. Only 1 patient had a positive initial urine culture; 3 of 5 operative cases only had positive intraoperative culture. Organisms cultured were Staphylococcus aureus, enterococcus, Mycobacterium tuberculosis, and Mycobacterium avium.

Conclusions. Transrectal ultrasonography is the imaging modality of choice for diagnosing this condition; it also directs the appropriate surgical approach. Transurethral unroofing should be attempted whenever significant extension outside the prostate is not found. Intraoperative cultures for aerobes, anaerobes, fungi, and mycobacteria must be obtained.

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Citation Excerpt :
Since PA is infrequently encountered, many physicians may not be familiar with the clinical manifestations and the diagnosis may be missed or delayed with untoward consequences (Ackerman et al., 2018; Weinberger et al., 1988). Commonly cited risk factors for PA in the modern era include diabetes, HIV infection, prostatitis, GU tract instrumentation, indwelling urethral catheters, voiding dysfunction secondary to obstruction, and neurogenic bladder ([Ackerman et al., 2018; McGowan and Krieger, 2015; Trauzzi et al., 1994; Weinberger et al., 1988], Table 3]). In our case series, 23% of patients were immunosuppressed (2 with HIV) and 50% had diabetes mellitus.
Prostatic abscess (PA) is uncommon and may be difficult to distinguish from acute prostatitis which often leads to delayed or missed diagnoses. Although gram-negative bacilli are the traditional etiology of PA, Staphylococcus aureus is an emerging cause. The goals of this study were to characterize the current clinical features, microbiology, management, and outcomes of PA at a US academic center.
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Management of prostatic abscess in patients with human immunodeficiency syndrome

Abstract

J Urol

J Urol

Am J Surg

J Urol

J Urol

J Urol

J Urol

J Urol

J Urol