MANAGEMENT OF PROSTATIC ABCESS - TRUS GUIDED ASPIRATION VS TRANSURETHRAL DEROOFING

Volume : VII, Issue : V, May - 2018

Sivasankar Govindaraju, Senthilvel Arumugam, Aravindh Rathinam

BACKGROUND : Transrectal ultrasound is particularly useful for early recognition and treatment of prostatic abscess. Simple drainage is the

treatment of choice done by transrectal ultrasound guided or transurethral deroofing. Prostatic abscess can be drained by both transrectal aspiration

and by transurethral deroofing . Both procedures has advantage and disadvantage

AIM AND OBJECTIVE: To compare the outcome of both TRUS guided aspiration and transurethral deroofing of prostatic abscess.

METHODS AND MATERIALS: This a randomized , clinical study . Patient admitted with features of fever with or without supra pubic pain or

/with tender and fluctuant swelling in prostate in our hospital from JAN 2016 to DEC 2017 are evaluated for prostatic abscess by TRUS or MRI .

Patient are randomly selected and undergone either of TRUS guided aspiration or transurethral deroofing done . All the patient are screened by

both pre and post drainage TRUS . Urine culture and associated co morbidities are noted . Drainage fluid sent for culture sensitivity. Post drainage

complications in both procedure are compared .

RESULTS : All patient had abscess size more than 20 cc by TRUS. Transurethral drainage has complications of retrograde ejaculate

(33%),incontinence (33%) , no residual abscess and bulbar urethra stricture urethra(one case). TRUS guided aspiration has complications of

residual (60%) and no retrograde ejaculate and incontinence

CONCLUSION: TRUS guided aspiration has less complications except for high chance of residual abscess requiring reaspiration and long

hospital stay compared with transurethral drainage . TRUS guided aspiration has less complications compared to with transurethral drainage.

Transurethral drainage has short hospital stay and complete cure of disease .