Access to prostate abscess
The choice of access depends on the location and size of the lesion according to TRUS: the abscess adjacent to the urethra is opened transurethrally with a resectoscope - pus flows into the urethra, a catheter is installed; a large abscess of the posterior part of the gland is punctured and drained transrectally or through the perineum under ultrasound guidance, leaving a thin drainage for several days. The pus is sent for culture, and antibiotics are administered intravenously for 7–14 days. In case of urinary retention, a cystostomy is temporarily installed. After treatment, PSA and TRUS are monitored; Some patients still have chronic prostatitis, which requires observation.
Abscesses in urology
Purulent foci in urological practice occur against the background of urinary tract infection, obstruction, diabetes mellitus, after manipulation: prostate abscess as a complication of prostatitis, abscess of the perineum and scrotum, groin boils, abscess and paranephritis of the kidney with pyelonephritis. Signs are increasing throbbing pain, temperature with chills, thickening and redness, and with prostate abscess - urinary retention and pain during defecation. The formed abscess does not resolve with antibiotics and requires opening or drainage.
After opening
The cavity is drained until the purulent discharge stops (2–7 days), daily dressings and rinsing are performed, and the antibiotic is selected based on culture. The wound heals by secondary intention in 1–3 weeks. It is imperative to eliminate the cause: correction of diabetes, treatment of urinary tract infections, and in case of obstruction, drainage of the urinary tract. Control ultrasound confirms the disappearance of the cavity.
