Göğüş Cağatay, Ozden Eriz, Karaboğa Resul, Yağci Cemil
Department of Urology, Ankara University, School of Medicine, Ankara, Turkey.
Eur J Radiol. 2004 Oct;52(1):94-8. doi: 10.1016/S0720-048X(03)00231-6.
Prostatic abscess (PA) is a very uncommon disorder. The value of transrectal ultrasound (TRUS) guided aspiration in the treatment of PA has not been clearly defined. We present our experience with six such patients.
Between July 1997 and December 2002, six patients with PA were diagnosed by TRUS and treated by TRUS guided needle aspiration in our department. PA was defined as hypoechoic, inhomogeneous, thick walled fluid collection. TRUS guided needle aspiration of the abscess was performed transrectally in all patients with a 20-cm long 18 gauge Chiba needle. Successful treatment criteria were defined as clinical improvement in symptoms and decrease of more than half of the estimated abscess volume on follow up TRUS control. Patients with continuing clinical symptoms were defined as treatment failures.
The most common TRUS finding was detection of a hypoechoic area with inhomogeneous structures, which was determined in all patients (100%). In some patients irregular contour and heterogeneous areas were additionally described. TRUS guided needle aspiration treatment of PA was successful in five of six patients (83.3%). In one patient treatment failed and the abscess recurred 3 weeks after the procedure. As this patient had additionally a bladder outflow obstruction, transurethral resection of the prostate was performed instead of a repeat procedure. There were no complications associated with the procedure.
In conclusion, TRUS has an important value in diagnosis and treatment of PA. TRUS guided aspiration is an effective and minimally invasive treatment modality for PA which causes no serious complications.
前列腺脓肿（PA）是一种非常罕见的疾病。经直肠超声（TRUS）引导下穿刺抽吸在PA治疗中的价值尚未明确界定。我们介绍我们治疗6例此类患者的经验。
1997年7月至2002年12月期间，我们科室通过TRUS诊断出6例PA患者，并采用TRUS引导下针吸术进行治疗。PA被定义为低回声、不均匀、厚壁的液性聚集。所有患者均经直肠使用一根20厘米长的18号千叶针进行TRUS引导下脓肿针吸术。成功治疗标准定义为症状临床改善以及在随访TRUS检查时估计脓肿体积减少超过一半。持续有临床症状的患者被定义为治疗失败。
最常见的TRUS表现是检测到一个结构不均匀的低回声区，所有患者（100%）均有此表现。部分患者还描述有不规则轮廓和异质区域。TRUS引导下针吸术治疗PA在6例患者中有5例（83.3%）成功。1例患者治疗失败，术后3周脓肿复发。由于该患者还存在膀胱流出道梗阻，遂行经尿道前列腺切除术而非重复手术。该手术无相关并发症。
总之，TRUS在PA的诊断和治疗中具有重要价值。TRUS引导下穿刺抽吸是一种治疗PA的有效且微创的治疗方式，不会引起严重并发症。
