%0 Journal Article
%T Transurethral Resection of Prostate Abscess: Is It Different from Conventional Transurethral Resection for Benign Prostatic Hyperplasia?
%A Neeraj Kumar Goyal
%A Apul Goel
%A Satyanarayan Sankhwar
%A Divakar Dalela
%J ISRN Urology
%D 2013
%R 10.1155/2013/109505
%X Purpose. To present our experience of prostate abscess management by modified transurethral resection (TUR) technique. Methods. Seventeen men with prostate abscess undergoing TUR between 2003 and 2011 were retrospectively analyzed. Details of demography, surgical procedures, complications, and followup were noted. Results. With a mean age of 61.53 ¡À 8.58 years, all patients had multifocal abscess cavities. Initially, 6 men underwent classical TUR similar to the technique used for benign prostatic enlargement (group 1). Next, 11 men underwent modified TUR (group 2) in which bladder neck and anterior zone were not resected. The abscess cavities resolved completely, and no patient required a second intervention. One patient in group 1 and three in group 2 had postoperative fever requiring parenteral antibiotics . Three patients in group 1 had transient urinary incontinence, whereas none of the patients in group 2 had this complication ( ). Four and five men in group 1 and 2 reported retrograde ejaculation, respectively . Conclusion. The modified technique of prostate resection edges over conventional TURP in the form of reduced morbidity but maintains its high success rate for complete abscess drainage. It alleviates the need for secondary procedures, having an apparent advantage over limited drainage techniques. Use of this technique is emphasized in cases associated with BPH and lack of proper preoperative imaging. 1. Introduction In the modern antibiotic era, prostatic abscess is a rarely encountered entity, particularly in developed countries [1, 2]. However, in developing countries it continues to be a significant health problem and can result in severe complications and even death on account of delayed diagnosis or inadequate management [3]. Therapeutically, it requires some form of surgical intervention as a medical treatment as monotherapy is usually not sufficient [3]. The management options include transrectal ultrasound- (TRUS-) guided aspiration/tube drainage, transurethral incision over abscess (TUI), transurethral deroofing of the abscess cavity (TUD), or formal transurethral resection of prostate (TURP) [3¨C9]. No management algorithm is currently available to guide the surgical drainage, and the decision is usually based on the preference of the treating physician. Although TUD and TURP have been described as two separate procedures for prostatic abscess, the techniques are overlapping and poorly defined in the contemporary literature. Similarly, the indications of a particular procedure (whether deroofing or resection) and complications are
%U http://www.hindawi.com/journals/isrn.urology/2013/109505/