18例前列腺脓肿微创治疗分析

Analysis of minimally invasive treatment in the management of prostatic abscess

目的:探讨前列腺脓肿微创治疗方式和时机选择。方法:回顾性分析2017年2月至2022年7月收治18例前列腺脓肿患者的临床资料,分析其临床特点、治疗方式的选择及其疗效。结果:18例患者中1例因脓肿自行破溃痊愈,17例患者经超声引导穿刺后14例痊愈,3例未愈患者经尿道脓肿去顶治疗痊愈。结论:经直肠超声引导穿刺治疗前列腺脓肿疗效显著,对于难治性(复发、多灶、穿刺引流效果欠佳)或者位置邻近尿道的前列腺脓肿,为缩短病程和减轻医疗负担,可考虑首选经尿道脓肿去顶治疗。

Objective:To analyze the proper time and method for treatment of prostatic abscess(PA).Methods:This is a retrospective study that included 18 patients diagnosed with and treated for prostatic abscess between February 2017 and July 2022.After obtaining data from the patients'medical records,we analyzed their clinical features as well as the therapeutic methods opted for and their effectiveness.Results:Of the 18 patients included,one achieved a full recovery after a spontaneous rupture of the abscess.Transrectal ultrasound(TRUS)-guided aspiration was performed in the remaining 17 patients,of whom 14 had a complete resolution after this procedure whereas 3 experienced recurrence.The recurrent cases were successfully managed with transurethral(TU)de-roofing.Conclusion:TRUS-guided aspiration is a treatment modality with a marked curative effect for simple PAs.For refractory abscesses(recurrent,multifocal,incomplete or unsuccessful drainage)or PA located near the urethra,TU de-roofing can be considered as a first choice to shorten the course of the disease and alleviate the medical treatment expenses due to recurrence.