Prostatic abscesses

　　The causative bacteria of most prostatic abscesses are Escherichia coli, with other pathogenic bacteria including Pseudomonas, Staphylococcus, and anaerobic bacteria. The infection route is the same as that of bacterial prostatitis. Most are complications of acute bacterial prostatitis caused by ascending urinary tract infections and infected urinary prostatic reflux.

　　Prostatic abscesses can溃烂 into the rectum, forming perirectal abscesses. The pus can directly enter the ureter and bladder, leading to ureteritis and cystitis, often with symptoms of frequent urination, urgency, dysuria, and urinary burning. Immunosuppressed individuals and those who have long-term use of immunosuppressants may have the infection spread to the testicle, leading to epididymo-orchitis, which can be severe enough to affect sperm quality and lead to infertility.

　　The symptoms of prostatic abscesses include fever, frequent urination, urgency, dysuria, and other bladder irritation symptoms; difficulties in urination, urinary retention, urethral discharge of pus, hematuria, and pyuria may also occur. Some patients may also have acute epididymitis and discomfort during defecation. Digital rectal examination may reveal spasm of the anal sphincter, enlargement of the prostate, marked tenderness, and fluctuation, with fluctuation of the prostate being the most characteristic change.

　　Most prostatic abscesses are complications of acute bacterial prostatitis caused by ascending urinary tract infections and infected urinary prostatic reflux. The preventive measures for prostatic abscesses include active treatment for urinary tract infections as soon as they are detected, so for patients with ascending infections through the urethra, active anti-infection treatment should be carried out to avoid the spread of infection affecting the prostate.

　　Prostatic abscess is a complication of acute prostatitis, urethritis, and epididymitis. Urinalysis and midstream urine culture can detect bacterial growth, which is the basis for the diagnosis of prostatic abscess. Below, experts introduce the examination items that need to be done for prostatic abscess:

　　1. Transrectal ultrasound shows enlargement of the prostate, and there are hyperechoic or anechoic areas as well as peripheral high-echoic halos.

　　2. CT scan can show varying degrees of enlargement of the prostate with low-density areas, and sometimes there may be fluid dark areas. After enhancement scanning, the abscess wall presents as a ring-like enhancement.

　　3. Digital rectal examination shows明显 enlarged glands, which can involve one or two lobes, asymmetric, severe tenderness, soft with fluctuation, after the abscess ruptures and pus is discharged, forming an empty cavity, and there is a local depression when digital rectal examination is performed.

　　4. Urethroscopy shows thick pus discharge.

　　5. Urography shows that one side of the abscess causes urethral displacement, contrast medium overflow to the outside of the urethra, or contrast medium retention.

　　The diet of prostatic abscess patients should be light and nutritious, and attention should be paid to dietary balance. Spicy and刺激性 foods should be avoided to prevent recurrence of the condition. Eat more fresh vegetables and fruits. Fresh vegetables and fruits contain a large number of nutrients needed by the human body. Eat more immune-boosting foods: postoperative patients have poor physical condition and low immunity, so they should eat more immune-boosting foods such as yam, turtle, mushroom, kiwi, fig, apple, sardine, honey, milk, pork liver, etc., to improve the body's ability to resist diseases.

　　General prostatic abscess patients should use antibiotics according to the results of urine or pus culture and drug sensitivity test; for patients with acute urinary retention or those with indwelling catheters, suprapubic cystostomy should be adopted. Diabetics should also control blood sugar and improve the body's immunity. The surgical treatment of this disease can be puncture aspiration of pus, incision and drainage, and transurethral resection of the prostate (TURP), with surgical routes including rectal, perineal, and transurethral. Currently, most cases are punctured for abscess aspiration under rectal ultrasound guidance, which can not only clarify the location, size, and number of the abscess, but also perform accurate operation, rinse the abscess cavity and inject antibiotics. It has small trauma, can be repeated, and is easy to operate.