影響攝護腺膿瘍病人接受保守治療或介入性治療的因子與預後分析
潘思穎、張議徽、李宗叡、葉進仲、鄒頡龍、陳汶吉、連啟舜
謝博帆、蕭博任、黃志平、張兆祥
中國醫藥大學附設醫院 泌尿部
Analyze influential factors of patients with prostate abscess underwent conservative or intervention treatment and prognosis of either treatment
Szu-Ying Pan, Yi-Huei Chang, Tzung-Ruei Li, Chin-Chung Yeh, Chieh-Lung Chou, Wen-Chi Chen, Chi-Shun Lien, Po-Fan Hsieh, Po-Jen Hsiao, Chi-Ping Huang, Chao-Hsiang Chang
Department of Urology, China Medical University Hospital, Taichung, Taiwan
Purpose: To evaluate treatment outcome of patients with prostate abscess underwent conservative antibiotic treatment only or intervention treatment ( Transurethral resection of the prostate TURP or Transperineal drainage ) .
Materials and Methods: During 2016 and March 2020, we retrospectively collected 28 male patients with prostate abscess in a single institute (China Medical University Hospital). Patients’ demographic paramenters including comorbidity , laboratory data , prostate and abscess size , management and hospital duration. Complication was recorded by Clavien-Dindo Classification.
Chi square and student t test are applied with SPSS.
Results: Patients’ age ranged from 34 to 92 (median 59). The basic data were no significant differences between conservative group (10 patients) and intervention group (14 for TURP , 4 for perineal drainage), except different prostate abscess size between two groups (8.17cm3 Vs 24.41cm3). Risk factors percentage such as Diabetes mellitus , HIV infection, and transplant status were 71%, 14% and 7% respectively. The HbA1c was average …. in DM patients. Over half of patients suffered from fever as initial presentation. 33% of patient presented with dysuria initially and 21% patients suffered from acute urinary retention. The average hospital days of conservative and intervention group was 13.4 and 21.3 days respectively. Only one patient expired because of septic shock with multiple organ dysfunction after TURP .( Clavien–Dindo classification grade V).
Conclusion:
Diabetes mellitus with poor control and immunodeficient patients are high risk population of prostate abscess. Conservative antibiotic treatment seems effective in patients with prostate abscess under 8.17cm3 in size. Drainage is also a successful method to treat prostate abscess if TURP is not suitable for unstable patients.