Prostate abscess is an infectious disease in which tissue decomposes in the organ and pus accumulates in the capsule. In its origin, it can be an independent process associated with prostate diseases and a consequence of infectious diseases occurring in the body. Regardless of the origin, most often the treatment of the disease involves surgery. If treatment is started, life-threatening complications may develop.
What is
An abscess is a protective reaction of the body that localizes inflammation in a capsule that limits it from tissues that are not subject to inflammation.
The reasons that may cause purulent inflammation of the prostate gland are divided into 2 types:
- Primary abscess most often occurs due to acute prostatitis, adenoma, blockage of the ducts with calculous prostatitis, tuberculosis or prostate cancer. The basis for development may be an unsuccessful surgical intervention: bougienage, puncture or catheterization, during which the integrity of the mucous membrane is violated and infection occurs.
- Secondary begins due to the introduction of bacteria from other organs through the circulatory or lymphatic system. It can be caused by: purulent sore throat, boils, pneumonia, bacterial infection in the urethra, gall or bladder, sweat glands.
It is possible to determine the presence of an abscess in the prostate gland using transrectal ultrasound, tomography or digital examination of the prostate.
Sometimes, if treatment is not timely or medical recommendations are not followed, the formation of a prostate fistula can occur. If pus breaks through, re-infection may occur, which will lead to relapse of the disease or the formation of fibrinous inflammation.
Fibrinous prostate abscess is characterized by the formation of scar tissue around it, which replaces the functional one, which impairs the functioning of the entire organ. The occurrence is possible as a result of an advanced purulent process, secondary infection or due to the development of a malignant neoplasm.
Symptoms
Purulent inflammation has 2 stages:
- Infiltrative – the formation of an abscess.
- Purulent-destructive – creation of a capsule and its limitation by additional connective tissue.
The symptoms of prostate abscess depend on the stage of the disease:
- At the first stage, they are similar to the signs of acute prostatitis, so it is not always possible to identify the disease at an early stage: throbbing pain in the perineum, fever, retention of urination and defecation, headache, weakness.
- During the purulent-destructive stage, the symptoms subside, and the disease seems to go away. This occurs as a result of the abscess being surrounded by a layer of granulation tissue. At this stage, there is a danger of an abscess breaking through.
Signs of a purulent infection can be seen in laboratory tests of urine and blood. There is an increase in indicators:
- erythrocyte sedimentation rate (ESR);
- leukocytes;
- protein in urine.
In case of a breakthrough, the symptoms depend on which organ it occurred in:
- The urethra (pus in the urine, unpleasant odor, discoloration).
- Rectum (mucus, pus in stool).
- Abdominal cavity (pain with pressure, temperature, nausea, vomiting).
Treatment
Treatment of prostate abscess depends on the stage at which the disease is located:
- In case of infiltrative inflammation at an early stage, it is possible to do without surgical intervention and carry out drug therapy. For this purpose, antibacterial drugs, analgesics, and detoxicants are prescribed. In acute cases of the disease, blockades performed in the prostate area may be prescribed.
- If the disease has progressed to a purulent-destructive stage and a fully formed abscess is visible on ultrasound, surgical intervention is necessary.
If the abscess is small (up to 6 ml of pus), it is removed using a puncture. Under local anesthesia, the patient is punctured using a syringe with a long needle. Under ultrasound control, the pus is pumped out, then using another syringe with a thicker needle, the abscess cavity is washed out to prevent relapse. At the final stage, an antibiotic solution is injected into the abscess cavity for disinfection.
If there is a large volume of pus, open surgery is necessary. The incision is made in the perineal area under general anesthesia. In order not to damage the urethra, it is recommended to perform bougienage. The abscess is opened, it is cleaned and treated with an antiseptic.
Then antibacterial medications and detoxicants are prescribed. Treatment can be combined with the use of folk remedies and physiotherapy.
The use of folk remedies involves taking tinctures, decoctions and agents with antibacterial and anti-inflammatory effects.
In physiotherapy, electrophoresis with the use of medications and laser therapy have proven themselves well.
Thermal procedures and massage of the prostate during an abscess are prohibited, as the abscess may rupture.
Possible consequences
If you do not consult a doctor in a timely manner, a fistula may form. In this case, the abscess ruptures into neighboring organs:
- bladder;
- rectum;
- urethra;
- abdominal cavity.
When an abscess breaks, the pus does not come out completely, so the following may develop:
- relapse;
- complications (formation of phlegmon);
- fibrinous abscess.
The most severe consequences of prostate abscess are peritonitis and urosepsis. These complications can lead to death.
