prostate abscess
Introduction
Introduction to prostate abscess Prostate abscess is a complication of acute prostatitis, urethritis and epididymitis. Common pathogens are aerobic Gram-negative bacilli, followed by Staphylococcus aureus. The patient is usually 40 to 60 years old, with frequent urination, dysuria or urinary retention, perineal pain, evidence of acute epididymitis, hematuria and purulent urethral secretions are less common. Some patients may have fever, and rectal examination may reveal tenderness and fluctuations in the prostate, but prostate enlargement is often the only abnormality seen, and sometimes prostate palpation feels normal. Leukocytosis is common, although pus and bacteriuria are common, but urine can be normal, and blood culture in a few patients is positive. basic knowledge Proportion of disease: The probability of illness in men over 20 years old is 0.76% Susceptible people: male Mode of infection: non-infectious Complications: anorectal abscess
Cause
Causes of prostate abscess
Infection factor (45%)
In bacterial prostatitis, pathogenic microorganisms are similar to pathogenic bacteria causing genitourinary tract infections. Common pathogenic bacteria are Escherichia coli (E. coli), and a few are Proteus, Klebsiella, Enterococcus, etc. Gram-positive bacteria have few chances of infection. Absolute anaerobic bacteria rarely cause prostate infection. The role of Gram-positive bacteria in etiology is still controversial. Most researchers agree that enterococci cause chronic prostate abscess, but other leathers Blue-positive bacteria such as Staphylococcus, Streptococcus, Artococcus, and diphtheria have a pathogenic effect on prostatitis. Most are complications of acute bacterial prostatitis caused by ascending urinary tract infections and infections in the urinary prostate.
Other relevant factors (30%)
Previous studies have found that sex hormone nutrition, past urinary tract infection history, stress, mental factors, allergies and sexual life, etc., are potential factors for prostate abscess.
Prevention
Prostate abscess prevention
Once an infection of the urinary tract is found to require active treatment, it is necessary to actively carry out anti-infective treatment for the infection of the pathogen through the urethra to prevent the spread of infection from affecting the prostate. Usually pay attention to your own personal hygiene, reduce the incidence of inflammation.
Complication
Prostatic abscess complications Complications around the anorectal abscess
Prostate abscess can rupture into the rectum, forming an abscess around the rectum.
Symptom
Symptoms of prostate abscess Common symptoms Urethral orifice adhesions pyuria urinary frequency hematuria prostate calcified abscess bladder irritation urinary pain urgency
Fever, frequent urination, urgency, dysuria and other symptoms of bladder irritation, dysuria, urinary retention; urinary tract discharge, hematuria and pyuria, some patients with acute epididymitis and bowel movements, anal sphincter can be found The prostate enlarges, the tenderness is obvious, and there is a sense of fluctuation. Among them, the fluctuation of the prostate is the most characteristic change.
Examine
Examination of prostate abscess
Urine routine, mid-stage urine culture can be found in bacterial growth.
1. The rectal B-ultrasound shows an enlarged prostate, and there is a low echo or no echo zone and a peripheral high echo aperture.
2. CT plain scan can show that the prostate is increased in different degrees with low-density area, sometimes visible in the dark area of the liquid, and the wall of the abs is enhanced after the enhanced scan.
3, rectal finger examination gland enlargement significantly, can involve one or two leaves, asymmetry, intense tenderness, soft and fluctuating, abscess ulceration and pus discharge into a cavity, localized depression when the anus is diagnosed.
4, urethroscopic examination see thick pus out.
5, urethra angiography see one side of the abscess to shift the urethra, contrast agent overflow to the urethra or contrast agent retention.
Diagnosis
Diagnosis and differentiation of prostate abscess
diagnosis
According to clinical manifestations, digital rectal examination and imaging examination, it is not difficult to make a diagnosis. Rectal ultrasound or CT examination is of great significance for diagnosis and guidance treatment.
Differential diagnosis
1. Acute prostatitis: also manifested as frequent urination, urgency, dysuria with chills, fever, but no urethra pus, and rectal examination of prostate enlargement, tenderness but no fluctuations, transrectal B-ultrasound and CT examination There is no liquid occupying performance in the prostate.
2. Acute pyelonephritis: manifested as frequent urination, urgency, dysuria with chills, fever, but no dysuria, no urethra pus, and pain in the waist, normal rectal examination, normal prostate, no tenderness, no fluctuations, Transrectal B-ultrasound and CT examination of the absence of fluid in the prostate.
3. Abscess around the rectum: also manifested as chills, fever with perineal discomfort, rectal irritation, local tenderness of the rectal examination, fluctuating, but no dysuria, no urethral pus, transrectal B-ultrasound and CT Examination showed that there was a liquid dark area around the rectum, and there was no liquid occupying change in the prostate.
