Name of the Procedure:

Transurethral drainage of prostatic abscess
(Commonly referred to as: Transurethral aspiration of prostatic abscess, Prostatic abscess drainage)

Summary

Transurethral drainage of prostatic abscess is a minimally invasive surgical procedure aimed at removing pus from an infected prostatic abscess through the urethra, alleviating symptoms and preventing further complications.

Purpose

This procedure addresses the condition of a prostatic abscess, an accumulation of pus within the prostate gland due to infection. The goals are to relieve pain, reduce infection, and restore normal urinary function.

Indications

• Persistent fever and chills
• Severe pelvic or lower abdominal pain
• Difficult or painful urination
• Diagnosis of prostatic abscess via imaging (e.g., ultrasound, MRI)
• Failure to respond to antibiotic therapy

Preparation

• Patients may be asked to fast for several hours before the procedure.
• Medication adjustments, particularly blood thinners, may be necessary.
• Pre-procedure diagnostic tests, like blood tests, urinalysis, and imaging, are usually required.

Procedure Description

1. The patient is positioned on the operating table, typically in a lithotomy position.
2. After administering local or general anesthesia, a cystoscope is inserted through the urethra to reach the prostate gland.
3. The abscess is located using imaging guidance if needed.
4. A needle or small catheter is used to puncture and drain the abscess, removing the pus.
5. The area is flushed with an antibiotic solution to reduce the risk of re-infection.
6. The instruments are withdrawn, and the patient is monitored as anesthesia wears off.

Duration

The procedure typically takes about 30 minutes to 1 hour, depending on the complexity and size of the abscess.

Setting

Transurethral drainage of prostatic abscess is usually performed in a hospital operating room or an outpatient surgical center.

Personnel

• Urologist or surgeon
• Anesthesiologist
• Nurses and surgical technicians

Risks and Complications

• Bleeding
• Infection
• Injury to the urethra or surrounding tissues
• Urinary incontinence or retention
• Recurrence of the abscess

Benefits

• Rapid relief from severe pain and symptoms
• Decrease in infection and related complications
• Restoration of normal urinary and prostate function

Recovery

• Antibiotics may be prescribed to prevent infection.
• Pain management medication and instructions will be provided.
• Restricted activities for a few days to a week.
• Follow-up appointments are necessary to monitor healing and check for recurrence.

Alternatives

• Antibiotic therapy alone (often ineffective for abscesses)
• Perineal drainage (a more invasive procedure with a different approach)
• Watchful waiting (not typically recommended due to risk of complications)

Patient Experience

During the procedure, the patient will be under anesthesia and should feel no pain. Post-procedure, there may be some discomfort or mild pain managed with medication. The patient might experience a temporary urinary catheter. Full recovery varies but usually occurs within a few weeks, with most returning to normal activities relatively soon.