成吉 昌一¹, 西村 武久¹, 辻 祐治²

Shouichi NARIYOSHI¹, Takehisa NISHIMURA¹, Yuji TSUJI²

¹西村泌尿器科病院, ²福岡大学医学部泌尿器科学教室　

¹Nishimura Hospital, ²Department of Urology, Fukuoka University School of Medicine

キーワード : Abscess , Inflammation, Prostate, Transrectal ultrasonography

An 81-year-old man with diabetes mellitus had urinary retention and urinary tract infection. Digital rectal examination showed the prostate to be enlarged and tender, while transrectal ultrasonography (TRUS) showed a markedly enlarged prostate with a focal hypoechoic area consistent with prostatic abscess. Despite oral antibiotic therapy, TRUS findings showed progression of the disease. The abscess, however, suddenly disappeared and the size of the prostate decreased. These US findings suggested disruption of the abscess to the rectum. Subsequent transurethral resection of the prostate resulted in a rectourethral fistula. Because prostatic abscess is rare, its proper diagnosis and optimal management are sometimes difficult. Prostatic abscess requires case-by-case treatment strategies depending on the progression of the infection. Accordingly, TRUS of the prostate should be repeated whenever necessary to obtain a precise understanding of the status of the disease.