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Prostate Abscess Treatment
jwallon posted:
After two months of prostatitis, I now have an abscess in my prostate, diagnosed by a CT scan. I understand that this is a very rare condition, and I'm concerned about the treatment that I am receiving. I have considerable pelvic and lower back pain (achy), as well as aching/sensitive testicles, painful and difficult urination, and painful ejaculation. I ran a fever at the worst of it. Cipro for the prostatitis did no good (the abscess may have started after the antibiotics) and I'm now on augmentin. After one week on augmentin, the worst of the pain resolved. However, after 20 minutes of much-needed sex with my wife, which was very painful afterward, the worst symptoms have returned and have grown worse over the last 4 days. My urologist said that I need to give the antibiotics more time to work, and that this will take a long time to heal.

Doing some research on the web, I found a few articles that seem to agree that transrectal aspiration of the abscess should be performed, followed up by antibiotic therapy using antibiotics that I haven't been on. This hasn't even been mentioned. I feel like I am losing the fight against this thing and I don't want to die of sepsis or need emergency surgery to remove the prostate and become impotent at 43. I made an appointment with another urologist for a second opinion, but that is a week from now. Does anyone have any advice about my situation? Anything would be greatly appreciated.
Sheldon_Marks_MD responded:
Antibiotics will be of minimal help until the abscess is drained. That is what needs to be done, and sooner rather than later. Only bad things will happen if you postpone the drainage.
counterso replied to Sheldon_Marks_MD's response:
I totally agree with Dr. Marks. It's irresponsible not to drain the abscess. However you may feel about your "need" for sex, it doesn't sound wise when you have an infection like this. Who knows what further irritation could occur or rupture or whatever?
jeffreykay responded:

My situation resembles yours. I am 47 years old. Have been on antibiotics (cipro) for over 6 weeks with no improvement. 2 CT scans, cystocopy and anal prostate ultrasound. Even had overnight stay at hospital due to pain/infection. Urologist identified suspiscous area within prostate and i go for biopsy tomorrow. My urologist has never mentioned this (possibility of abscess) to me either. I am going to mention this to my urologist before my biopsy and see if drainage can be done at same time.

Since its been 4 months do you have an update to your condition?

Thanks and good luck.
counterso replied to jeffreykay's response:
There are also prostate stones that can occur, similar to the way you can get kidney stones or bladder stones. They can also cause quite unpleasant symptoms.

Prostate tissue is very dense, gets little blood circulation, and as a result can be difficult to treat with any kinds of medication that requires circulation through the blood stream to reach the organ. This is part of why prostatitis and prostate cancer are such a challenge to treat with medications.

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