Patient's question:
Six years ago, the patient had some lower back pain and went to a clinic. They said there was some inflammation in the prostate and treated him with microwave therapy and a large amount of antibiotics. The next day, he started to have a fever, and pain began in the left side, lower back, legs, and lower abdomen. It lasted for about 40 days, and then he had another fever, but he did not receive a clear diagnosis.Doctor's answer:
Treatment includes transurethral drainage or perineal incision and drainage with appropriate antibiotics.1. Medication Therapy
(1) General supportive and symptomatic treatment, including bed rest, semi-recumbent position to facilitate inflammation localization, adequate nutrition and fluid intake, physical cooling for high fever, correction of electrolyte disorders and acid-base balance, and sedatives and analgesics for severe pain.
(2) Antibiotics are selected based on bacterial culture results from urine and pus. When conditions are not available, penicillin should be the first choice. For severe cases, intravenous broad-spectrum antibiotics may be administered. Antibiotics should be used in sufficient doses to control the condition in the short term.
2. Physical Therapy
Prostate abscesses can be treated with local heat therapy. Simple and common methods include paraffin therapy or applying a hot water bag to the lower abdomen and perineum for heat application. This increases local blood circulation, promotes abscess localization, and facilitates inflammation resolution. However, burns should be prevented.
3. Surgical Therapy
For most prostate abscesses, perineal prostate aspiration and drainage is recommended, with antibiotics injected into the abscess cavity. If the abscess significantly enlarges and cannot drain spontaneously into the urethra or rupture into the urethra, abscess drainage surgery may be performed.