급성 전립샘염에서 전립샘 농양 유무에 따른 임상경과
Clinical Outcomes According to Prostatic Abscess in Acute Prostatitis
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Purpose: To evaluate differentiation of clinical course and outcomes between patients with acute prostatitis only and acute prostatitis with prostatic abscess. Materials and Methods: This retrospective study examined the records of 68 patients with acute prostatitis from January 2006 to June 2010. These patients were divided into two groups according to the presence of the prostate abscess: group 1 (prostate abcess; 18 patients, mean age 59.1±13.3 years) and group 2 (acute prostatitis without prostatic abscess; 50 patients, mean age 57.7±14.6 years)-. We evaluated clinical parameters including degree and duration of fever, admission period, transrectal ultrasonographic findings, and laboratory test including prostate specific antigen (PSA), white blood cells (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), urinalysis, urine culture, and antibiotic sensitivity. Results: The degree of fever in group 1 (38.4±<1.3℃) was higher than group 2 (37.7±0.9℃) (p=0.024), and duration of fever and admission period (3.2±3.0 days vs 1.5±1.6 days, respectively; p=0.006) (22.2±12.6 days vs 6.7±2.9 days, respectively; p<0.001) were longer in group 1. Total prostate volume in group 1 (46.6±720.3ml) was larger than group 2 (32.9±13.9ml) (p=0.002). The results of laboratory tests indicating inflammation in group 1 were higher than group 2 (WBC; 20,592±13258/uL vs 14,577±9097/uL, p=0.040, ESR; 65.1±22.3mm/hr vs 34.3±11.9mm/hr, p=0.001, CRP; 19.4±10.7mg/dL vs 12.1±9.4mg/dL, p=0.023). The causative organisms in group 1 were more resistant to quinolone than group 2 (p=0.019). Conclusions: The clinical course of prostate abscess is more severe and longer than acute prostiaitis. We propose that early imaging study for diagnosis of prostatic abscess in acute prostatitis patients with low response to initial empirical conservative treatment for 2 days. Because antibiotic resistant rate was higher, careful choice of antibiotics and different therapeutic plans including abscess drainage will be needed in patients with prostatic abscess.
Abstract
Purpose: To evaluate differentiation of clinical course and outcomes between patients with acute prostatitis only and acute prostatitis with prostatic abscess. Materials and Methods: This retrospective study examined the records of 68 patients with acute prostatitis from January 2006 to June 2010. These patients were divided into two groups according to the presence of the prostate abscess: group 1 (prostate abcess; 18 patients, mean age 59.1±13.3 years) and group 2 (acute prostatitis without prostatic abscess; 50 patients, mean age 57.7±14.6 years)-. We evaluated clinical parameters including degree and duration of fever, admission period, transrectal ultrasonographic findings, and laboratory test including prostate specific antigen (PSA), white blood cells (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), urinalysis, urine culture, and antibiotic sensitivity. Results: The degree of fever in group 1 (38.4±<1.3℃) was higher than group 2 (37.7±0.9℃) (p=0.024), and duration of fever and admission period (3.2±3.0 days vs 1.5±1.6 days, respectively; p=0.006) (22.2±12.6 days vs 6.7±2.9 days, respectively; p<0.001) were longer in group 1. Total prostate volume in group 1 (46.6±720.3ml) was larger than group 2 (32.9±13.9ml) (p=0.002). The results of laboratory tests indicating inflammation in group 1 were higher than group 2 (WBC; 20,592±13258/uL vs 14,577±9097/uL, p=0.040, ESR; 65.1±22.3mm/hr vs 34.3±11.9mm/hr, p=0.001, CRP; 19.4±10.7mg/dL vs 12.1±9.4mg/dL, p=0.023). The causative organisms in group 1 were more resistant to quinolone than group 2 (p=0.019). Conclusions: The clinical course of prostate abscess is more severe and longer than acute prostiaitis. We propose that early imaging study for diagnosis of prostatic abscess in acute prostatitis patients with low response to initial empirical conservative treatment for 2 days. Because antibiotic resistant rate was higher, careful choice of antibiotics and different therapeutic plans including abscess drainage will be needed in patients with prostatic abscess.
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