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Acute prostatitis in middle‐aged men: a prospective study
Author(s) -
Kravchick S.,
Cytron S.,
Agulansky L.,
BenDor D.
Publication year - 2004
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2004.04642.x
Subject(s) - medicine , prostatitis , transrectal ultrasonography , prostate , prospective cohort study , prostate cancer , abscess , urology , prostate specific antigen , gastroenterology , surgery , cancer
OBJECTIVES To determine the clinical outcome of middle‐aged men with acute prostatitis, the optimum time for re‐assessing their prostate‐specific antigen (PSA) levels, and to detect any possible echotextural and vascular changes that remain as a consequence of acute inflammation. PATIENTS AND METHODS Persistent fever prompted a re‐evaluation for prostatic abscess formation in 28 middle‐aged men, using transrectal ultrasonography (TRUS) colour Doppler imaging, undertaken at the 3‐, 6‐ and 12‐month visits. The results of TRUS were compared with laboratory data and clinical outcome. RESULTS Two abscesses were detected; 19 (68%) of the patients remained infection‐free at the 3‐month visit. Serum PSA levels were elevated in 11 (39%) of the patients at this visit; three prostate carcinomas were diagnosed. Increased intraprostatic colour flow was detected in 68% and there were hypoechoic areas in 46% of the patients. CONCLUSION The re‐evaluation for abscess formation should not be postponed for > 48 h. Patients with acute prostatitis tend to have persistent infection. PSA levels could be high even up to 3 months after an acute episode. Middle‐aged men with carcinoma could be missed during the acute phase of inflammation. PSA and TRUS monitoring are strongly recommended.