Management of prostatic abscess in patients with human immunodeficiency syndrome

Objective. To review and assess the management and evaluation of prostatic abscess in patients with the acquired immunodeficiency syndrome (human immunodeficiency virus [HIV)). Methods. Retrospectively reviewed 7 cases of prostattc abscess in HIV-positive patients treated at our institution. Results. All 7 patients presented with fever and irritative voiding symptoms. Only 1 patient had a positive initial urine culture; 3 of 5 operative cases only had positive intraoperative culture. Organisms cultured were Staphylococcus aureus, enterococcus, Mycobacterium tuberculosis, and Mycobacterium avium. Conclusions. Transrectal ultrasonography is the imaging modality of choice for diagnosing this condition; it also directs the appropriate surgical approach. Transurethral unroofing should be attempted whenever significant extension outside the prostate is not found. Intraoperative cultures for aerobes, anaerobes, fungi, and mycobacteria must be obtained.