When is surgery indicated for prostatitis and which surgical interventions should be considered?

Updated: Aug 27, 2019
  • Author: John L Brusch, MD, FACP; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Surgery is indicated only for a few specific conditions, including bladder neck obstruction, prostatic calculi (seen in the image below), and recurrent infection with the same bacteria. [3]

Prostatic calcifications in a male with a urinary Prostatic calcifications in a male with a urinary tract infection.

Transurethral incision of the bladder neck benefits some patients with bladder neck obstruction; however, transurethral balloon dilatation of the prostate is not helpful. A partial transurethral prostatectomy (TURP) removes only part of the infected gland and, therefore, benefits only one third of patients.

Radical or total prostatectomy is usually not required or beneficial; complications include incontinence and impotence. Patients for whom a radical TURP or total prostatectomy should be considered are those with either prostatic calculi or those in whom the same bacteria have been consistently isolated from prostatic specimens. A prostate biopsy may confirm that the bacteria are actually originating from the prostate. These are rarely cured by antimicrobials alone; drainage is best achieved by an ultrasonographically guided needle.

Other surgical interventions may be needed to remove or address other complications, such as bladder calculi (seen in the image below).


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