The role of surgical intervention in prostatic abscess remains uncertain. Our study aims to explore the impact of drainage on prostatic abscess and identify mortality-related risk factors.

In the retrospective study, 822 patients was diagnosed with acute prostatitis or prostatic abscess between 2007 to 2021. We collected data including patient demographics, comorbidities, initial vital signs, laboratory results, and treatment interventions. Interventions included TRUS-guided aspiration and TURP. Primary outcomes measured by mortality and hospital stay duration.

Among 822 oatients,105 patients were confirmed prostatic abscess, 19 underwent drainage, and 86 without procedure. With the drainage group showed significantly larger prostate volumes (54.53 vs. 41.67, p=0.011) and abscess sizes (3.94 vs. 2.60, p=0.014). TURP was mainly performed in the drainage group, with 73.68%. Additionally, cystostomy was more frequent in the drainage group (31.58% vs. 11.63%, p=0.040). Mortality rates between groups showed no significant difference, with 10.47% in the non-drainage group and 5.26% in the drainage group (p=0.685). The median hospital stay was also similar between non-drainage and drainage (16 vs. 19, p=0.874). Univariate analysis of risk factor for prostate abscess-related death showed significant correlation with age, fever before admission and alpha blocker use. Multivariate analysis showed no identified risk factor.

In our study, drainage did not significantly affect patient outcomes, and notably, undergoing TURP had no impact on overall survival.