OBJECTIVE: To evaluate the clinical manifestations and management of tuberculous prostatitis at Taipei Veterans General Hospital.PATIENTS AND METHODS: Nine adult males presented to the urology clinic with an
enlarged prostate. Clinically, a malignant tumor was suspected after digital rectal examination (DRE). Core needle biopsy was performed for further diagnosis at Taipei Veterans General Hospital during a period of over 10 years (from January 1989 to October 1999). They were well
identified histologically.RESULTS: The histopathological sections depicted chronic inflammation in all cases and caseous necrosis in 7 patients (78%). Acid-fast stain revealed positive acid-fast bacilli (AFB) in 7 patients (78%). These cases were diagnosed as tuberculosis of the prostate and were treated with an antituberculous drug regimen.
CONCLUSIONS: Tuberculosis of the prostate is sometimes difficult to differentiate from carcinoma of the prostate. Transrectal ultrasound-guided biopsy of the prostate allows a reliable diagnosis in tuberculous prostatitis. Therefore, it is recommended as the method of choice for diagnosis and follow-up, as has been advocated for the diagnosis of prostate cancer.