(Disclaimer: This article is only for scientific purposes, in order to protect the privacy of patients, the following content of the relevant information has been processed) Abstract: prostate abscess is a rare clinical inflammatory lesions of the prostate, this paper, the patient is an elderly man, due to progressive urinary difficulties for 5 years, anal swelling with fever for 3 days to the hospital, after the relevant examination, diagnosed as prostatic hyperplasia, prostate abscess. Cefmenoxime, piperacillin sodium tazobactam were given to control the development of the disease, together with the transurethral prostate electrocautery and abscess incision and drainage, the patient was cured of dysuria and the prostate abscess disappeared. 【Basic information】 Male, 75 years old 【Disease type】Difficulty in urination, prostate abscess 【Hospitalization】 Shijiazhuang People’s Hospital 【Time of consultation】 May 2018 【Treatment plan】Medication (cefmenoxime, piperacillin sodium tazobactam) + Surgery (transurethral prostatic electrocutaneous resection and abscess incision and drainage surgery) 【Treatment cycle】 Hospitalization for 20 days, outpatient follow-up for 1 month 【Treatment effect】Difficulty in urination is cured, and the prostate abscess disappears. Difficulty in urination was cured and prostate abscess disappeared I. Initial interview The patient was a 75-year-old male, who was admitted to the hospital because of progressive difficulty in urination for 5 years and anal swelling with fever for 3 days, with a history of type 2 diabetes mellitus for 20 years and unsatisfactory blood glucose control, and a history of prostatic hyperplasia for 10 years, and was on long-term symptomatic treatment of oral finasteride and tamsulosin, with history of urinary catheterization for many times and retention of catheter. Rectal palpation: prostate was obviously enlarged with significant pressure pain; blood cell analysis: leukocytes 16.3× 10^9 /L, urine culture was Escherichia coli, ultrasound showed unclear demarcation between inner and outer glands of the prostate, internal echogenicity was not uniform, and there was no echogenicity in the glands around the urethra, the border was not clear, the morphology was irregular, and the size was 3.5cmx4.2cm, CDFI: blood flow signal was not seen in the mass. Magnetic resonance imaging (MRI) scan showed an enlarged prostate, with a mass of abnormal signal visible within the prostate, measuring 3.6cmx4.5cm, with a slightly elevated prostate abscess around the lesion, low T1WI within, and a markedly high signal shadow on DWI. Combined with the medical history, the possibility of prostate abscess was considered, and the preliminary diagnosis was: prostatic hyperplasia and prostate abscess. The patient was admitted to the hospital and given cefmenoxime intravenous infusion treatment, blood culture and urine culture suggests Escherichia coli, drug sensitivity test suggests that piperacillin sodium sulbactam sodium is sensitive, so it was replaced with piperacillin sodium sulbactam sodium to continue intravenous infusion anti-inflammatory treatment. After the patient’s body temperature was normal, blood cell analysis of leukocytes returned to normal, and urine analysis of leukocytes was approximately normal, the urodynamic examination was perfected, suggesting that: bladder outlet obstruction, bladder contractility was approximately normal, and the maximum urinary flow rate was 3.5 ml/s. After discussion in the department, it was recommended to perform transurethral prostatic electrocutaneous resection and abscess incision and drainage surgery, and the patient was under lumbar-rigid anesthesia, and the patient was subjected to transurethral prostatic electrocutaneous resection and prostatic abscess incision and drainage surgery. The patient underwent transurethral resection of prostate and incision and drainage of prostate abscess under lumbar-rigid anesthesia. During the operation, moderate to severe hyperplasia was found in both lobes of prostate, and a large amount of pus was spewed out after incision of abscess, which led to adequate drainage of the abscess cavity, and the patient was retained in urinary catheterization for 5-7 days after the operation. The patient was treated with intravenous infusion of cefmenoxime, piperacillin sodium sulbactam sodium and other drugs, together with urethro-prostatic electrocision and incision and drainage of prostatic abscess, the number of leukocytes was reduced, fever symptoms were initially relieved, bladder obstruction was relieved, and the symptom of dysuria was gradually restored to patency, and the patient was able to pass urine normally after removal of catheter in 1 week after the operation, and he stayed in the hospital for 20 days, the patient basically recovered, and it did not affect daily life, and he was discharged from the hospital. After 20 days of hospitalization, the patient was basically recovered and his daily life was not affected, so he was discharged from the hospital and followed up in outpatient clinic for 1 month. After the drug combined with surgical treatment, it is very happy that the patient’s prostate abscess situation has been recovered, after discharge from the hospital, pay attention to avoid high-sugar diet, blood sugar control, but also to prevent constipation, avoid spicy and stimulating food, it is advisable to eat a light diet, and pay attention to the nutritional allocation, eat more fresh fruits and vegetables. Pay attention not to hold urine, timely urination, in order to prevent the emergence of urinary tract infection. If you have any discomfort after discharge, such as difficulty in urination, anal discomfort, etc., come to the hospital for follow-up. V. Personal perception Prostate abscess is rare in clinic and easy to be misdiagnosed and missed. 2/3 of the patients with prostate abscess can be touched with obvious fluctuating sensation on rectal fingerprinting, most of the patients can be detected and diagnosed by imaging, sensitive antibiotics can be given, timely surgical incision and drainage is the key to the treatment of prostate abscess. Surgery is the key to the treatment of prostate abscesses. It is generally believed that patients with ineffective antibiotic treatment, abscess cavities >2 cm, and multiple abscesses require surgical treatment. In this patient, an elderly man with urodynamics suggesting bladder outlet obstruction was treated with transurethral resection of the prostate to relieve lower urinary tract obstruction, and at the same time, the prostate was incised and drained to control inflammation, which resulted in a good clinical outcome.