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Use of Urokinase in Percutaneous Drainage of Large Breast Abscesses

Departments of Radiology (J.D.B.-S., J.D.B.-M.) and Surgery (P.J.G.), Virgen de la Arrixaca University Hospital, El Palmar, Spain; and Department of Surgery, Reina Sofia University Hospital, Murcia, Spain (M.M.).

Address correspondence to Juan D. Berná-Serna, MD, Department of Radiology, Virgen de la Arrixaca University Hospital, 30120 El Palmar (Murcia), Spain. E-mail: jdberna{at}um.es

Objective. The purpose of this study was to evaluate intracavitary urokinase therapy versus irrigation with a saline solution in percutaneous drainage of large breast abscesses. Methods. A prospective randomized study was conducted in 19 nonlactating women (median age, 35.7 years) with breast abscesses of greater than 3 cm. Percutaneous drainage with an ultrasound-guided catheter was performed in group A patients (saline solution) and group B patients (urokinase). Postdrainage care and ultrasound-guided drainage control were performed on an outpatient basis. The Student t test, Fisher exact test, ² test, and Mann-Whitney U test were used for statistical analysis. Results. Percutaneous drainage with saline or urokinase irrigation was successful in all cases. No statistically significant differences were observed between groups A and B for clinical parameters and sonographic characteristics of the abscesses. However, a statistically significant difference was observed between the two groups for the average drainage times (P < 0.012), which were 3.8 days for the urokinase group and 5.3 days for the saline group. A recurrence was observed in 1 saline group patient who had a diagnosis of a chronic abscess, which was resolved with intracavitary urokinase irrigation. Conclusions. Percutaneous drainage of large breast abscesses in nonlactating women with intracavitary urokinase irrigation is a simple and safe procedure. It reduces the treatment time and improves the clinical course of patients more than conventional drainage with saline irrigation.

Key Words: breast abscess • percutaneous drainage • ultrasound guidance • urokinase