Use of urokinase in percutaneous drainage of large breast abscesses.

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, chi(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.