Rectoprostatic fistula: unusual presentation of a prostatic abscess

To present the case and iconography of a rectoprostatic fistula as a form of presentation of a prostatic abscess and to review the literature on the diagnosis and treatment of this pathology. 69-year-old male with multiple pathologic conditions who presents an orifice in the prostatic fossa on digital rectal examination in the scenario of a urinary tract infection with fever. CT scan and colonoscopy showed a prostatic abscess fistulizing to rectum. Due to spontaneous drainage of the abscess, conservative treatment with intravenous fluid therapy and antibiotics was chosen. Prostatic abscess is often difficult to diagnose because of its low prevalence and unspecific symptomatology. Since the introduction of antibiotics, cases in which abscess fistulas or opens spontaneously to neighboring structures like urethra or rectum have decreased.