A.16 1.16 Inflammations of the prostate and the male genitals

Question 1

Prostatitis
incidence
statistics

Answer 1

• most common urological disease in men < 50 yrs
• men > 50 yrs it is the 3rd most common
• 6% incidence

Question 2

Prostatitis Classification? (4)

Answer 2

• Acute bacterial prostatitis
• Chronic bacterial prostatitis
• Chronic abacterial prostatitis / chronic
  pelvic syndrome
  -Inflammatory chronic pelvic
  -Non-inflammatory chronic pelvic
• Asymptomatic inflammatory prostatitis

Question 3

what is Acute bacterial prostatitis ?

Answer 3

Acute infection of the prostate with
sudden onset of chills, fever, lower
back pain and perineal pain

Question 4

what is Chronic bacterial prostatitis?

Answer 4

Chronic recurrent infection of prostate
3months or more

Question 5

what is Chronic abacterial prostatitis / chronic
pelvic syndrome?

Answer 5

Chronic recurrent infection but the Infective agent not found

Question 6

what is Inflammatory CPPS?

Answer 6

chronic pelvic pain synd
prostatitis with Inflammatory cells in semen

Question 7

what is Non-inflammatory chronic pelvic?

Answer 7

prostatitis with Non-inflammatory cells in semen

Question 8

what is Asymptomatic inflammatory prostatitis

Answer 8

inflammatory cells detected in the semen either by prostate biopsy or during evaluation for other disorders

Question 9

Etiology of prostatitis?

Answer 9

Multifunctional reasons:
- Infections from urethra
- Prostate calculi
- Pelvic musculature spasms

Question 10

prostatitis Most common pathogens?

Answer 10

• Proteus
• E. coli
• Klebsiella
• Enterococcus
• Pseudomonas

PEEK P

Question 11

prostatitis symps?

Answer 11

o LUTS in prostatitis:
- Weak stream
- difficult urination
- frequency

o Pain in prostatitis

Question 12

how do you diagnose prostatitis?

Answer 12

• Clinical evaluation
• exclusion of STD
• urinalysis and urine culture
• uroflowmetry and residual volume

o Physical examination, DRE!!

Question 13

prostatitis Treatment ?

Answer 13

o Antibiotics:
- Aminoglycosides IV + cephalosporins/fluoroquinolones

o Alpha blockers:
relax smooth muscle

o Surgery
- Bladder drainage: Suprapubic catheter. Never indwelling!!!
- If abscess is present–> transrectal/perineal US guided puncture
- Semicastration

Question 14

what is Epididymitis?

its the most common ——

Answer 14

• The most common intrascrotal inflammation
• Acute inflammation of the epididymitis
• usually unilateral
• Acute or chronic

Question 15

what is Orchitis?

Answer 15

when epididymitis comes with involvement of the testes

epididymis-orchitis

Question 16

symps of epididymis-orchitis

Answer 16

• Local pain and tenderness
• swelling and erythma of the affected
  side of the scrotum
• Fever
• cramps
  -inguinal discomfort
• urethral discharge

Question 17

fun facts about epididymitis?
-rarely result in
-due to
-becomes chronic in

Answer 17

• It is rarely the result of hematogenous spread
• it is mostly due to retrograde extension of organisms from vas deferens
• Become chronic in 15%

Question 18

which infection epididymitis is preceeded by?

Answer 18

• mumps infection
• 20-30%

Question 19

epididymitis Diagnosis

Answer 19

o Palpation
o Acute inflammation:
-Rapid onset of nausea, vomiting diarrhea, fever, pain
o Testicular US

Question 20

epididymitis Treatment?
Abx

Answer 20

Antibiotics: FAAC
§ Fluoroquinolones
§ Aminopenicillin
§ Aminoglycosides
§ Ceftriaxone

Question 21

epididymitis Treatment?
supportive care

Answer 21

Pain killers
bed rest
positioning of the testes

Question 22

epididymitis Complications>?
after acute

Answer 22

• Chronic epididymitis
• abscess
• atrophic lesion of testis

Question 23

epididymitis complications?
in chronic

Answer 23

Testicular atrophy

Question 24

what complication can epididymitis cause
most annoying

Answer 24

Occlusion of ducts –> infertility

Question 25

types of penis inflammations?

Answer 25

Balanitis=Balanitis is pain and inflammation of the glans

Balanoposthitis= is an inflammation that affects both the glans penis and prepuce.

Question 26

what is balanitis?

Answer 26

Inflammation of the glans penis

Question 27

types of balanitis?

Answer 27

erosive circinate Balanitis
Balanitis ulcerans/gangrenosa
Chronic balanitis

Question 28

what is Balanitis erosive circinate?

Answer 28

Recurrent necrotic

Question 29

what does Balanitis ulcerans/gangrenosa includes?

Answer 29

• Fever
• ulcers
• lymph node enlargement

Question 30

what is Balanoposthitis?

Answer 30

Inflammation of the foreskin and glans in uncircumcised men

Question 31

clinical findings of acute balanoposthitis?

Answer 31

hyperemia and pus at preputium and glans

Question 32

How does Chronic balanitis look

Answer 32

hyperemic pathches
scarring

Question 33

what is the Etiology of the balanitis?

Answer 33

o microrganisms:
-Bacterial
-fungal

o Irritants:
- Hygiene problem
- tight foreskin
- smegma irritation

o immunological:
Contact allergy

Question 34

what is the treatment of balanitis?

Answer 34

o Local: Antiseptic solution
o Systemic: If fever, gangrene
o Surgical: If the infection is recurrent

Question 35

Complications of balanitis?

Answer 35

Inflammation of the foreskin might lead to phimosis

Question 36

how do you prevent balanitis?

Answer 36

Good hygiene