A.16 1.16 Inflammations of the prostate and the male genitals Flashcards
Prostatitis
incidence
statistics
- most common urological disease in men < 50 yrs
- men > 50 yrs it is the 3rd most common
- 6% incidence
Prostatitis Classification? (4)
- Acute bacterial prostatitis
- Chronic bacterial prostatitis
- Chronic abacterial prostatitis / chronic
pelvic syndrome
-Inflammatory chronic pelvic
-Non-inflammatory chronic pelvic - Asymptomatic inflammatory prostatitis
what is Acute bacterial prostatitis ?
Acute infection of the prostate with
sudden onset of chills, fever, lower
back pain and perineal pain
what is Chronic bacterial prostatitis?
Chronic recurrent infection of prostate
3months or more
what is Chronic abacterial prostatitis / chronic
pelvic syndrome?
Chronic recurrent infection but the Infective agent not found
what is Inflammatory CPPS?
chronic pelvic pain synd
prostatitis with Inflammatory cells in semen
what is Non-inflammatory chronic pelvic?
prostatitis with Non-inflammatory cells in semen
what is Asymptomatic inflammatory prostatitis
inflammatory cells detected in the semen either by prostate biopsy or during evaluation for other disorders
Etiology of prostatitis?
Multifunctional reasons:
- Infections from urethra
- Prostate calculi
- Pelvic musculature spasms
prostatitis Most common pathogens?
- Proteus
- E. coli
- Klebsiella
- Enterococcus
- Pseudomonas
PEEK P
prostatitis symps?
o LUTS in prostatitis:
- Weak stream
- difficult urination
- frequency
o Pain in prostatitis
how do you diagnose prostatitis?
- Clinical evaluation
- exclusion of STD
- urinalysis and urine culture
- uroflowmetry and residual volume
o Physical examination, DRE!!
prostatitis Treatment ?
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
what is Epididymitis?
its the most common ——
- The most common intrascrotal inflammation
- Acute inflammation of the epididymitis
- usually unilateral
- Acute or chronic
what is Orchitis?
when epididymitis comes with involvement of the testes
epididymis-orchitis
symps of epididymis-orchitis
- Local pain and tenderness
- swelling and erythma of the affected
side of the scrotum - Fever
- cramps
-inguinal discomfort - urethral discharge
fun facts about epididymitis?
-rarely result in
-due to
-becomes chronic in
- It is rarely the result of hematogenous spread
- it is mostly due to retrograde extension of organisms from vas deferens
- Become chronic in 15%
which infection epididymitis is preceeded by?
- mumps infection
- 20-30%
epididymitis Diagnosis
o Palpation
o Acute inflammation:
-Rapid onset of nausea, vomiting diarrhea, fever, pain
o Testicular US
epididymitis Treatment?
Abx
Antibiotics: FAAC
§ Fluoroquinolones
§ Aminopenicillin
§ Aminoglycosides
§ Ceftriaxone
epididymitis Treatment?
supportive care
Pain killers
bed rest
positioning of the testes
epididymitis Complications>?
after acute
- Chronic epididymitis
- abscess
- atrophic lesion of testis
epididymitis complications?
in chronic
Testicular atrophy
what complication can epididymitis cause
most annoying
Occlusion of ducts –> infertility
types of penis inflammations?
Balanitis=Balanitis is pain and inflammation of the glans
Balanoposthitis= is an inflammation that affects both the glans penis and prepuce.
what is balanitis?
Inflammation of the glans penis
types of balanitis?
erosive circinate Balanitis
Balanitis ulcerans/gangrenosa
Chronic balanitis
what is Balanitis erosive circinate?
Recurrent necrotic
what does Balanitis ulcerans/gangrenosa includes?
- Fever
- ulcers
- lymph node enlargement
what is Balanoposthitis?
Inflammation of the foreskin and glans in uncircumcised men
clinical findings of acute balanoposthitis?
hyperemia and pus at preputium and glans
How does Chronic balanitis look
hyperemic pathches
scarring
what is the Etiology of the balanitis?
o microrganisms:
-Bacterial
-fungal
o Irritants:
- Hygiene problem
- tight foreskin
- smegma irritation
o immunological:
Contact allergy
what is the treatment of balanitis?
o Local: Antiseptic solution
o Systemic: If fever, gangrene
o Surgical: If the infection is recurrent
Complications of balanitis?
Inflammation of the foreskin might lead to phimosis
how do you prevent balanitis?
Good hygiene
