Acute Prostatitis

Question 1

What is prostatitis?

Answer 1

Inflammation and infection of the prostate gland.

Question 2

What is the usual cause of prostatitis?

Answer 2

E.Coli and pseudomonas
Gram negative

Question 3

What is the most likely cause?

Answer 3

Ascent up the urethra

Question 4

What is the most likely routes?

Answer 4

Reflux of infected urine into the prostatic ducts
Lymphatic and hematogeneous routes are rare

Question 5

What are the signs and symptoms?

Answer 5

Perineal, sacral, or suprapubic pain
High fever
Irritative voiding
Varying degrees of obstructive symptoms may occur as the acutely inflamed prostate swells.
Warm, often exquisitely tender prostate.

Prostate massage is contraindicated.

Question 6

What lab findings will you have?

Answer 6

Leukocytosis
Pyuria
Bacteiruria

Question 7

What is the treatment for prostatitis?

Answer 7

Inpatient
Ampicillin, 1g every 6hrs, gentamicin 1mg/kg every 8 hrs, IV with 4-6 weeks of oral antibiotics to follow.

Outpatient
Ciprofloxacin 750mg every 12 hours by mouth 4-6 wks
Levofloxacin 750mg daily by mouth for 4-6 weeks
Bactrim 160/800mg every 12 hrs by mouth for 4-6 weeks

Question 8

Can you give NSAIDS and Tylenol for this?

Answer 8

Yes

Question 9

If urinary retention occurs what is required?

Answer 9

Percutaneous suprapubic tube is required
Urethral catheterization is CONTRAINDICATED

Question 10

What follow up is required?

Answer 10

MEDEVAC to urology
With effective treatment, chronic bacterial prostatitis is rare