Men's Health Flashcards
Acute bacterial prostatitis
Signs and symptoms?
What constitutes a severe acute bacterial prostatitis?
Systemic: Fevers > 38, chills, sweats
LUTS: obstructive - hesitancy, weak stream, dribbling, retention,
UTI symptoms: dysuria, increased frequency, urgency
Specifically Pelvic or perianal pressure, (prostate tenderness on DRE
Severe= systemic features
Investigations for ABP (acute bacterial prostatitis)?
Urine MCS
If appropriate (sepsis or in hospital) then blood cultures
Imaging- Transrectal U/S or CT pelvis to identify an abscess
Treatment for severe vs. non severe ABP?
ABP- acute bacterial prostatitis
non severe
Trimethoprim 300mg, orally, daily for 14 days
Second line: cephalexin 500mg, orally, taken 6 hourly for 14 days
(continue for 21 days if symptoms persist after 14 day course finished)
severe
Needs hospital management
Complications that can arise from acute bacterial prostatitis?
Urinary retention
Abscess- prostatic
Osteomyelitis of the spine
Fistula formation
Sepsis
Potential recurrent and/or chronic bacterial prostatitis
What are common causes for epipdidymo-orchitis in adult men under or over age 35?
Under 35, usually sexually transmitted infection
chlamydia or gonorrhea
Over 35 usually E.coli
In a man age 29 with epipdidymo-orchitis, what empiric treatment would you use?
- Ceftriaxone 500mg in 2ml of lidocaine 1%, given intramuscularly (or 500mg IV), stat as a single dose
PLUS
doxycycline 100mg, orally, 12 hourly for 14 days
(or second line: azithromycin 1gram orally stat, then repeated in 7 days)
In a man aged 55 with suspected epididymo-orchitis what is the empiric treatment?
Over 35 years old, suggests likely UTI (e.coli) pathogen.
Treat the same as for acute bacterial prostatitis
Non severe:
Trimethoprim 300mg, orally, daily for 14 days
or
2nd line: cephalexin 500mg, orally, 6 hourly for 14 days.
If Severe –> send to hospital
What is this condition?
How can you treat it
Balanitis
hydrocortisone+clotrimazole 1%+1% cream topically, twice daily until the skin is clear and symptoms have resolved