Prostate Path

Question 1

Acute Bacterial Prostatitis - Clinical Sx?

Answer 1

• Fever and chills
• Low back & perineal pain
• Irritative urinary tract symptoms (frequency, urgency and dysuria)

Question 2

Acute Bacterial Prostatitis - Rectal Exam?

Answer 2

Swollen, boggy and tender prostate

Question 3

Acute Bacterial Prostatitis - Urine cultures?

Answer 3

positive (usually gram-negative, E coli most common) and leukocytosis (≥ 10 WBCs/HPF)

Question 4

Acute Bacterial Prostatitis - Tx?

Answer 4

Antibiotics

biopsy or resection not indicated

Question 5

Chronic Bacterial Prostatitis - Clinical Sx?

Answer 5

• Recurrent UTI (cystitis, urethritis)
• Low back & perineal pain
• Mild irritative symptoms (frequency, urgency and dysuria)

Question 6

Chronic Bacterial Prostatitis - Rectal Exam?

Answer 6

Swollen and boggy

Question 7

Chronic Bacterial Prostatitis - Urine Cultures?

Answer 7

positive (usually gram-negative, E coli most common)

≥10 WBCs/HPF

Question 8

Chronic Bacterial Prostatitis - Tx?

Answer 8

Antibiotics

biopsy or resection not indicated

Question 9

Non-bacterial Prostatitis - Clinical Sx?

Answer 9

• Frequency, urgency, perineal pain and dysuria

- No recurrent urinary tract infection

Question 10

Non-bacterial Prostatitis - Rectal Exam

Answer 10

May be normal

Question 11

Non-bacterial Prostatitis - Urine cultures?

Answer 11

Negative (occasionally may find mycoplasma, chlamydia et al.)

≥ 10 WBCs/HPF

Question 12

Non-bacterial Prostatitis - Tx?

Answer 12

Oxybutynin

Question 13

Nonspecific Granulomatous Prostatitis - Clinical Sx & Demographics?

Answer 13

• Obstructive symptoms
• Recurrent infections
• Age 50-70 year old

Question 14

Nonspecific Granulomatous Prostatitis - Rectal Exam?

Answer 14

• Nodular and hard

- suspicious of carcinoma.

Question 15

Nonspecific Granulomatous Prostatitis - Pathogenesis?

Answer 15

Related to duct obstruction with accumulation of secretions, rupture, and tissue response to the leaked material; often associated with hyperplasia

Question 16

What type of Prostatitis?

Mixture of histocytes, lymphocytes, plasma cells, eosinophils, neutrophils, and giant cells arranged in sheets without formation of discrete granulomas

Answer 16

Nonspecific Granulomatous Prostatitis

Question 17

Post-Transurethral Resection Granulomatous Prostatitis - Clinical Sx?

Answer 17

• May be found up to 5 years following transurethral resection
• No clinical significant

Question 18

What type of Prostatitis?

• Resemble rheumatoid nodules.
• Central zone of fibrinoid necrosis

Answer 18

Post-Transurethral Resection Granulomatous Prostatitis

Question 19

What type of Prostatitis?

• Rim of palisaded epithelioid histocytes.
• Variable numbers of multinucleated giant cells

Answer 19

Post-Transurethral Resection Granulomatous Prostatitis

Question 20

Post-BCG therapy Granulomatous Prostatitis - Clinical Sx?

Answer 20

Fever, mild hematuria and urinary frequency

Question 21

Post-BCG therapy Granulomatous Prostatitis - Exam findings?

Answer 21

• 40% of patients with abnormal rectal exam
• 55% with ultrasonographic abnormalities
• PSA↑- Lesions mimic carcinoma

Question 22

What type of Prostatitis?

• Diffuse, discrete granulomas
• With or without caseating necrosis
• Acid-fast bacilli can be identified (rarely

Answer 22

Post-BCG therapy Granulomatous Prostatitis