Prostatitis Flashcards
What are the main classifications of prostatitis?
BACTERIAL
- most common <35yrs
- can be acute or chronic
- associated with gram -ve bacteria i.e. Ecoli most common
- TB and candida in immunosuppressed
CHRONIC -bacterial -BPH -prostate cancer I.e. causing elevated prostatic pressure leading to inflammation of the prostate
What are the risk factors for developing prostatitis?
UTI epididymitis Transurethral surgery Indwelling catheter Immunosuppression
How might someone with prostatitis present? What is the difference between presentation acute vs chronic?
ACUTE Fevers Rigors General malaise Sepsis
CHRONIC Perineal pain i.e. between scrotum and anus Lower back pain Pain on ejaculation Urethral discharge LUTS AUR Recurrent UTIs Suprapubic tenderness and palpable bladder if retaining Pain with bowel movements
What would you expect to find on examination of prostate in DRE for prostatitis?
ACUTE
Boggy
Tender on palpation
Hot
CHRONIC
-might feel hard due to calfication
What investigations would you do if prostatits was suspected?
Urine dip
FBC
UE
CRP
Lactate-> measure of severity of infection to see if septic
Post-voiding bladder scan to see if retaining and catheter needed
Blood culture if suspect sepsis
How is prostatitis managed?
Treat the cause
Treat sepsis Analgesia Tamulosin Catheterise if retaining Abx if bacterial infection -broad spect and quinolone (for gram -ve) -4-6 weeks
Why should number of DREs be limited in someone with bacterial prostatitis?
Want to limit the seeding of infection
