prostatitis Flashcards
when is it chronic prostatitis?
> 3 months
inflammation persists after the infection has resolved
what are the symptoms of chronic prostatitis?
- Pelvic pain, which may affect the perineum, testicles, scrotum, penis, rectum, groin, lower back or suprapubic area
- Lower urinary tract symptoms, such as dysuria, hesitancy, frequency and retention
- Sexual dysfunction, such as erectile dysfunction, pain on ejaculation and haematospermia (blood in the semen)
- Pain with bowel movements
- Tender and enlarged prostate on examination (although examination may be normal)
what are the symptoms of acute bacterial prostatitis?
Fever Myalgia Nausea Fatigue Sepsis
what types of investigations would you do when suspecting prostatitis?
Urine dipstick testing can confirm evidence of infection.
Urine microscopy, culture and sensitivities (MC&S) can identify the causative organism and the antibiotic sensitivities.
Chlamydia and gonorrhoea NAAT testing on a first pass urine, if sexually transmitted infection is considered.
what is the management of acute prostatitis?
Hospital admission for systemically unwell or septic patients (for bloods, blood cultures and IV antibiotics)
Oral antibiotics, typically for 2-4 weeks (e.g., ciprofloxacin, ofloxacin or trimethoprim)
Analgesia (paracetamol or NSAIDs)
Laxatives for pain during bowel movements
what is the management for chronic prostatitis?
Alpha-blockers (e.g., tamsulosin) relax smooth muscle, with rapid improvement in symptoms
Analgesia (paracetamol or NSAIDs)
Psychological treatment, where indicated (e.g., cognitive behavioural therapy and / or antidepressants)
Antibiotics if less than 6 months of symptoms or a history of infection (e.g., trimethoprim or doxycycline for 4-6 weeks)
Laxatives for pain during bowel movements
what are complications of prostatitis?
Sepsis
Prostate abscess (may be felt as a fluctuant mass and requires surgical drainage)
Acute urinary retention
Chronic prostatitis
