Prostatitis

Question 1

Prostatitis etiology and pathophysiology

Answer 1

Common urologic disorder of inflammatory and noninflammatory conditions

2 mil treate/yr

4 categories

• acute bacterial prostatitis
• chronic bacterial prostatitis
• chronic prostatitis/chronic pelvic pain syndrome
• asymptomatic inflammatory prostatitis (most common: nonbacterial)

Question 2

Acute and chronic bacterial prostatitis

Answer 2

Organisms reach prostate by:
-Ascending urethra, descending from bladder, or invading bloodstream/lymph channels

Most common organisms:
E. coli, Klebsiella, Pseudomonas, Enterobacter, Proteus, Chlamydia trachomatis, Neisseria gonorrhoeae, and group D streptococci

Chronic bacterial prstatitis - recurrent infection –> most common UTI in adult men

Question 3

Chronic prostatitis/ chronic pelvic pain syndrome

Answer 3

recurrent prostate and urinary pain without ovious infection

etiology unknown; may occur after virus or STI

Leukocytes in prostatic secretions but negative culture

Question 4

Asymptomatic inflammatory prostatitis

Answer 4

diagnosed during other GU tract problems

Seminal fluid of prostate contains leukocytes

Etiology unclear

Question 5

Manifestations of acute prostatitis

Answer 5

fever, chills, back and perineal pain

dysuria, frequency, urgency, cloudy urine
-mimics UTI; acute cystitis is uncommon in men

acute urinary retention

DRE: prostate very swollen, tender, and boggy

Question 6

complications of prostatitis

Answer 6

epididymitis and cystitis

Sexual dysfunction: post ejaculation pain, libido probs, and ED

Abscess is rare

Question 7

Manifestations of chronic bacterial prostatitis and chronic prostatitis and chronic pelvic pain syndrome

Answer 7

irritative voiding symptoms

backache, perineal and pelvic pain, ejaculatory pain

DRE: prostate is enlarged and soft or boggy and slightly tender

chronic prostatitis can lead to recurrent UITs