Prostatitis Flashcards

1
Q

Define Prostatitis

A

Prostatitis is inflammation of the prostate gland

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2
Q

Types of prostatitis

A
  • Acute bacterial prostatitis
  • Chronic bacterial prostatitis
  • Non-bacterial prostatitis
  • Prostatodynia
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3
Q

Bacterial prostatitis types

A
  • Acute bacterial prostatitis
  • Chronic bacterial prostatitis
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4
Q

Non-bacterial prostatitis types

A
  • Non-bacterial prostatitis
  • Prostatodynia
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5
Q

Acute bacterial prostatitis pathophysiology

A

caused by ascending urethral infection

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6
Q

what is the most common causative organism of bacterial prostatitis

A

E. coli

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7
Q

Rare causative organism of bacterial prostatitis

A
  • Chlamydia
  • Gonorrhoea
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8
Q

Chronic bacterial prostatitis pathophysiology

A

is a chronic bacterial infection of the prostate +/- prostatitis Sx and is thought to be the sequelae of inadequately treated acute prostatitis

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9
Q

acute bacterial prostatitis risk factors

A
  • Indwelling catheters
  • Phimosis or urethral stricture
  • Recent surgery, including cystoscopy or transrectal prostate biopsy
  • Immunocompromised
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10
Q

Acute bacterial prostatitis clinical presentations

A
  • LUTS
  • Pyrexia
  • Perineal pain
  • Suprapubic pain
  • Urethral discharge
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11
Q

Acute bacterial prostatitis examination findings

A
  • DRE: tender / boggy prostate
  • Inguinal lymphadenophathy
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12
Q

Chronic prostatitis clinical presentations

A
  • Pelvic pain / discomfort (perineum, lower back, groin)
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13
Q

Prostatitis initial Ix

A

1.Urinalysis: for nitrites, haematuria, leukocytes
2.Urine MC&S
3.Urine NAAT for CT / NG
4.Bloods: FBC (WCC, CRP, UEs)

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14
Q

why is PSA not recommended in suspected prostatits

A

PSA will often be raised due to the inflammation of the prostate

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15
Q

Prostatitis further Ix

A
  • Transrectal prostatic ultrasound (TRUS)
  • non-contrast CT KUB
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16
Q

when is further i.e. imaging Ix indicated in prostatitis

A

when initial therapy has failed or to investigate for potential underlying causes (to rule out prostate abscess)

17
Q

prostatitis pharmacological Mx

A

1st line: Abx Tx - Ciprofloxacin (quinolone) 500mg BD 14/7
+ Analgesia: NSAIDs / paracetamol

2nd line: Tamsulosin (Alpha blockers) or Finasteride 5a-redictase inhibitors

18
Q

when to admit pt w/ prostatitis

A
  • features of sepsis
  • severely unwell
  • unable to tolerate oral Abx
19
Q

Alternate Abx if ciprofloxacin not suitable

A

Trimethroprim 200mg BD 14/7

20
Q

Quinolone SEs

A
  • tendone damage
  • lowers seizure threshold
21
Q

when should follow up be arrange after starting Abx

A

48 hours + review urine MC&S result to check Abx sensitivity