Prostatitis Flashcards
Define Prostatitis
Prostatitis is inflammation of the prostate gland
Types of prostatitis
- Acute bacterial prostatitis
- Chronic bacterial prostatitis
- Non-bacterial prostatitis
- Prostatodynia
Bacterial prostatitis types
- Acute bacterial prostatitis
- Chronic bacterial prostatitis
Non-bacterial prostatitis types
- Non-bacterial prostatitis
- Prostatodynia
Acute bacterial prostatitis pathophysiology
caused by ascending urethral infection
what is the most common causative organism of bacterial prostatitis
E. coli
Rare causative organism of bacterial prostatitis
- Chlamydia
- Gonorrhoea
Chronic bacterial prostatitis pathophysiology
is a chronic bacterial infection of the prostate +/- prostatitis Sx and is thought to be the sequelae of inadequately treated acute prostatitis
acute bacterial prostatitis risk factors
- Indwelling catheters
- Phimosis or urethral stricture
- Recent surgery, including cystoscopy or transrectal prostate biopsy
- Immunocompromised
Acute bacterial prostatitis clinical presentations
- LUTS
- Pyrexia
- Perineal pain
- Suprapubic pain
- Urethral discharge
Acute bacterial prostatitis examination findings
- DRE: tender / boggy prostate
- Inguinal lymphadenophathy
Chronic prostatitis clinical presentations
- Pelvic pain / discomfort (perineum, lower back, groin)
Prostatitis initial Ix
1.Urinalysis: for nitrites, haematuria, leukocytes
2.Urine MC&S
3.Urine NAAT for CT / NG
4.Bloods: FBC (WCC, CRP, UEs)
why is PSA not recommended in suspected prostatits
PSA will often be raised due to the inflammation of the prostate
Prostatitis further Ix
- Transrectal prostatic ultrasound (TRUS)
- non-contrast CT KUB
when is further i.e. imaging Ix indicated in prostatitis
when initial therapy has failed or to investigate for potential underlying causes (to rule out prostate abscess)
prostatitis pharmacological Mx
1st line: Abx Tx - Ciprofloxacin (quinolone) 500mg BD 14/7
+ Analgesia: NSAIDs / paracetamol
2nd line: Tamsulosin (Alpha blockers) or Finasteride 5a-redictase inhibitors
when to admit pt w/ prostatitis
- features of sepsis
- severely unwell
- unable to tolerate oral Abx
Alternate Abx if ciprofloxacin not suitable
Trimethroprim 200mg BD 14/7
Quinolone SEs
- tendone damage
- lowers seizure threshold
when should follow up be arrange after starting Abx
48 hours + review urine MC&S result to check Abx sensitivity