Prostatitis

Question 1

What is bacterial prostatitis?

Answer 1

-inflammation of prostate and surrounding tissue as a result of infection

Question 2

What must be present to make diagnosis of bacterial prostatitis?

Answer 2

-pathogenic bacteria and significant inflammatory cells must be present in prostatic secretions and urine

Question 3

Possible Routes of Infection in Prostatitis

Answer 3

• reflux of infected urine into prostate gland
• intraprostatic reflux of sterile urine –> chemical prostatitis –> nonbacterial prostatitis
• sex
• indwelling catheterization, urethral instrumentation

Question 4

Pathogens in Acute BP

Answer 4

Gm negative, enteric organisms most common

• E coli 75%
• Klebsiella, Proteus, Pseudomonas
• Enterobacter, Serratia
• Occasional gonococcal or staphylococcal

Question 5

Pathogens in Chronic BP

Answer 5

• E coli most common
• other gram negative
• gram positives controversial

Question 6

Clinical Presentation of ABP

Answer 6

• high fever, chills
• malaise, myalgia, localized pain
• urinary sxs: frequency, urgency, dysuria, nocturia
• prostatic massage will express purulent discharge but is contraindicated

Question 7

Clinical Presentation of CBP

Answer 7

• more difficult to dx
• characterized by recurrent UTIs with same pathogen
• most have prostatic enlargement
• voiding difficulties (frequency, urgency, dysuria)
• perineal and suprapubic discomfort

Question 8

Dx of ABP

Answer 8

• clinical presentation
• presence of significant bacteriuria
• culture midstream specimen

Question 9

Dx of CBP

Answer 9

• urinary tract localization studies

- sequential cultures