Prostatitis

Question 1

What is the most common urologic diagnosis in men

Answer 1

Prostatitis

Question 2

What are the three types of prostatitis?

Answer 2

• Acute bacterial
• Chronic bacterial
• Chronic pelvic pain syndrome / abacterial prostatitis

Question 3

What is the aetiology of acute bacterial prostatitis?

Answer 3

Ascending urethral infections with KEEPS

Question 4

What are the common pathogens causing cystitis / prostatitis?

Answer 4

KEEPS

• Klebsiella spp
• E. coli (90%)
• Enterococci
• Proteus mirabilis, pseudomonas
• S. saprophyticus

Question 5

What is acute bacterial prostatitis often associated with?

Answer 5

• Outlet obstruction
• Recent cystoscopy
• Prostatic Bx

Question 6

Where do most prostate infections occur?

Answer 6

In the peripheral zone

Question 7

CFx prostatitis?

Answer 7

• Acute onset fever / chills
• Malaise
• Rectal / lower back and perineal pain
• LUTS

Question 8

Ix in prostatitis?

Answer 8

Exam: abdo, genital, DRE

• Urinalysis
• Blood: FBE, MCS
• Transrectal U/S if non-resolving

Question 9

Rx prostatitis?

Answer 9

• Supportive measures
• PO or IV ABx depending how sick
• Catheterise if severe cuts / AUR
• I&D of abscess if present

Question 10

Antibiotic treatment in acute prostatitis?

Answer 10

-Ciprofloxacin (500-750mg PO bd)
OR
-IV Gentamicin + ampicillin / 3rd gen cephalosporin / fluorquinolone
4wk total with oral step-down.

Question 11

Antibiotic treatment chronic prostatitis?

Answer 11

Ciprofloxacin (500mg PO bd)

Question 12

Aetiology of chronic bacterial prostatitis?

Answer 12

Recurrent exacerbations of acute prostatitis-like signs and symptoms; recurrent UTI with same organism

Question 13

CFx chonic bacterial prostatitis?

Answer 13

• Pelvic pain
• Storage LUTS
• Ejaculatory pain
• Post ejaculatory pain