Prostatitis Flashcards
What are the 4 types of prostatitis?
- Acute bacterial
- Chronic bacterial
- Inflammatory Chronic Pelvic Pain Syndrome
- Non-inflammatory Chronic Pelvic Pain Syndrome
What is the hallmark of prostatitis?
Prostatic pain
How does acute bacterial prostatitis present?
- Fever, irritative, obstructive sx, warm boggy tender prostate
- Young men
- E. coli
What labs should you perform for acute bacterial prostatitis?
Urine culture (not post-massage)
CBC, blood cultures
When should you admit a pt w/ acute bacterial prostatitis & give IV abx?
If significant fever, highly elevated WBC, sepsis
*At discharge, treat w/ 4-6 wk course of abx po
When is a CT indicated for acute bacterial prostatitis?
If persistently febrile to r/o abscess
How does chronic bacterial prostatitis present?
- Recurrent prostatic inf
- Pain in genitals, UT, perineum, low back
- Irritative urinary sx & pain w/ ejaculation
- Older men
- E. coli
What labs should you perform in chronic bacterial prostatitis?
- Expressed prostatic secretion (EPS)
- Post prostate massage urine culture
- Meares Stamey 4 glass test
What types of meds do you use to tx chronic bacterial prostatitis?
Abx: FQs, TMP/SMX, prolonged therapy 8-16 wks
NSAIDs
Alpha blockers
Anticholinergics
What are other forms of tx for chronic bacterial prostatitis?
- phytotherapy
- zinc
- diet
- manage stress
- prostate massage, ejaculation
- sitz baths
How does ICPPS present?
- Similar to chronic bacterial
- Hx of UTIs, but neg cultures
- Prostatic tenderness
What lab results will you see in ICPPS?
Prostatic fluid w/ leukocytes, but no bacteria present
How do you treat ICPPS?
SMX-TMP x 6-8wks
How do you treat ICPPS if unresponsive to SMX-TMP?
Doxy 4-6wks
What is another name for noninflammatory chronic pelvic pain syndrome?
Prostadynia
