Prostatitis, Urethritis, Balanitis, Phimosis Flashcards
S+S of acute prostatitis
Symptoms of UTI
Symptoms of prostatitis = perineal, penile or rectal pain, acute urinary retention, obstructive voiding symptoms, low back pain, pain on ejaculation, tender swollen prostate
Bacteremia = rigors, arthralgia, myalgia, fever
Assessment of ?acute prostatitis
MSU sample to confirm UTI
Blood cultures + FBC
STI tests
Management of acute prostatitis
Abx for 14 days
Ciprofloxacin BD or trimethroprim BD
What is chronic prostatitis?
3 months of pain in perineum or pelvic floor, associated with UTI symptoms + sexual dysfunction
Frequently relapsing + remitting symptoms
Types of chronic prostatitis
Bacterial
Pelvic pain syndrome
What other conditions must be ruled out to diagnose chronic prostatits?
UTI Urethritis Epididymo-orchitis/ epididymiria BPH Prostate cancer Urethral stricture Obstructive calculus
Management of chronic bacterial prostatitis
Abx course
Referral to urology
Management of chronic pelvic pain syndrome
Prescribe paracetamol + stool softener
4-6 week trial of alpha blocker
Referral if symptoms persist
Pathology of balanitis
Inflammation of the glans penis
Pathology of posthitis
Inflammation of prepuce (foreskin)
Causes of balanitis
Dermatitis
Lichen planus/ sclerosus
STIs
Candida/ bacterial infection
Complications of balanitis
Phimosis, meatal stenosis, urethral stricture, sexual dysfunction, penile SCC
S+S of balanitis
Penile soreness + itch
Odour
Dysuria
Redness + swelling of glans penis with exudate
Management of balanitis
Clean + dry penis
Topical hydrocortisone + imidazole for dermatitis or candida infection
Oral flucloxacillin or clarithromycin if bacterial balanitis
Oral metronidazole for Gardnerella balanitis
Pathology of paraphimosis + phimosis
Retracted foreskin in uncircumcised male that cannot be returned to normal position
Phimosis = tight foreskin
