PROSTATITS

Question 0

SYMPTOMS OF TYPE 1?

Answer 0

Fever
Low back/perineal pain 
Urinary symptoms: dysuria, frequency, urgency 
PR - tender gland 
Complication -> sepsis/prostatic abcess

Question 1

Types of prostatitis?

Answer 1

I - acute bacterial
II - chronic bacterial I.e recurrent infection of prostate
III - chronic abacterial or chronic pelvic pain syndrome (90% prostatitis!! AKA NON-UTI)

Question 2

Type II symptoms?

Answer 2

Older men with recurrent UTIs

Less dramatic symptoms as type 2 
Same urinary symptoms
Pelvic pain
Sexual dysfunction 
PR exam can be normal to inflamed

Question 3

Type III symptoms?

Answer 3

Pelvic pain
Lower UT symptoms
Pain during or after ejaculating
PR findings vary again

Question 4

Ix?

Answer 4

Urine MCS

Question 5

How do you diagnose?

Answer 5

I - clinal + urine MCS
II + III - 4 glass test and 2 glass test with urine MCS before and after prostatic massage

III overlaps with BPH but differentiating feature is pain.

III - diagnosis of exclusion especially BPH, bladder and prostate cancer

Question 6

Management?

Answer 6

I - antibiotics
II - antibiotics
III - symptomatic

Urinary symptoms -> alpha blocker
Pain -> add anti-inflammatory agent

Plus others