Urology: prostatitis

Question 2

Presentation/ clinical features of prostatitis?

Answer 2

Acute onset
Pain in perianal area, prostatic pain, rectal pain, lower back pain, or pain on ejaculation
Systemic symtoms - fever, rigors, tachycardia
Voiding symptoms - weak stream, haematuria, straining, dysuria, urgency, frequency
DRE - prostate gland is tender, “boggy”, swollen, warm

Question 3

Causative organism in prostatitis?

Answer 3

Escherichia coli
(Neisseria gonnorhoea can also cause it!)

Question 4

RF for prostatitis?

Answer 4

UTI
Intermittent bladder catheter
Epididymitis
Recent prostate biopsy
Urethral surgery
Prostate stone

Question 5

Examination to do for prostatitis and what is found?

Answer 5

DRE - tender, boggy, swollen, warm prostate gland

Question 6

Investigations for prostatitis?

Answer 6

DRE
MSSU
Screen for STI - gonorrhoea in particular

Question 7

How to manage prostatitis?

Answer 7

Abx - 14 days of quinolone w.g ciprofloxacin
Analgesia - paracetamol
Treat urinary retention if present
Advise to drink fluids to avoid dehydration

Question 8

Ddx for prostatitis?

Answer 8

BPH
UTI
Epididymo-orchitis
Prostate cancer