Prostatitis

Snapshot

A 60-year-old man with a history of benign prostatic hyperplasia presents to his primary care physician for a 3-day period of fever, chills, and pain with urination. He was recently catheterized during an admission in the hospital. Physical exam reveals a tender and enlarged prostate on digital rectal exam. Urinalysis reveals pyuria and hematuria. He is started on empiric antibiotics.

Introduction

Clinical definition
- infectious or non-infectious inflammation of prostate
- acute prostatitis
  - typically infectious
  - < 35 years of age
    - most commonly C. trachomatis and N. gonorrhoeae
  - > 35 years of age
    - most commonly E. coli, P. aeruginosa, K. pneumoniae
- chronic prostatitis
  - can be due to recurrent infections lasting > 3 months (10% of chronic prostatitis)
  - can be due to chronic pelvic pain (90% of chronic prostatitis)
    - > 3 months of pain in the absence of other identifiable causes
    - noninfectious etiology but often unknown
    - can be due to trauma, psychological stress, and increased prostate tissue pressure
Epidemiology
- incidence
  - 10-15% men have it once in their lifetime
- risk factors
  - catheterization
benign prostatic hypertrophy

Presentation

Studies

Differential

Treatment

Complications