Prostatitis: Difference between revisions

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#E. coli involved in 80% of cases
#E. coli involved in 80% of cases
#Risk factors:
#Risk factors:
##Urinary tract obstruction
##[[Urinary Tract Obstruction]]
##Epididymitis
##[[Epididymitis]]
##Urethritis
##[[Urethritis]]
##Unprotected rectal intercourse
##Unprotected rectal intercourse
##Phimosis
##[[Phimosis]]
##Indwelling urethral catheter
##Indwelling urethral catheter


Revision as of 19:52, 31 March 2012

Background

  1. E. coli involved in 80% of cases
  2. Risk factors:
    1. Urinary Tract Obstruction
    2. Epididymitis
    3. Urethritis
    4. Unprotected rectal intercourse
    5. Phimosis
    6. Indwelling urethral catheter

Diagnosis

Acute Prostatitis

  • Clinical diagnosis (UA and Ucx may be normal)
    • Dysuria/urgency/frequency, perineal pain/low back pain, fever
    • Rectal exam: Exquisitely tender and boggy prostate

Chronic Prostatitis

  • Similar to acute prostatitis with exception of fever/chills
  • Rectal exam is often unremarkable

Work-Up

  • UA, Ucx

DDx

  1. Cystitis
  2. Pyelonephritis

Treatment

  1. Abx
    1. 4-6 wk course
    2. Cipro 500mg PO BID OR
    3. Bactrim DS 1 tab PO BID (less expensive but also less efficacious)
  2. IV antibiotics
    1. Cipro 400mg IV q12 OR Levofloxacin 500mg IV q24
    2. OR Ceftriaxone 2g IV q24 +/- Gentamycin 3-5mg/kg/day

Disposition

  1. Admit toxic pts or pts with urinary retention
  2. Urology f/u

Source

Rosens, Tintinalli

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