Prostatitis

Question 1

1) When is prostatitis considered chronic?
2) What are the 2 subdivisions of prostatitis, and how do they differ?

Answer 1

1) When symptoms last for more than 3 months
2) Chronic prostatitis/chronic pelvic pain syndrome (no infection) and chronic bacterial prostatitis (infection)

Question 2

Name 2 symptoms that chronic prostatitis presets with for at least 3 months

Answer 2

• Pelvic pain
• Lower urinary tract symptoms
• Sexual dysfunction
• Pain with bowel movements
• Tender and enlarged prostate on examination

Question 3

Acute bacterial prostatitis presents with a more acute presentation of similar symptoms to chronic prostatitis, however, symptoms can also be systemic - name 2 of these

Answer 3

• Fever
• Myalgia
• Nausea
• Fatigue
• Sepsis

Question 4

1) Name an antibiotic that may be used in the management of acute bacterial prostatitis, and how long would they be taken for?
2) Which 2 are first line, and which can be given if either of the 1st line aren’t suitable?

Answer 4

1) Ciprofloxacin, ofloxacin or trimethoprim, 2-4 weeks
2) 1st line = ciprofloxacin (500mg) or ofloxacin (200mg). 2nd line = trimethoprim (200mg)

Question 5

Name 2 aspects of the treatment of chronic prostatitis

Answer 5

• Alpha-blockers (relax smooth muscle, with rapid improvement in symptoms)
• Analgesia
• Antibiotics if history of infection (trimethoprim or doxycycline)
• Laxatives for pain during bowel movements

Question 6

Name a complication of acute bacterial prostatitis

Answer 6

• Sepsis
• Prostate abscess (may be felt as a fluctuant mass and requires surgical drainage)
• Acute urinary retention
• Chronic prostatitis