Prostatitis

Question 1

What is acute bacterial prostatitis?

Answer 1

Acute infection in prostate with rapid onset of symptoms

Question 2

What is chronic prostatitis?

Answer 2

Symptoms lasting for at least 3 months

Question 3

How does chronic prostatitis present?

Answer 3

Pelvic pain

LUTS
- Dysuria
- Hesitancy
- Frequency
- Retention

Sexual dysfunction

Pain with bowel movements

Tender and enlarged prostate

Question 4

How does acute bacterial prostatitis present?

Answer 4

Acute presentation of similar symptoms to chronic prostatitis

Systemic symptoms
- Fever
- Myalgia
- Nausea
- Fatigue
- Sepsis

Question 5

What investigations are used for prostatitis?

Answer 5

Urine dipstick

Urine microscopy, culture and sensitivities
Identify organism + antibiotics to be used

Chlamydia and gonorrhoea NAAT
On a first pass urine, if STI considered

Question 6

How is acute bacterial prostatitis managed?

Answer 6

Hospital admission

Oral antibiotics (ciprofloxacin or trimethoprim)

Analgesia

Laxatives

Question 7

How is chronic prostatitis managed?

Answer 7

Alpha-blockers
Tamsulosin, rapid improvement in symptoms

Analgesia

Antibiotics
Trimethoprim or doxycycline for 4-6 weeks

Laxatives

Question 8

What are the complications of acute bacterial prostatitis?

Answer 8

Sepsis
Prostate abscess
Acute urinary retention
Chronic prostatitis