Prostatitis Flashcards
What typically causes acute bacterial prostatitis?
Gram-negative bacteria entering the prostate gland via the urethra
Common pathogens include Escherichia coli.
Which pathogen is most commonly isolated in cases of acute bacterial prostatitis?
Escherichia coli
It is a gram-negative bacterium.
List risk factors for acute bacterial prostatitis.
- Recent urinary tract infection
- Urogenital instrumentation
- Intermittent bladder catheterisation
- Recent prostate biopsy
These factors increase the likelihood of bacterial entry into the prostate.
What are some features of acute bacterial prostatitis?
- Pain referred to perineum, penis, rectum, or back
- Obstructive voiding symptoms
- Fever and rigors
- Tender, boggy prostate gland on digital rectal examination
Symptoms can vary widely among patients.
What is the recommended management for acute bacterial prostatitis according to the BNF?
A 14-day course of a quinolone
Quinolones are a class of antibiotics effective against gram-negative bacteria.
True or False: Screening for sexually transmitted infections is not recommended in the management of acute bacterial prostatitis.
False
Screening is considered as part of the management plan.
What is balanitis?
Inflammation of the glans penis
Balanitis can also involve the foreskin, termed balanoposthitis.
What are the most common causes of balanitis?
Infective causes (bacterial and candidal) and autoimmune causes
Proper hygiene is crucial in managing balanitis.
What is the role of hygiene in the treatment of balanitis?
Key part of treatment; improper washing and tight foreskin can worsen balanitis.
What is candidiasis and its common symptoms?
Very common condition, usually occurs after intercourse, associated with itching and white non-urethral discharge.
What symptoms are associated with dermatitis in balanitis?
Itching and clear non-urethral discharge.
What type of discharge is caused by bacterial infections in balanitis?
Acute yellow non-urethral discharge, typically due to Staphylococcus.
What is lichen planus and its symptoms?
A condition causing itching with striae and pamphlets.
What are the common bacterial causes of balanitis?
- Staphylococcus spp.
- Group B Streptococcus spp.
Treated with oral flucloxacillin or clarithromycin if allergic to penicillin.
What is priapism?
A persistent penile erection lasting longer than 4 hours and not associated with sexual stimulation.
What are the two types of priapism?
- Ischaemic priapism
- Non-ischaemic priapism
What causes ischaemic priapism?
Impaired vasorelaxation and reduced vascular outflow, resulting in congestion of de-oxygenated blood.
What is the cause of non-ischaemic priapism?
High arterial inflow, often due to fistula formation from congenital or traumatic mechanisms.
What is the age distribution for priapism presentation?
Bimodal distribution with peaks between 5-10 years and 20-50 years of age.
What is the estimated incidence of priapism?
Up to 5.34 per 100,000 patient-years.
List some causes of priapism.
- Idiopathic
- Sickle cell disease or other haemoglobinopathies
- Erectile dysfunction medication (e.g. Sildenafil)
- Other drugs (anti-hypertensives, anticoagulants, recreational drugs)
- Trauma
What are typical patient presentations for priapism?
- Persistent erection lasting over 4 hours
- Pain localized to the penis
- History of known haemoglobinopathy or use of certain medications
What investigations help differentiate between ischaemic and non-ischaemic priapism?
- Cavernosal blood gas analysis
- Doppler or duplex ultrasonography
- Full blood count and toxicology screen
What is the first-line treatment for ischaemic priapism lasting longer than 4 hours?
Aspiration of blood from the cavernosa combined with saline flush injection.
