Renal

Question 1

Most common urologic dx in men under 50?

Answer 1

Prostatitis

Question 2

Types of prostatitis

Answer 2

• Acute
• Chronic - intermittent UTIs with same bug
• Chronic + Chronic pelvic pain syndrome (inflammatory or non-inflammatory - non bacterial)
• Asymptomatic inflammatory prostatitis (histological & leukocytosis) - do not investigate

Question 3

Category 1 vs. Category 2 prostatitis

Answer 3

Category 1: acute bacterial prostatitis
- associated with severe & systemic sx
- UTI acute

Category 2: chronic bacterial prostatitis
- may have symptoms
- UTI recurrent
- at least 3 months

Question 4

Prostatitis symptoms

Answer 4

fever, chills
UTI sx: dysuria, frequency, urgency
poorly localized pain
obstructive sx: dribbling, hesistancy, double void

prostate is warm, firm, swollen and VVV tender

Question 5

Prostate investigations

Answer 5

Urinalysis/urine dip
Urine culture & sensitivity (mid stream)

If not responding to treatment do a trans-rectal prostatic U/S to rule out prostate abscess

bladder scan if severe obstruction

Question 6

For hematuria, what investigation do you order?

Answer 6

Cystoscopy

Question 7

For obstructive symptoms, what do you order? What medication can help?

Answer 7

Urodynamics

Tamsulosin 0.4mg po daily
Have to catheterize for severe obstruction (do bladder scan)

Question 8

Treatment for prostatitis?

Answer 8

C & S will guide treatment

Generally:
- Bactrim or ciprofloxacin