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Prostatitis

Elena Voronejskaia, MD and Robert Bonanno, MD Reviewed 06/2020
 


BASICS

DESCRIPTION

  • Painful or inflammatory condition affecting the prostate gland with or without bacterial etiology, often characterized by urogenital pain, voiding symptoms, and/or sexual dysfunction

  • ...

DIAGNOSIS

HISTORY

  • Acute prostatitis (class I):

    • Acutely ill with fever, chills, malaise

    • Low back pain, myalgias

    • Frequency, urgency, dysuria, nocturia

    • Prostatodynia, pelvic pain, perineal pain

    • Cloudy urine

    • Obs...

TREATMENT

GENERAL MEASURES

  • NSAIDs for analgesia

  • Alpha-1 blockers for lower urinary tract symptoms (obstructive/voiding symptoms)

  • Antipyretics/stool softeners

  • Hydration

  • Sitz baths to relieve pain and spasm

  • U...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Negative urine culture at 7 days predictive of cure after completion of treatment course

  • Consider prostatic abscess in patients who do not respond well to therapy.

Patient Monitoring

REFERENCES

1
Gill BC, Shoskes DA. Bacterial prostatitis. Curr Opin Infect Dis.  2016;29(1):86–91.
2
Almugbel SK, Alanezi FKB, Alhoshan FM, et al. Classification and treatment of prostatitis: a revie...

ADDITIONAL READING

  • Coker TJ, Dierfeldt DM. Acute bacterial prostatitis: diagnosis and management. Am Fam Physician.  2016;93(2):114–120.

SEE ALSO

  • Prostate Cancer; Prostatic Hyperplasia, Benign (BPH...

CODES

ICD10

  • N41.9 Inflammatory disease of prostate, unspecified

  • N41.0 Acute prostatitis

  • N41.1 Chronic prostatitis

  • N41.4 Granulomatous prostatitis

ICD9

  • 601.9 Prostatitis, unspecified

  • 601.0 Acute prostatitis

  • 60...

CLINICAL PEARLS

  • Prostatic massage is contraindicated in acute prostatitis.

  • Fluoroquinolones are recommended first-line antibiotic for bacterial prostatitis, both acute and chronic.

  • At least 14 to 30 day...

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