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Prostatitis

Kyle B. Stephens, DO Reviewed 06/2018
 


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

    • O...

TREATMENT

GENERAL MEASURES

  • Analgesics/antipyretics/stool softeners

  • Hydration

  • Sitz baths to relieve pain and spasm

  • Suprapubic catheter for urinary retention

  • Anxiolytics, antidepressants if anxiety and/or de...

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
Lipsky BA, Byren I, Hoey CT. Treatment of bacterial prostatitis. Clin Infect Dis.  2010;50(12):1641–1652. [View Abstract on OvidMedline]
2
Videčnik Zorman J, Matičič M, Jeverica S, et ...

ADDITIONAL READING

  • Anderson RU, Wise D, Sawyer T, et al. 6-Day intensive treatment protocol for refractory chronic prostatitis/chronic pelvic pain syndrome using myofascial release and paradoxical rel...

SEE ALSO

  • Prostate Cancer; Prostatic Hyperplasia, Benign (BPH); Urinary Tract Infection (UTI) in Males

  • Algorithm: Hematuria

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

  • Vigorous prostatic massage is contraindicated in acute prostatitis.

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

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