Prostatitis

Prostatitis 

Updated: 01/29/2021

© Jun Wang, MD, PhD


General features
  • Various etiology
  • Chronic pelvic pain syndrome (CPPS): including prostatodynia, category III or abacterial prostatitis, is the most common urological diagnosis in men older than 50 years
Diagnostic approaches
  • Quantitative bacterial cultures and microscopic examination of fractionated urine specimens and expressed prostatic secretions
Acute bacterial prostatitis
  • Commonly due to Gram-negative bacteria
  • Associated with reflux, surgical manipulation or sexually transmitted disease
  • Usually localized, may cause obstruction, retention, abscess 
  • Diagnosis: Symptoms, digital rectal exam for edematous prostate, urine Gram stain and culture
Chronic bacterial prostatitis
  • Chronic or recurrent urogenital symtoms
  • Evidence of prostate bacterial infection
  • Diagnosis: symptom, enlarged prostate, prostate fluid culture
Chronic prostatitis/Chronic pelvic pain syndrome
  • Pelvic pain or discomfort for at least 3 of the preceding 6 months
  • Commonly with urologic symptoms and sexual dysfunction
  • Diagnosis clinically after excluding other etiology
Granulomatous prostatitis
  • Usually idiopathic
  • Necrotizing or non-necrotizing granulomas
  • May be associated with BCG treatment for bladder cancer
  • Also occurs post-transurethral resection
  • Other causes include fungal infection



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