Master Prostatitis with Picmonic for Physician Assistant

Acute Bacterial Prostatitis is caused by bacteria ascending from the urethra or descending from the bladder. The bacteria may also reach the prostate gland by circulating in the bloodstream or lymphatic system. Common bacterial organisms include E. coli, Klebsiella, Pseudomonas, Enterobacter, Chlamydia, Neisseria gonorrhoeae, and group D streptococci.

Sexually Transmitted Organisms such as Neisseria gonorrhoeae and Chlamydia trachomatis can also cause acute bacterial prostatitis in sexually active men, especially those under 35 years of age.

Acute Bacterial Prostatitis is usually caused by gram-negative bacteria, specifically Enterobacteriaceae. E. Coli is the most common cause of acute bacterial prostatitis, especially in men more than 35 years old.

Prostatitis presents with flu-like symptoms such as fevers and chills. The clinical manifestations of prostatitis are similar to the symptoms of a urinary tract infection (UTI). Chronic prostatitis may increase the patient's risk of developing recurrent UTIs. If the patient develops a fever, a WBC count and blood cultures are indicated to identify the causative organism for appropriate antibiotic therapy.

Perineal and back pain may occur in the patient with prostatitis. Back ache and pelvic pain may occur in both acute and chronic prostatitis.

Prostatic swelling caused by prostatitis may cause dysuria. The prostate may be extremely swollen, tender, and firm. Additional urinary complications include urinary frequency, urinary urgency, urinary retention, and cloudy urine.

Patients with prostatitis may experience erectile dysfunction, post-ejaculation pain, and problems with libido. Since sexual dysfunction may occur, emotional support and sexual counseling may benefit the patient diagnosed with prostatitis.

Recurrent UTIs can be seen in patients with chronic bacterial prostatitis due to translocation of bacteria from an inflamed prostate into the urine and the urinary bladder.

Urinalysis typically shows pyuria and bacteriuria in patients with bacterial prostatitis.

Tender Boggy Prostate on digital rectal exam established the diagnosis of acute bacterial prostatitis. Digital rectal exam should be performed gently without vigorous prostatic massage.

Antibiotics are prescribed to treat acute and chronic bacterial prostatitis. Examples are trimethoprim/sulfamethoxazole (Bactrim), ciprofloxacin (Cipro), ofloxacin (Floxin), and carbachol (Miostat). Additional antibiotics include carbenicillin (Geocillin), cephalexin (Keflex), doxycycline (Vibramycin), and tetracycline. Patients with multiple sex partners are especially considered for prostatitis antibiotic therapy. Acute bacterial prostatitis is treated with oral antibiotics up to four weeks while chronic or complicated prostatitis is treated with hospitalization and IV antibiotics.

Chronic Prostatitis, also known as chronic pelvic pain syndrome, is characterized as prostate and urinary pain related to nonbacterial causes. This type of prostatitis is caused by a viral illness or sexually transmitted infection, such as chlamydia or gonorrhea. Although a culture is unable to identify causative organisms, leukocytes may be found in prostatic secretions.