Information
Editors
Acute Bacterial Prostatitis
Essentials
- Usually a febrile disease with intense symptoms. The prostate gland is typically very tender to palpation.
Etiology
- Disturbances in emptying of the bladder may predispose to infections.
- A urinary tract pathogen that causes an abscess in the prostate.
- Benign prostatic hyperplasia
- Functional disturbance in opening of the urethra
Symptoms
- Increased urinary frequency, burning sensation in lower abdomen = symptoms of urinary tract infection
- Voiding difficulties, painful voiding
- The patient often has fever and feels ill.
Differential diagnosis and investigations
Findings
- Tenderness in the lower abdomen.
- Very tender prostate on palpation.
Treatment
- Oral fluoroquinolone or sulpha-trimethoprim in normal (UTI) doses is usually sufficient. Of the fluoroquinolones, ciprofloxacin and norfloxacin yield the highest concentrations. The duration of treatment is 10-14 days at the shortest, but depending on the severity of the disease up to 4-6 weeks.
- In septic disease, antimicrobial therapy may also be started intravenously (piperacillin-tazobactam or fluoroquinolone), as required.
- Massage of the prostate is contraindicated.
- Suprapubic cystostomy may occasionally be necessary to secure the emptying of the bladder. Do not catheterize.
- A prostatic abscess should be emptied surgically in a hospital.
References