Assignment: Women’s Health Week 10: Prostatitis
Assignment: Women’s Health Week 10: Prostatitis
In week 10 you are reviewing disorders of the male genitourinary system.
For this assignment on the male genitourinary system, present Prostatitis. Include
epidemiology, morbidity, pathophysiology, clinical presentation, diagnosis and management of the disorder.
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Women’s Health Week 10: Prostatitis
Prostatitis is an infection or inflammation of the prostate gland. It is characterized by inflammation of the tissue of the prostate gland. There are four types of prostatitis: acute bacterial (ABP), chronic bacterial (CBP), chronic pelvic pain syndrome (CPPS), and asymptomatic inflammatory prostatitis. The purpose of this paper is to discuss prostatitis, including epidemiology, pathophysiology, clinical presentation, diagnosis, and management.
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Epidemiology
Prostatitis is diagnosed in about 25% of males presenting with genitourinary symptoms. Among the four categories of prostatitis, the most common is CPSS, accounting for 90-95% of prostatitis cases (Davis & Silberman, 2021). Males who have an episode of bacterial prostatitis are highly likely to have other episodes and progress to chronic bacterial and CPSS.
Morbidity
If not managed appropriately, prostatitis can result in significant morbidity. Prostatitis is associated with complications like epididymitis, cystitis, and prostatic abscess (Davis & Silberman, 2021). A patient with acute or chronic bacterial prostatitis is likely to develop urinary tract infections and experience reduced sexual functioning due to discomfort.
Pathophysiology
Bacterial prostatitis mainly occurs with urethritis or an infection of the lower urinary tract. Bacteria from the urethra ascend to the prostate or may travel through the bloodstream, causing inflammation. Prostatitis is primarily caused by bacteria Escherichia coli, Enterobacter, Proteus, and group D streptococci (Khan et al., 2018). However, it can occur following a viral illness or may be associated with a sexually transmitted disease, especially in young males. Bacterial prostatitis can also be caused by direct inoculation from manipulation or prostate biopsy. In young males, the most common pathology of bacterial prostatitis is an ascending urethral infection after anal or vaginal intercourse (Khan et al., 2018). However, prolonged catheterization and instrumentation are the common causes in the elderly.
Clinical Presentation
ABP manifests with fever, chills, urethral discharge, painful urination, and a boggy, tender prostate (Khan et al., 2018). Patients with CBP present with urinary hesitancy, dysuria, urgency, difficulty initiating and terminating the flow of urine and decreased strength and volume of urine (Pirola et al., 2019). The prostate is usually not acutely inflamed on physical exam but may be tender to palpation. Some patients with CBP also report sexual dysfunction.
Diagnosis and Management
Urinalysis and urine culture are used to confirm the presence of infection and identify the causative pathogens. Besides, a complete blood count with blood cultures is indicated in acutely toxic patients or suspected septicemia cases. Early diagnosis and management of prostatitis with antimicrobials are crucial. Patients with ABP without symptoms of toxicity are managed on an outpatient basis with oral antibiotics, a fluoroquinolone, or trimethoprim-sulfamethoxazole for 14- to 28-days (Xiong et al., 2020). Patients with CBP and CPPS are managed with antibiotics (fluoroquinolones, tetracyclines, macrolides, and trimethoprim) for 4-6 weeks. In addition, Stool softeners are usually prescribed to prevent straining and rectal prostate irritation during a bowel movement (Pirola et al., 2019). Alpha-blockers such as tamsulosin can be prescribed to promote voiding.
Conclusion
Chronic pelvic pain syndrome is the most common type of prostatitis. Prostatitis occurs when bacteria from the lower urinary tract ascend to the prostate, causing infection. ABP usually presents with abrupt signs and symptoms of infection, while CBP symptoms are gradual. Treatment involves antibiotics for 14-28 days for ABP and 4-6 weeks for CBP.
References
Davis, N. G., & Silberman, M. (2021). Bacterial Acute Prostatitis. In StatPearls. StatPearls Publishing.
Khan, F. U., Ihsan, A. U., Khan, H. U., Jana, R., Wazir, J., Khongorzul, P., Waqar, M., & Zhou, X. (2018). Comprehensive overview of prostatitis. Biomedicine & pharmacotherapy = Biomedicine & pharmacotherapy, 94, 1064–1076. https://doi.org/10.1016/j.biopha.2017.08.016
Pirola, G. M., Verdacchi, T., Rosadi, S., Annino, F., & De Angelis, M. (2019). Chronic prostatitis: current treatment options. Research and reports in urology, 11, 165–174. https://doi.org/10.2147/RRU.S194679
Xiong, S., Liu, X., Deng, W., Zhou, Z., Li, Y., Tu, Y., Chen, L., Wang, G., & Fu, B. (2020). Pharmacological Interventions for Bacterial Prostatitis. Frontiers in pharmacology, 11, 504. https://doi.org/10.3389/fphar.2020.00504
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