What is prostatitis

Prostatitis refers to an inflammation of the prostate gland that can be manifested in a variety of ways. Symptoms of acute bacterial prostatitis include urinary frequency, urgency dysuria or painful urination, nocturia, perineal pain, low back pain, fever, and/or chills. Some men with acute bacterial prostatitis may present with inability to urinate and will require a catheter or supra-pubic tube placement until the inflammation and pain have resolved. Some men with acute prostatitis may develop a prostatic abscess that will require drainage. Chronic bacterial prostatitis may present in a similar manner, but men are typically less toxic in appearance.

Prostatitis normally does not occur in children or adolescents, but can occur in adult men of any age. The diagnosis can be elusive and treatment is often empiric.

What types of prostatitis are there?

The National Institutes of Health (NIH) has recently defined the different prostatitis syndromes:

Prostatitis syndromes: NIH classification

I. Acute bacterial prostatitis II. Chronic bacterial prostatitis

III. Chronic prostatitis/chronic pelvic pain syndrome (CPPS)

A. Inflammatory

B. Noninflammatory Asymptomatic inflammatory prostatitis

Acute bacterial prostatitis is usually a sudden illness with irritative urinary symptoms and can be associated with fever. Urinary and/or prostatic secretions are often positive for bacteria. Some patients with acute prostatitis will have a transient elevation of their PSA. A PSA should not be done during an episode of acute prostatitis. If a PSA is inadvertently drawn during an episode of acute prostatitis and comes back elevated, a repeat PSA should be obtained after a course of antibiotics has been administered. Chronic bacterial prostatitis tends to be a more indolent condition. Irritative urinary symptoms are typical; however, fever is rare, and positive cultures are uncommon.

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