II. Epidemiology

  1. Prostatitis accounts for 25% genitourinary complaints in men

III. Types: NIH Consensus Classification of Prostatitis

  1. Acute Bacterial Prostatitis
    1. Severe, acute prostate Bacterial Infection with an ill, toxic appearing patient
  2. Chronic Bacterial Prostatitis
    1. Symptoms >3 months with culture demonstrating the same organism
  3. Chronic Nonbacterial Prostatitis (90% of Chronic Prostatitis)
    1. Symptoms >3 months with inconsistent culture results
    2. May be Inflammatory (White Blood Cells >10 per HPF) or Non-Inflammatory
    3. Causes Chronic Pelvic Pain in Men
  4. Asymptomatic Prostatitis
    1. White Blood Cells >10 per HPF despite lack of symptoms

IV. Types: Uncommon

  1. Gonococcal Prostatitis (NeisseriaGonorrheae)
  2. Tuberculous Prostatitis (Tuberculosis)
  3. Parasitic Prostatitis (e.g. Trichomonas vaginalis)
  4. Mycotic Prostatitis (Fungal organisms - Aspergillus, Candida, Cryptococcus, Histoplasma)

V. Symptoms

  1. Irritative urinary symptoms
    1. Dysuria
    2. Urinary Frequency
    3. Urinary urgency
    4. Ejaculatory pain
    5. Hematospermia
  2. Referred pain
    1. Low pack pain
    2. Perineal pain
    3. Lower Abdominal Pain
    4. Scrotal Pain
    5. Pain in penis
    6. Pain in inner thighs
  3. Systemic symptoms (e.g. fever)
    1. Suggests Acute Prostatitis, Prostate abscess or other significant acute infection
  4. Obstructive urinary symptoms (diminished urinary stream, hesitancy, straining)
    1. Suggests Acute Prostatitis, Benign Prostatic Hyperplasia

VI. Exam

  1. Abdominal exam including Pelvis and flank
  2. Genitourinary exam (scrotal exam and penis exam)
  3. Digital Rectal Exam
    1. Avoid Prostatic Massage in suspected Acute Bacterial Prostatitis
    2. Obtain Urinalysis and Urine Culture before and after Prostatic Massage

VIII. Precautions

  1. Cystoscopy (and urine cytology) Indications
    1. Hematuria and Bladder Cancer risk factors (Tobacco Abuse, age >40 years old)

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Ontology: prostatitis (C0033581)

Definition (NCI_NCI-GLOSS) Inflammation of the prostate gland.
Definition (NCI) An infectious or non-infectious inflammatory process affecting the prostate gland.
Definition (CSP) inflammation of the prostate.
Definition (MSH) Infiltration of inflammatory cells into the parenchyma of PROSTATE. The subtypes are classified by their varied laboratory analysis, clinical presentation and response to treatment.
Concepts Disease or Syndrome (T047)
MSH D011472
ICD9 601.9, 601
ICD10 N41 , N41.9
SnomedCT 197962006, 155907007, 266637008, 155911001, 197971002, 9713002
English Prostatitides, Prostatitis, Inflammatory diseases of prostate, Prostatitis, unspecified, Inflammatory disease of prostate, unspecified, Prostatic inflammatory disease, prostatitis (diagnosis), Prostatitis NOS, Prostatitis [Disease/Finding], prostate inflammation, Prostatitis NOS (disorder), Prostate inflammatory diseases, Inflammation of prostate, Prostatitis (disorder), inflammation; prostate, prostate; inflammation, Prostatitis, NOS, prostatitis
Dutch inflammatoire prostaataandoeningen, niet-gespecificeerde prostatitis, ontsteking; prostaat, prostaat; ontsteking, Ontstekingsproces van prostaat, niet gespecificeerd, prostatitis, Ontstekingsprocessen van prostaat, Prostatitis
French Maladies inflammatoires de la prostate, Prostatite, non précisée, Prostatite
German Entzuendungskrankheiten der Prostata, Prostatitis, unspezifisch, Entzuendliche Krankheit der Prostata, nicht naeher bezeichnet, Entzuendliche Krankheiten der Prostata, Prostatitis, Prostataentzündung
Italian Prostatite, non specificata, Patologie infiammatorie della prostata, Prostatite
Portuguese Doenças inflamatórias da próstata, Prostatite NE, Prostatite
Spanish Prostatitis no especificada, Enfermedades inflamatorias de la próstata, prostatitis, SAI (trastorno), prostatitis, SAI, Prostatitis NOS, inflamación de la próstata, inflamación prostática, prostatitis (trastorno), prostatitis, Prostatitis
Japanese 前立腺炎、詳細不明, ゼンリツセンエンショウサイフメイ, ゼンリツセンエン, 前立腺炎
Swedish Prostatit
Czech prostatitida, prostata - zánět, Prostatitida, Prostatitida, blíže neurčená, Zánětlivá onemocnění prostaty, prostatitis, zánět prostaty
Finnish Eturauhastulehdus
Korean 전립샘의 염증성 질환, 상세불명의 전립샘의 염증성 질환
Polish Zapalenie gruczołu krokowego, Zapalenie prostaty, Zapalenie stercza
Hungarian Prostatitis, Nem meghatározott prostatitis, Prostata gyulladásos betegségei
Norwegian Blærehalskjertelbetennelse, Prostatabetennelse, Prostatitt