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Prostatitis
Published in Firza Alexander Gronthoud, Practical Clinical Microbiology and Infectious Diseases, 2020
If chronic bacterial prostatitis is suspected: Two-glass test: Clean-catch urine before prostate massage in glass 1 and clean-catch urine after prostate massage in glass 2 and send both for culture.Meares–Stamey four-glass test: 10 mL of urine in glass 1, 10 mL of midstream urine in glass 2, prostatic massage followed by collection of expressed prostatic secretion (EPS) glass 3 and post-massage urine in glass 4.Glass 1 is tested for N. gonorrhoea and C. trachomatis, glass 2 is cultured for uropathogens, the EPS is examined for WBCs. The post-massage urine is used to flush out bacteria in the prostate that may remain within the urethra.Urine culture.Perform transrectal ultrasound to look for prostatic calcification, which may serve as a source for recurrent infection. Consider performing urodynamics to document bladder problems or obstruction.
Prostatitis
Published in Shiv Shanker Pareek, The Pictorial Atlas of Common Genito-Urinary Medicine, 2018
Prostatitis is inflammation of the prostate gland and may be caused by bacterial infection. There are four types of prostatitis: acute bacterial prostatitis.chronic bacterial prostatitis.chronic non-bacterial prostatitis.asymptomatic inflammatory prostatitis.
Urology
Published in Kaji Sritharan, Samia Ijaz, Neil Russell, Tim Allen-Mersh, 300 Essentials SBAs in Surgery, 2017
Kaji Sritharan, Samia Ijaz, Neil Russell, Tim Allen-Mersh
A 60-year-old man presents to urology outpatients with a several-month history of perineal pain, pain on ejaculation and urinary frequency. Urine samples have not cultured any organisms, so the likely diagnosis is: Acute bacterial prostatitisChronic pelvic pain syndromeBenign prostatic hypertrophyChronic bacterial prostatitisBladder neck obstruction
Pharmacotherapeutic interventions for the treatment of bacterial prostatitis
Published in Expert Opinion on Pharmacotherapy, 2022
Ester Marquez-Algaba, Joaquin Burgos, Benito Almirante
Prostatitis is one of the most common urogenital diseases in men, and approximately 1 of 6 men will receive a diagnosis of prostatitis in their lifetime [1]. It is characterized by voiding symptoms and genitourinary pain and is sometimes associated with sexual dysfunction [2]. Although it is rarely serious or fatal, prostatitis is associated with significant morbidity, and it substantially impairs quality of life. Since 1994, the National Institute of Health consensus has classified prostatitis into four categories based on clinical characteristics: I, acute bacterial prostatitis (ABP); II, chronic bacterial prostatitis (CBP); III, chronic prostatitis/chronic pelvic pain syndrome (CP/CPSS); and IV, asymptomatic inflammatory prostatitis [3] (Table 1). This scheme clarified that a minority of men with prostatitis, approximately 20%, have a bacterial infection (acute or chronic). However, there is still a lack of agreement about how to define acute and chronic prostatitis, including debates over the relative importance of various clinical, microbiological, radiological, and histopathological findings.
Using the UPOINT system to manage men with chronic pelvic pain syndrome
Published in Arab Journal of Urology, 2021
Darren J. Bryk, Daniel A. Shoskes
Once the physical examination is complete, the next step is laboratory tests or other diagnostic tools [9,15]. Urine analysis and urine culture should be obtained. During the DRE, prostate massage can be performed to obtain expressed prostate secretions (EPS), which can be cultured, or to obtain a post-massage urine for culture. Pre- and post-massage urine cultures, also known as the ‘two-glass’ test can aid in diagnosis of chronic bacterial prostatitis with similar accuracy as the historical ‘four-glass’ test [17]. As antibiotics can persist in the prostate fluid, cultures should ideally be obtained after being off antibiotics for ≥2 weeks. If appropriate by history, testing for sexually transmitted infections should be included [8]. We routinely measure a post-void residual in all men with pelvic pain or LUTS. The PSA level should be measured as appropriate for age and physical examination. Cystoscopy is indicated if other pathology is suspected (e.g. haematuria, interstitial cystitis) but does not need to be part of the routine evaluation [5]. The key features in men to suggest interstitial cystitis are severe LUTS and pain that worsens with bladder filling and improves with emptying [18].
Increased risk of prostatitis in male patients with depression
Published in The World Journal of Biological Psychiatry, 2020
Chi-Shun Lien, Chi-Jung Chung, Cheng-Li Lin, Chao-Hsiang Chang
Prostatitis accounts for 8% of the cases in urology outpatient clinics and causes lifetime suffering of approximately 16% of men in the United States. According to the National Institutes of Health’s consensus classification, prostatitis is divided into four categories: acute bacterial prostatitis, chronic bacterial prostatitis, chronic prostatitis/pelvic pain syndrome (CP/CPPS), and asymptomatic inflammatory prostatitis. Acute bacterial prostatitis is an acute urinary tract infection related to the prostate. Chronic bacterial prostatitis is a recurrent urinary tract infection with the same bacteria cultured in prostatic secretions during asymptomatic periods (Krieger et al. 1999). Approximately 10% of men with acute prostatitis will eventually develop chronic prostatitis. Similarly, chronic prostatitis comprises approximately 10% of all prostatitis cases (Krieger and Egan 1991). The guideline defines CP/CPPS as that which presents chronic pelvic pain and possible voiding symptoms without the evidence of infection (Nickel et al. 1999). The aetiology of chronic prostatitis and chronic pelvic pain syndrome is poorly understood but may involve an infectious or inflammatory initiator that results in neurological injury, and eventually in pelvic floor dysfunction in the form of increased pelvic tone (Murphy et al. 2009). One study also found that the synergistic interaction of benign prostatic hyperplasia and prostatitis is a risk factor for prostate cancer (Hung et al. 2013).