Acute prostatitis - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Acute prostatitis is the most frequent urologic diagnosis in men <50 years old.
Commonly caused by Escherichia coli bacteria.
Can cause extreme lower abdominal, ejaculatory, rectal, and perineal pain.
May be successfully treated with antibiotics, but a prolonged course is frequently required if chronic prostatitis follows the acute occurrence.

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History & Exam
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Definition

Epidemiology

Etiology

Pathophysiology

Citations

Key Articles

Rothman JR, Jaffe WI. Prostatitis: updates on diagnostic evaluation. Curr Urol Rep. 2007 Jul;8(4):301-6.[Abstract]
Krieger JN, Lee SW, Jeon J, et al. Epidemiology of prostatitis. Int J Antimicrob Agents. 2008 Feb;31(suppl 1):S85-90.[Abstract][Full Text]
European Association of Urology. Guidelines on urological infections. 2022 [internet publication].[Full Text]
Nickel JC. Prostatitis. Can Urol Assoc J. 2011 Oct;5(5):306-15.[Abstract][Full Text]
National Institute for Health and Care Excellence. Prostatitis (acute): antimicrobial prescribing. Oct 2018 [internet publication].[Full Text]

Referenced Articles

1. Rothman JR, Jaffe WI. Prostatitis: updates on diagnostic evaluation. Curr Urol Rep. 2007 Jul;8(4):301-6.[Abstract]
2. Krieger JN, Lee SW, Jeon J, et al. Epidemiology of prostatitis. Int J Antimicrob Agents. 2008 Feb;31(suppl 1):S85-90.[Abstract][Full Text]
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12. European Association of Urology. Guidelines on urological infections. 2022 [internet publication].[Full Text]
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14. Terai A, Ishitoya S, Mitsumori K, et al. Molecular epidemiological evidence for ascending urethral infection in acute bacterial prostatitis. J Urol. 2000 Dec;164(6):1945-7.[Abstract]
15. Weidner W, Schiefer HG, Krauss H, et al. Chronic prostatitis: a thorough search for etiologically involved microorganisms in 1,461 patients. Infection. 1991;19(suppl 3):S119-25.[Abstract]
16. Meares EM Jr. Prostatitis and related disorders. In: Walsh PC, Retik AB, Vaughan ED, et al, eds. Campbell's urology. 7th ed. Philadelphia, PA: WB Saunders; 1998:615-30.
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18. Schneider H, Ludwig M, Hossain HM, et al. The 2001 Giessen Cohort Study on patients with prostatitis syndrome: an evaluation of inflammatory status and search for microorganisms 10 years after a first analysis. Andrologia. 2003 Oct;35(5):258-62.[Abstract]
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26. Nickel JC. Prostatitis. Can Urol Assoc J. 2011 Oct;5(5):306-15.[Abstract][Full Text]
27. Coker TJ, Dierfeldt DM. Acute bacterial prostatitis: diagnosis and management. Am Fam Physician. 2016 Jan 15;93(2):114-20.[Abstract][Full Text]
28. Zermann DH, Ishigooka M, Doggweiler R, et al. Neurourological insights into the etiology of genitourinary pain in men. J Urol. 1999 Mar;161(3):903-8.[Abstract]
29. Meares EM, Stamey TA. Bacteriologic localization patterns in bacterial prostatitis and urethritis. Invest Urol. 1968 Mar;5(5):492-518.[Abstract]
30. Nickel JC, Shoskes D, Wang Y, et al. How does the pre-massage and post-massage 2-glass test compare to the Meares-Stamey 4-glass test in men with chronic prostatitis/chronic pelvic pain syndrome? J Urol. 2006 Jul;176(1):119-24.[Abstract]
31. Sindhwani P, Wilson CM. Prostatitis and serum prostate-specific antigen. Curr Urol Rep. 2005 Jul;6(4):307-12.[Abstract]
32. Stopiglia RM, Ferreira U, Silva MM Jr, et al. Prostate specific antigen decrease and prostate cancer diagnosis: antibiotic versus placebo prospective randomized clinical trial. J Urol. 2010 Mar;183(3):940-4.[Abstract]
33. Nickel JC, Ardern D, Downey J. Cytologic evaluation of urine is important in evaluation of chronic prostatitis. Urology. 2002 Aug;60(2):225-7.[Abstract]
34. Langer JE, Cornud F. Inflammatory disorders of the prostate and the distal genital tract. Radiol Clin North Am. 2006 Sep;44(5):665-77.[Abstract]
35. Wasserman NF. Prostatitis: clinical presentations and transrectal ultrasound findings. Semin Roentgenol. 1999 Oct;34(4):325-37.[Abstract]
36. Ackerman AL, Parameshwar PS, Anger JT. Diagnosis and treatment of patients with prostatic abscess in the post-antibiotic era. Int J Urol. 2018 Feb;25(2):103-110.[Abstract][Full Text]
37. Zaidi S, Gandhi J, Seyam O, et al. Etiology, diagnosis, and management of seminal vesicle stones. Curr Urol. 2019 May 10;12(3):113-20.[Abstract][Full Text]
38. Lee JC, Muller CH, Rothman I, et al. Prostate biopsy culture findings of men with chronic pelvic pain syndrome do not differ from those of healthy controls. J Urol. 2003 Feb;169(2):584-7.[Abstract]
39. Collins MM, Stafford RS, O'Leary MP, et al. How common is prostatitis? A national survey of physician visits. J Urol. 1998 Apr;159(4):1224-8.[Abstract]
40. Schiller DS, Parikh A. Identification, pharmacologic considerations, and management of prostatitis. Am J Geriatr Pharmacother. 2011 Feb;9(1):37-48.[Abstract]
41. Ludwig M. Diagnosis and therapy of acute prostatitis, epididymitis and orchitis. Andrologia. 2008 Apr;40(2):76-80.[Abstract][Full Text]
42. National Institute for Health and Care Excellence. Prostatitis (acute): antimicrobial prescribing. Oct 2018 [internet publication].[Full Text]
43. European Medicines Agency. Quinolone- and fluoroquinolone-containing medicinal products. Mar 2019 [internet publication].[Full Text]
44. Medicines and Healthcare products Regulatory Agency. Fluoroquinolone antibiotics: new restrictions and precautions for use due to very rare reports of disabling and potentially long-lasting or irreversible side effects. Mar 2019 [internet publication].[Full Text]
45. US Food and Drug Administration. FDA drug safety communication: FDA advises restricting fluoroquinolone antibiotic use for certain uncomplicated infections; warns about disabling side effects that can occur together. Sept 2018 [internet publication].[Full Text]
46. US Food and Drug Administration. FDA warns about increased risk of ruptures or tears in the aorta blood vessel with fluoroquinolone antibiotics in certain patients. Dec 2018 [internet publication].[Full Text]
47. US Food and Drug Administration. FDA reinforces safety information about serious low blood sugar levels and mental health side effects with fluoroquinolone antibiotics; requires label changes. Oct 2018 [internet publication].[Full Text]
48. Barbalias GA, Nikiforidis G, Liatsikos EN. Alpha-blockers for the treatment of chronic prostatitis in combination with antibiotics. J Urol. 1998 Mar;159(3):883-7.[Abstract]
49. Schaeffer AJ. Prostatitis: US perspective. Int J Antimicrob Agents. 1999 May;11(3-4):205-11.[Abstract]
50. European Medicines Agency. Disabling and potentially permanent side effects lead to suspension or restrictions of quinolone and fluoroquinolone antibiotics. Nov 2018 [internet publication].[Full Text]
51. Sahin A, Eiley D, Goldfischer ER, et al. The in vitro bactericidal effect of microwave energy on bacteria that cause prostatitis. Urology. 1998 Sep;52(3):411-5.[Abstract]
52. Nickel JC, Sorenson R. Transurethral microwave thermotherapy for nonbacterial prostatitis: a randomized double-blind sham controlled study using new prostatitis specific assessment questionnaires. J Urol. 1996 Jun;155(6):1950-4.[Abstract]
53. Rees J, Abrahams M, Doble A, et al. Diagnosis and treatment of chronic bacterial prostatitis and chronic prostatitis/chronic pelvic pain syndrome: a consensus guideline. BJU Int. 2015 Oct;116(4):509-25.[Abstract][Full Text]
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55. Franco JV, Turk T, Jung JH, et al. Pharmacological interventions for treating chronic prostatitis/chronic pelvic pain syndrome. Cochrane Database Syst Rev. 2019 Oct 6;10:CD012552.[Abstract][Full Text]
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