Complication which commonly accompanies acute prostatitis –
Correct Answer: Seminal vesiculitis
Description: • Acute inflammation of prostate associated with UTI
• Caused by ascending urethral infection or reflux of infected urine into prostatic ducts
• MC organism: E. coli
• Patients present with sudden onset high grade fever with chills and rigors, severe irritative symptoms and enlarged, tender and boggy prostate
• Catheterization and prostatic massage is contraindicated
• MC used antibiotics are: TMP-SMX and Ciprofloxacin (Both are having better concentration in prostatic tissue)
• Around 4-6 weeks of antibiotic therapy is used to avert chronic bacterial prostatitis.
Chronic Bacterial Prostatitis
• Due to persistent bacterial infection of prostate
• Insidious in onset, characterized by relapsing or recurrent UTI caused by persistence of pathogen in prostatic fluid despite of antibiotic therapy
• Diagnosis is made by microscopic examination and culture of prostatic expressate and culture of urine obtained before and after prostatic massage.
• Treated by chronic antibiotic suppression (3–4 months)
Prostatic Abscess
• Most cases result from complications of acute bacterial prostatitis
• Fluctuation is a very late sign
• Predisposing factors: Diabetes, renal insufficiency, immunosuppression, urethral instrumentation, chronic indwelling catheter
• Diagnosis: TRUS or pelvic CT scan is crucial for diagnosis and treatment
• Treated by transurethral drainage and antibiotics
Category:
Surgery
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