Acute prostatitis
Pathogenesis
Acute prostatitis is caused by urogenital pathogens, including.
Gram-negative bacteria, most commonly Escherichia coli, Aspergillus, Klebsiella, and Pseudomonas.
Enterococci.
Staphylococcus aureus.
Anaerobes with bacilli-like bacteria.
Clinical features
(1) Symptoms: Acute prostatitis is a serious acute systemic disease with symptoms including
(2) Urinary tract infection symptoms: difficulty urinating, urinary frequency, urinary urgency
(3) Prostatitis symptoms: lumbosacral pain, perineal, penile, and sometimes rectal pain
(4) Symptoms of bacteraemia: fever and chills, and possibly joint and muscle pain.
Physical signs.
(1) Local signs of prostate: extremely soft, swollen, tense prostate, smooth tissue, elevated temperature.
(2) Bacteremia signs: fever, rapid heartbeat
(3) Complications: Acute prostatitis may lead to acute secondary urinary retention due to prostate edema.
Diagnosis.
(1) Smear microscopy, bacterial culture and drug sensitivity of the middle urine sample
(2) Blood culture and drug sensitivity
(3) Prostate massage is contraindicated in patients with acute prostatitis as it can be very painful and exacerbate bacteremia with limited benefit, as the pathogen is almost always separated from the urine.
Treatment.
General rule: Maintain adequate water intake, encourage rest, and pain medications such as non-steroidal anti-inflammatory drugs can be used.
Treatment.
(1) Because acute prostatitis is a serious and dramatic disease, empirical treatment should be started immediately.
(2) The choice between non-digestive administration or oral medication should be based on the patient’s clinical condition. If the use of oral medication is ineffective or worsens, the patient should be admitted to the hospital or switched to non-digestive tract administration. Due to intense inflammation, a wide range of good antibiotic injections in the prostate may be used.
(3) The decision to continue or change the antibiotic now in use should be based on the drug sensitivity results.
(4) In case of acute urinary retention, suprapubic catheterization should be performed to avoid damage to the prostate.