Acute Prostatitis - Symptoms & Treatment

Acute prostatitis is a common disease, but is usually underdiagnosed. The usual organism responsible is Escherichia coli. The infection may be haematogenous that is spread via blood from a distant focus or it may be secondary to acute urinary infection. Clinically the General manifestations overshadow the local symptoms. The patient feels ill, shivers, may have a rigor, has ‘aches’ all over, especially in the back, and may easily be diagnosed as having influenza. The temperature may be up to 39°C. Pain on micturition is usual, but not invariable. The urine contains threads in the initial voided sample, which should be cultured. Perineal heaviness, rectal irritation and pain on defecation can occur; a urethral discharge is rare. Increased Urinary frequency occurs when the infection involves the bladder. Rectal examination reveals a tender prostate, one lobe may be swollen more than the other, and the seminal vesicles may be involved. A frankly fluctuant abscess is uncommon. Treatment must be rigorous and prolonged otherwise the infection will not be eradicated and recurrent attacks may ensue. Spread of infection to the epididymis and testes may occur. Prolonged treatment with an antibiotic that penetrates the prostate wall is indicated like trimethoprim, ciprofloxacin or aminoglycoside.