Chronic bacterial prostatitis: Difference between revisions

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	Chronic Bacterial Prostatitis;
ICD-10	N41.1
ICD-9	601.1
DiseasesDB	10801
MedlinePlus	000523
MeSH	D011472

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Revision as of 15:39, 27 September 2012

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Historical Perspective

Pathophysiology

Causes

Differentiating Chronic bacterial prostatitis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Treatment

Case Studies

Case #1

External links

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Additional images

Prostate, urethra, and seminal vesicles.
The arteries of the pelvis.
Male pelvic organs seen from right side.

Template:Diseases of the pelvis, genitals and breasts

de:Prostatitis it:Prostatite nl:Prostatitis fi:Eturauhasen tulehdus

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 {{Chronic bacterial prostatitis}}
 {{CMG}}
-==Overview==
-'''Chronic bacterial prostatitis''' is a [[bacteria|bacterial]] [[infection]] of the [[prostate]] gland. It should be distinguished from other forms of prostatitis such as [[Acute prostatitis|acute bacterial prostatitis]] and chronic pelvic pain syndrome (CPPS).
+==[[Chronic bacterial prostatitis overview|Overview]]==
-===Signs and symptoms===
+==[[Chronic bacterial prostatitis historical perspective|Historical Perspective]]==
-Chronic bacterial prostatitis is a relatively rare condition — occurs in less than 5% of patients with prostate-related non-[[Benign prostatic hyperplasia|BPH]] lower urinary tract symptoms (LUTS) — that usually presents with an intermittent [[Urinary_tract_infection|UTI]]-type picture and that is defined as recurrent urinary tract infections in men originating from a chronic infection in the prostate. Dr. Weidner, Professor of Medicine, Department of Urology, University of Gießen, has stated: "In studies of 656 men, we seldom found chronic bacterial prostatitis. It is truly a rare disease. Most of those were E-coli."<ref name="pmid14535851">{{cite journal |author=Schneider H, Ludwig M, Hossain HM, Diemer T, Weidner W |title=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 |journal=Andrologia |volume=35 |issue=5 |pages=258–62 |year=2003 |pmid=14535851 |doi= | doi = 10.1046/j.1439-0272.2003.00586.x <!--Retrieved from CrossRef by DOI bot-->}}</ref> Symptoms may be completely absent until there is also bladder infection, and the most troublesome problem is usually recurrent [[cystitis]].<ref name="pmid16409145">{{cite journal |author=Habermacher GM, Chason JT, Schaeffer AJ |title=Prostatitis/chronic pelvic pain syndrome |journal=Annu. Rev. Med. |volume=57 |issue= |pages=195–206 |year=2006 |pmid=16409145 |doi=10.1146/annurev.med.57.011205.135654}}</ref>
+==[[Chronic bacterial prostatitis pathophysiology|Pathophysiology]]==
-===Diagnosis===
+==[[Chronic bacterial prostatitis causes|Causes]]==
-In chronic bacterial prostatitis there are bacteria in the prostate but usually no symptoms. The prostate infection is diagnosed by culturing urine as well as prostate fluid (expressed prostatic secretions or EPS) which are obtained by the doctor doing a rectal exam and putting pressure on the prostate. If no fluid is recovered after this prostatic massage, a post massage urine should also contain any prostatic bacteria. [[Prostate specific antigen]] levels may be elevated, although there is no malignancy.
-===Treatment===
+==[[Chronic bacterial prostatitis differential diagnosis|Differentiating Chronic bacterial prostatitis from other Diseases]]==
-Treatment requires prolonged courses (4-8 weeks) of antibiotics that penetrate the prostate well ([[beta-lactam|&beta;-lactam]]s and [[nitrofurantoin]] are ineffective). These include [[quinolone]]s (ciprofloxacin, [[levofloxacin]]), [[Sulfonamide (medicine)|sulfas]] ([[trimethoprim-sulfamethoxazole|Bactrim, Septra]]) and [[macrolide]]s ([[erythromycin]], [[clarithromycin]]). Persistent infections may be helped in 80% of patients by the use of [[alpha blocker]]s ([[tamsulosin]] (Flomax), [[alfuzosin]]), or long term low dose antibiotic therapy.<ref name="pmid12629373">{{cite journal |author=Shoskes DA, Hakim L, Ghoniem G, Jackson CL |title=Long-term results of multimodal therapy for chronic prostatitis/chronic pelvic pain syndrome |journal=J. Urol. |volume=169 |issue=4 |pages=1406–10 |year=2003 |pmid=12629373 |doi=10.1097/01.ju.0000055549.95490.3c}}</ref> Recurrent infections may be caused by inefficient urination (benign prostatic hypertrophy, neurogenic bladder), prostatic stones or a structural abnormality that acts as a reservoir for infection.
-The addition of [[prostate massage]] to courses of antibiotics was previously proposed as being beneficial.<ref name="pmid10527258">{{cite journal |author=Nickel JC, Downey J, Feliciano AE, Hennenfent B |title=Repetitive prostatic massage therapy for chronic refractory prostatitis: the Philippine experience |journal=Techniques in urology |volume=5 |issue=3 |pages=146–51 |year=1999 |pmid=10527258 |doi=}}</ref><ref name="pmid12496826">{{cite journal |author=Shoskes DA, Zeitlin SI |title=Use of prostatic massage in combination with antibiotics in the treatment of chronic prostatitis |journal= Prostate Cancer and Prostatic Diseases |volume=2 |issue=3 |pages=159–162 |year=1999 |pmid=12496826 |doi=10.1038/sj.pcan.4500308}}</ref> However, in more recent trials, this was not shown to improve outcome compared to antibiotics alone.<ref name="pmid16566972">{{cite journal |author=Ateya A, Fayez A, Hani R, Zohdy W, Gabbar MA, Shamloul R |title=Evaluation of prostatic massage in treatment of chronic prostatitis |journal=Urology |volume=67 |issue=4 |pages=674–8 |year=2006 |pmid=16566972 |doi=10.1016/j.urology.2005.10.021}}</ref>
+==[[Chronic bacterial prostatitis epidemiology and demographics|Epidemiology and Demographics]]==
-===Prognosis===
+==[[Chronic bacterial prostatitis risk factors|Risk Factors]]==
-Over time, the relapse rate is high, exceeding 50%. A 2007 study showed that repeated courses of combination antibiotics may eradicate infection in 83.9% of patients with clinical remission extending throughout a follow-up period of 30 months for 94% of these patients.<ref name="pmid17336504">{{cite journal |author=Magri V, Trinchieri A, Pozzi G, ''et al'' |title=Efficacy of repeated cycles of combination therapy for the eradication of infecting organisms in chronic bacterial prostatitis |journal=Int. J. Antimicrob. Agents |volume=29 |issue=5 |pages=549–56 |year=2007 |month=May |pmid=17336504 |doi=10.1016/j.ijantimicag.2006.09.027 |url=}}</ref>
-== References ==
+==[[Chronic bacterial prostatitis screening|Screening]]==
-{{reflist|2}}
+==[[Chronic bacterial prostatitis natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
+==Diagnosis==
+[[Chronic bacterial prostatitis history and symptoms|History and Symptoms]] | [[Chronic bacterial prostatitis physical examination|Physical Examination]] | [[Chronic bacterial prostatitis laboratory findings|Laboratory Findings]] | [[Chronic bacterial prostatitis x ray|X Ray]] | [[Chronic bacterial prostatitis CT|CT]] | [[Chronic bacterial prostatitis MRI|MRI]] | [[Chronic bacterial prostatitis ultrasound|Ultrasound]] | [[Chronic bacterial prostatitis other imaging findings|Other Imaging Findings]] | [[Chronic bacterial prostatitis other diagnostic studies|Other Diagnostic Studies]]
+==Treatment==
+[[Chronic bacterial prostatitis medical therapy|Medical Therapy]] | [[Chronic bacterial prostatitis surgery|Surgery]] | [[Chronic bacterial prostatitis primary prevention|Primary Prevention]] | [[Chronic bacterial prostatitis secondary prevention|Secondary Prevention]] | [[Chronic bacterial prostatitis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Chronic bacterial prostatitis future or investigational therapies|Future or Investigational Therapies]]
+==Case Studies==
+[[Chronic bacterial prostatitis case study one|Case #1]]
 ==External links==


Chronic Bacterial Prostatitis
ICD-10	N41.1
ICD-9	601.1
DiseasesDB	10801
MedlinePlus	000523
MeSH	D011472

Chronic bacterial prostatitis: Difference between revisions

Revision as of 15:39, 27 September 2012

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