Prostatitis – Complicated UTIs

00:01 How about prostatitis? It's another category of are complicated UTI.

00:06 This occurs in about 25% of men during their lifetime.

00:10 The common microorganisms include gram-negative bacilli, like E.coli Proteus, Klebsiella and pseudomonas aeruginosa.

00:19 Less likely enterococci and staph aureus, but they can be present as well.

00:22 The pathogenesis includes reflux of infected urine from the urethra into the prostatic ducts.

00:28 So in terms of how our patient presents with symptoms of acute prostatitis, it includes dysuria, frequency, urgency, obstructive voiding symptoms, fever chills, and they might complain of pelvic pain as well.

00:42 An exam the prostate is edematous and tender to palpation.

00:45 But please be cognizant not to perform a prosthetic massage.

00:49 You will absolutely risk precipitating bacteremia.

00:53 The diagnosis is going to involve a urine analysis.

00:56 Once again, we're going to be looking for pyuria presence of white cells.

01:00 We also want to make sure that we obtain a urine culture and have sensitivities to those microorganisms in order to tailor antimicrobial therapy for our patient population.

01:11 In terms of hospitalization, same indications are going to apply as what we discussed in our acute pyelonephritis.

01:18 So when our patients are hospitalized we typically give them parenteral antibiotics again, tailored to tivities of that urine culture.

01:25 Outpatient treatment can consist of oral fluoroquinolones.

01:29 Treatment duration in the case of prostatitis is often times longer anywhere between 14 and 30 days.

01:36 These patients often times are also co-followed by urology.