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Prostatitis CKS | A4 Medicine

Prostatitis describes a combination of infectious diseases ( acute or bacterial prostatitis ) chronic pelvic pain syndrome and asymptomatic inflammation u2028( Krieger et al 2008 )<br><br>

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Prostatitis CKS | A4 Medicine

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  1. Prostatitis CKS a4medicine.co.uk

  2. Prostatitis CKS describes a combination of infectious diseases
 ( acute or bacterial prostatitis ) chronic pelvic pain syndrome and asymptomatic inflammation 
( Krieger et al 2008 ) Prevalence is high , comparable to rates of IHD and diabetes Third most important condition of the prostate AAFP reports prevalence of 8.2 % ( range from 2.2 to 9.7 % ) Rosebud et al quote a prevalence of 5 % to 9 % among unselected men in the community The lifetime probability of a man being diagnosed as prostatitis exceeds 25 % and prostatitis accounts for about ~ 25 % of men seeking medical attention for genitourinary complaints.

  3. Type 1 or 
Acute bacterial prostatitis acute infection of the prostate / urinary tract infection can be medical emergency with severe symptoms , systemic upset true incidence is not known but it is estimated that this may constitute about
10 % of all cases of prostatitis. Type II 
Chronic bacterial prostatitis persistent bacterial infection of the prostate gland causing recurrent UTI’s caused by the same strain of bacteria duration > 3 months. Type III
Chronic prostatitis/
chronic pelvic pain syndrome most common subtype no identifiable infection further subdivided into
○ Type A : inflammatory CPS previously known as chronic non bacterial prostatitis
○ Type B non inflammatory CPS previously called prostatodynia Type IV asymptomatic inflammatory prostatitis no symptoms but documented inflammation in prostatic tissue abnormal semen analysis , elevated PSA or incidental finding of prostatitis on examination of a biopsy specimen

  4. What causes prostatitis is a matter of ongoing debate Multiple etiologies both infectious & non infectious Some cases clearly infectious Majority of cases have no evidence of genitourinary infection and the cause is usually not known Risk factors include
○ genetic , behavioural and environmental factors
○ inflammatory mediators
○ urinary tract instrumentation
○ men with chronic indwelling catheters
○ diabetes
○ cirrhosis
○ a h/o sexually transmitted infections
○ having a urethral strictureAcute bacterial prostatitis –Acute prostatitis is used interchangeably with acute acute bacterial prostatitis ( ABP ) in literature NICE in its draft for consultation ( May 2018 ) mentions that
○ acute prostatitis is a bacterial infection of the prostate needing treatment with antibiotics
○ usually caused by bacteria which enter the prostate from the urinary tract
○ ABP can happen spontaneously or after medical procedures as prostate biopsy 
○ it can last for several weeks
○ complications include urinary retention & prostatic abscess ABP can be a life threatening event – requires prompt recognition and treatment.Presentation -Systemic symptoms as -fever / chills / malaise / tachycardia dysuria , frequency , urinary retention
( edema of prostate can cause lower
urinary tract obstruction ) pelvic / lower back / rectal / perineal pain tender , enlarged or boggy prostate painful ejaculation , haematospermia and 
painful defecation may also be reported.

  5. Krieger JN, Lee SW, Jeon J, Cheah PY, Liong ML, Riley DE. Epidemiology of prostatitis. Int J Antimicrob Agents. 2008 Feb;31 Suppl 1(Suppl 1):S85-90. doi: 10.1016/j.ijantimicag.2007.08.028. Epub 2007 Dec 31. PMID: 18164907; PMCID: PMC2292121. ( Abstract ) • Roberts, R.O., Jacobsen, S.J. Epidemiology of Prostatitis. CurrUrol Rep1, 135–141 (2000). https://doi.org/10.1007/s11934-000-0048-7 ( Abstract ) • Benjamin A. Lipsky, IvorByren, Christopher T. Hoey, Treatment of Bacterial Prostatitis, Clinical Infectious Diseases, Volume 50, Issue 12, 15 June 2010, Pages 1641–1652, https://doi.org/10.1086/652861 • Sharp VJ, Takacs EB, Powell CR. Prostatitis: diagnosis and treatment. Am Fam Physician. 2010 Aug 15;82(4):397-406. PMID: 20704171 • Prostatitis Infectious Disease Antimicrobial agents Dierdre L Church MD PhD FRCPC Prostatitis – Infectious Disease and Antimicrobial Agents (antimicrobe.org) • Prostatitis Diagnosis and treatment RACGP Volume 42 , No 4 , April 2013 RACGP – Prostatitis – diagnosis and treatment • Diagnosis and treatment of chronic bacterial prostatitis and chronic prostatitis/chronic pelvicpain syndrome: a consensus guideline Jon Rees, Mark Abrahams*, Andrew Doble† and Alison Cooper‡ for the Prostatitis Expert Reference Group (PERG)Backwell and Nailsea Medical Group, Bristol, *Department of Pain Medicine, †Department of Urology, Addenbrooke’s Hospital, Cambridge, and ‡Evidence Team, Prostate Cancer UK, London, UK https://www.bashhguidelines.org/media/1065/bju-prostatitis-2015.pdf • CKS NHS Chronic Prostatitishttps://cks.nice.org.uk/topics/prostatitis-chronic/ • Virtual Mentor. 2006;8(11):748-751. doi: 10.1001/virtualmentor.2006.8.11.cprl1-0611. • Leeds NHS Trust Acute and Chronic Prostatitis – Primary Care Acute and Chronic Prostatitis (leedsth.nhs.uk) • Prostatitis (acute): antimicrobial prescribing NICE guideline [NG110]Published date: 31 October 2018 Overview | Prostatitis (acute): antimicrobial prescribing | Guidance | NICE • Su, Z.T., Zenilman, J.M., Sfanos, K.S. et al. Management of Chronic Bacterial Prostatitis. CurrUrol Rep21, 29 (2020). https://doi.org/10.1007/s11934-020-00978-z REFERENCES

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