Prostatitis

Microbiology

• Haematogenous or secondary to UTI
• Usually E coli
• Can be chlamydia/gonorrhoea

Presentation

• Malaise
• Rigors
• Myalgia
• Fever up to 39
• Dysuria is common, but not always there
• Local symptoms - perineal heaviness, rectal irritation, pain on daefecation
• Tender prostate - can be asymmetrical - sometimes frankly fluctuant abscess

Treatment

• Prolonged Abx or it will recur

Prostatic abscess

• Severe, unremitting perineal and rectal pain
• TRUS/MRI may aid diagnosis
• Urinary retention is likely
• Can be treated via urethra or using a needle transrectally or perineally