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Feature Article

Prostatitis: a significant challenge

Nicholas P McLeod, Andrew J Brooks

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Abstract

Prostatitis can have a major impact on patients’ quality of life, and it poses significant management challenges for GPs and urologists. Acute and chronic bacterial prostatitis represent only a small proportion of prostatitis cases. Most affected patients experience a chronic pain syndrome.

Key Points

  • A bacterial cause is isolated in only 5 to 10% of cases of prostatitis.
  • Acute bacterial prostatitis can represent a urological emergency.
  • Chronic bacterial prostatitis is characterised by recurrent, symptomatic urinary tract infections, often with the same organism.
  • The hallmark of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is pain, which may be associated with voiding or ejaculation.
  • Initial evaluation of a patient with suspected prostatitis should include a detailed history, physical examination (including digital rectal examination), urinalysis and urine culture.
  • Antibiotics are the mainstay of treatment for patients with acute and chronic bacterial prostatitis. CP/CPPS requires a multimodality approach to treatment.

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