PROSTATITIS

1. PROSTATITIS
BY: MRS. PRECILLA C. STEPHEN

2. DEFINITION
 Prostatitis is an inflammation of the prostate gland, that is caused
by infectious agents(bacteria, fungi and mycoplasma) or other
conditions including urethral stricture, prostatic hyperplasia.

3. EPIDEMIOLOGY
Overall prevalence in men is 5
Higher risk age 20-50 & 70

4. CLASSIFICATION OF PROSTATITIS
 Acute Bacterial (Type 1)
 Chronic Bacterial (Type 2)
 Chronic prostatitis or chronic pelvic pain syndrome. CP/CPPS (Type 3)
 Asymptomatic inflammatory prostatitis (Type 4)

5. CONT.
 Both Acute and Chronic Bacterial prostatitis, generally result from organisms reaching the
prostate gland by one of the following routes:
1. Ascending from the urethra(upward)
2. Descending from the bladder (downwards) and invasion via the blood stream or the lymphatic
channels.
Common organisms are such as:
 Escherichia coli
 Klebsiella
 Pseudomonas
 Enterobacter
 Proteus
 Neisseria gonorrhoea and group D streptococci

6. CONT.
 Chronic Bacterial prostatitis involves recurrent episodes of
infection.
 CP/CPPS is a new term that describes the syndrome with prostate
and urinary pain in the absence of an obvious infectious process.
 The etiology of CP/CPPS is unclear. It may be associated with
STDs.

7. CONT.
 Asymptomatic inflammatory prostatitis is usually diagnosed in
individuals who have no symptom, but are found to have an
inflammatory process in the prostate.

8. CLINICAL MANIFESTATION
 Perineal discomfort
 Burning, urgency and frequency
 Pain with ejaculation
 Prostatodynia (pain in the prostate gland)
 Sudden fever, chills and perineal, rectal and low back pain in acute
bacterial prostatitis

9. URINARY SYMPTOMS
Dysuria, frequency, urgency and nocturia may occur
some patients do not have a symptoms.

10. DIAGNOSTIC EVALUATION
 History collection and physical examination
 Culture of the prostate fluid or tissue and occasionally
histological examination of the tissue
 Urine analysis and culture
 CBC
 MRI and transabdominal ultrasound

11. MEDICAL MANAGEMENT
 The goal of therapy for acute bacterial prostatitis is avoid the complications of
abscess formation and septicaemia.
 Antibiotics commonly used for acute or chronic bacterial prostatitis antibiotics
therapy involves for up to 10 to 14 days.
 The patient is encouraged to remain on bed rest to alleviate symptoms quickly
 Comfort is provided with analgesics to relieve pain, anti spasmodic medications and
bladder sedatives (to relieve bladder irritability) sitz bath and stool softeners.

12. MANAGEMENT
 Chronic bacterial prostatitis is difficult to treat because most antibiotics
diffuse poorly from the plasma into the prostatic fluid
 Treatment includes alpha – adrenergic blockers to promote relaxation of
the bladder and prostate.
 Other treatment modalities include for chronic prostatitis including the
retention of prostatic fluid by ejaculation through sexual intercourse,
others Anti spasmodic, sitz bath and stool softeners.

13. COMPLICATIONS
Swelling of the prostate gland
Urinary retention
Epididymitis
Bactermia and pyelonephritis

14.  Hyperthermia related to infectious process as evidenced by fever,
discomfort
 Acute pain related to prostatic inflammation as evidenced by pain,
difficulty in urine and in ejaculation
 Chronic pain related to chronic prostatitis, chronic pelvic syndrome .
 Deficient knowledge related to disease cause, clinical manifestation
and treatment
NURSING DIAGNOSIS

15.  Instruct patient to take antibiotics as prescribed.
 Emphasis importance of completing long course of therapy to prevent recurrence and
resistance of organisms.
 Instruct patient in comfort measures: sitz baths (10 to 20 mins) several times daily.
Continued use of stool softeners and not sitting for long periods.
 Advise patient to avoid sexual arousal and intercourse during period of acute
inflammation; encourage prescribed follow – up because recurrence is possible .
Patient Education And Health Maintenance

16. Afebrile
Verbalizes relief of pain after analgesics
Verbalizes reduction of chronic pain
EVALUATION: EXPECTED OUTCOMES