Prostatitis: Inflammation
of the prostate gland. This disorder may be acute or chronic.
Acute prostatitis most often results from gram-negative bacteria and is
easy to recognize and treat. Chronic prostatitis, the most
common cause of recurrent Urinary Tract Infection in men, isn’t easily
recognizable.
Cause: Primarily from infection
by Escherichia coli. It also results from infection by Klebsiella,
Enterobacter, Proteus, Pseudomonas, Streptococcus, or Staphylococcus.
Symptoms:
Acute prostatitis: Sudden fever, chills,
low back pain, myalgia, perineal fullness, arthralgia, urinary urgency,
possibly painful urination, nocturia, cloudy urine. Rectal palpation
of the prostate reveals marked tenderness, induration, swelling, firmness,
and warmth.
Chronic prostatitis: may present no symptoms.
Usually having the same symptoms as an acute prostatitis, but is less severe.
Other symptoms may include: painful ejaculation,
hemospermia, persistent urethral discharge, and sexual dysfunction
Treatment:
Systemic antibiotic therapy
Chronic prostatitis usually requires a long term
course of treatment
Epididymitis: Infection of
the epididymis. The cordlike excretory duct of the testis, is one
of the most common infections of the male reproductive tract. Usually,
the causative organisms spread from established UTI or prostatitis and
reach the epididymis through the lumen of the vas deferens. Rarely,
epididymitis is secondary to a distant infection, such as pharyngitis or
tuberculosis, that spreads through the lymphatic system or, less commonly,
the bloodstream. Epididymitis may spread to the testis itself.
Cause: Usually results from
pyogenci organisms, such as staphylococci, Escherichia coli, and streptococci.
Other causes include: gonorrhea, syphilis, chlamydial infection,
trauma, prostatectomy, and chemical irritation resulting form extravasation
of urine through the vas deferens.
Symptoms:
Pain
Extreme tenderness
Swelling in the groin and scrotum
High fever
Malaise
Treatment:
Broad spectrum antibiotic
Analgesics
Ice bag may be applied to the area to reduce swelling
and relieve pain
Bedrest may be needed
In older patient undergoing open prostatectomy,
bilateral vasectomy may be necessary to prevent epididymitis as a postoperative
complication. When epidymitis is refractory to antibiotic, epididymectomy
under local anesthesia is necessary.
Corticosteroids may be prescribed to help counteract
inflammation (but their use is controversial)