Prostate Problems

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

Cause:  Primarily from infection
by Escherichia coli.  It also results from infection by Klebsiella,
Enterobacter, Proteus, Pseudomonas, Streptococcus, or Staphylococcus.


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


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.



Extreme tenderness

Swelling in the groin and scrotum

High fever



Broad spectrum antibiotic


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)