Chronic bacterial prostatitis

Epidemiology

  • Young & middle-aged men
  • ↑ Risk with diabetes mellitus, smoking, urinary tract procedure

Pathogens

  • Coliforms enter from urethra via intraprostatic reflux
  • Escherichia coli causes >75% of cases

Presentation

  • Recurrent urinary tract infection (with the same organism)
  • ± Prostatic tenderness & swelling (often absent)
  • Pain with ejaculation
  • History of antibiotic treatment → transient improvement

Diagnosis

  • Pyuria and bacteriuria on urinalysis
  • Bacteria in prostatic fluid > bacteria in urine

Treatment

  • Fluoroquinolones (eg, ciprofloxacin) for 6 weeks