Chronic bacterial prostatitis
Chronic bacterial prostatitis refers to chronic or recurrent urogenital symptoms with evidence of bacterial infection of the prostate, usually defined as symptoms > 3 of the last 6 months. It's relatively rare.
- Etiology
- Often a complication of acute bacterial prostatitis, due to inadequate or too short treatment
- Clinical features
- Same as acute, but intermittent and less severe
- No systemic symptoms
- Diagnosis
- Meares-Stamey four-glass test
- 1st glass - the first 5 - 10 mL of urine
- 2nd glass - sample of midstream urine
- 3rd glass - the prostate is massaged, and any prostatic secretions are collected
- 4th glass - the subsequent 5 - 10 mL of urine after the prostate massage
- Enlarged, soft or boggy, moderately tender prostate on DRE
- Meares-Stamey four-glass test
- Treatment
- Long duration antibiotic treatment (6 – 12 weeks)
- Fluoroquinolones and sulphamethoxazole/trimethoprim penetrate the prostate
- NSAIDs
- Long duration antibiotic treatment (6 – 12 weeks)