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American Family Physician Jan 2016Acute bacterial prostatitis is an acute infection of the prostate gland that causes pelvic pain and urinary tract symptoms, such as dysuria, urinary frequency, and... (Review)
Review
Acute bacterial prostatitis is an acute infection of the prostate gland that causes pelvic pain and urinary tract symptoms, such as dysuria, urinary frequency, and urinary retention, and may lead to systemic symptoms, such as fevers, chills, nausea, emesis, and malaise. Although the true incidence is unknown, acute bacterial prostatitis is estimated to comprise approximately 10% of all cases of prostatitis. Most acute bacterial prostatitis infections are community acquired, but some occur after transurethral manipulation procedures, such as urethral catheterization and cystoscopy, or after transrectal prostate biopsy. The physical examination should include abdominal, genital, and digital rectal examination to assess for a tender, enlarged, or boggy prostate. Diagnosis is predominantly made based on history and physical examination, but may be aided by urinalysis. Urine cultures should be obtained in all patients who are suspected of having acute bacterial prostatitis to determine the responsible bacteria and its antibiotic sensitivity pattern. Additional laboratory studies can be obtained based on risk factors and severity of illness. Radiography is typically unnecessary. Most patients can be treated as outpatients with oral antibiotics and supportive measures. Hospitalization and broad-spectrum intravenous antibiotics should be considered in patients who are systemically ill, unable to voluntarily urinate, unable to tolerate oral intake, or have risk factors for antibiotic resistance. Typical antibiotic regimens include ceftriaxone and doxycycline, ciprofloxacin, and piperacillin/tazobactam. The risk of nosocomial bacterial prostatitis can be reduced by using antibiotics, such as ciprofloxacin, before transrectal prostate biopsy.
Topics: Anti-Bacterial Agents; Biopsy; Disease Management; Humans; Male; Prostate; Prostatitis
PubMed: 26926407
DOI: No ID Found -
Biomedicine & Pharmacotherapy =... Oct 2017Prostatitis is a common urinary tract syndrome that many doctors find problematic to treat effectively. It is the third most commonly found urinary tract disease in men... (Review)
Review
Prostatitis is a common urinary tract syndrome that many doctors find problematic to treat effectively. It is the third most commonly found urinary tract disease in men after prostate cancer and Benign Prostate Hyperplasia (BPH). Prostatitis may account for 25% of all office visits made to the urological clinics complaining about the genital and urinary systems all over the world. In the present study, we classified prostatitis and comprehensively elaborated the etiology, pathogenesis, diagnosis, and treatment of acute bacterial prostatitis (category I), chronic bacterial prostatitis (category II), chronic pelvic pain syndrome (CPPS) (category III), and asymptomatic prostatitis (category IV). In addition, we also tried to get some insights about other types of prostatitis-like fungal, viral and gonococcal prostatitis. The aim of this review is to present the detail current perspective of prostatitis in a single review. To the best of our knowledge currently, there is not a single comprehensive review, which can completely elaborate this important topic in an effective way. Furthermore, this review will provide a solid platform to conduct future studies on different aspects such as risk factors, mechanism of pathogenesis, proper diagnosis, and rational treatment plans for fungal, viral, and gonococcal prostatitis.
Topics: Animals; Humans; Male; Pelvic Pain; Prostatic Hyperplasia; Prostatic Neoplasms; Prostatitis
PubMed: 28813783
DOI: 10.1016/j.biopha.2017.08.016 -
Clinical Microbiology and Infection :... Jan 2023Bacterial prostatitis is a highly prevalent infection responsible for significant morbidity among men. The diagnosis and treatment for bacterial prostatitis remains... (Review)
Review
BACKGROUND
Bacterial prostatitis is a highly prevalent infection responsible for significant morbidity among men. The diagnosis and treatment for bacterial prostatitis remains complicated. The difficulty in diagnosis is in part owing to the paucity of high-quality evidence that guides a clinician's interpretation of patients' history, physical examination, and laboratory findings. Treatment is challenging because of the few antimicrobials capable of prostate penetration, growing antimicrobial resistance limiting effective treatment options, and the high risk of recurrence.
OBJECTIVES
We aimed to provide a useful resource for clinicians in effectively diagnosing and managing acute bacterial prostatitis (ABP) and chronic bacterial prostatitis (CBP).
SOURCES
A PubMed literature search on prostatitis was performed with no restrictions on publication date.
CONTENT
The epidemiology, pathophysiology, diagnosis, and treatment for ABP and CBP are explored using a clinical vignette as relevant context.
IMPLICATIONS
Bacterial prostatitis can be diagnosed through a focused history and microbiological investigations. The Meares-Stamey 4-glass test or modified 2-glass test can help confirm the diagnosis if uncertainty exists. Typical uropathogens are common contributors to bacterial prostatitis but there is growing interest in exploring the role atypical and traditional non-pathogenic organisms may have. Fluoroquinolones remain first-line therapy, followed by trimethoprim-sulfamethoxazole (TMP-SMX) or doxycycline if the pathogen is susceptible. Fosfomycin has emerged as a repurposed and useful agent because of the increasing incidence of multidrug-resistant pathogens. Selection of appropriate antimicrobial regimens can be challenging and is dependent on the host, chronicity of symptoms, uropathogens' susceptibilities, antimicrobials' side effect profile, and the presence of prostatic abscesses or calcifications. ABP can typically be treated similar to other complicated urinary tract infections. However, CBP requires prolonged therapy, with a minimum of 4 weeks and up to 12 weeks of therapy.
Topics: Male; Humans; Prostatitis; Anti-Bacterial Agents; Chronic Disease; Bacterial Infections; Anti-Infective Agents
PubMed: 35709903
DOI: 10.1016/j.cmi.2022.05.035 -
Frontiers in Endocrinology 2021Benign prostate hyperplasia (BPH), one of the most common diseases in older men, adversely affects quality-of-life due to the presence of low urinary tract symptoms... (Review)
Review
Benign prostate hyperplasia (BPH), one of the most common diseases in older men, adversely affects quality-of-life due to the presence of low urinary tract symptoms (LUTS). Numerous data support the presence of an association between BPH-related LUTS (BPH-LUTS) and metabolic syndrome (MetS). Whether hormonal changes occurring in MetS play a role in the pathogenesis of BPH-LUTS is a debated issue. Therefore, this article aimed to systematically review the impact of hormonal changes that occur during aging on the prostate, including the role of sex hormones, insulin-like growth factor 1, thyroid hormones, and insulin. The possible explanatory mechanisms of the association between BPH-LUTS and MetS are also discussed. In particular, the presence of a male polycystic ovarian syndrome (PCOS)-equivalent may represent a possible hypothesis to support this link. Male PCOS-equivalent has been defined as an endocrine syndrome with a metabolic background, which predisposes to the development of type II diabetes mellitus, cardiovascular diseases, prostate cancer, BPH and prostatitis in old age. Its early identification would help prevent the onset of these long-term complications.
Topics: Age of Onset; Aged; Aged, 80 and over; Aging; Endocrinology; Humans; Lower Urinary Tract Symptoms; Male; Prostate; Prostatic Hyperplasia; Prostatitis
PubMed: 33692752
DOI: 10.3389/fendo.2021.554078 -
Frontiers in Immunology 2023Prostatitis is a common urological condition that affects almost half of all men at some point in their life. The prostate gland has a dense nerve supply that... (Review)
Review
Prostatitis is a common urological condition that affects almost half of all men at some point in their life. The prostate gland has a dense nerve supply that contributes to the production of fluid to nourish sperm and the mechanism to switch between urination and ejaculation. Prostatitis can cause frequent urination, pelvic pain, and even infertility. Long-term prostatitis increases the risk of prostate cancer and benign prostate hyperplasia. Chronic non-bacterial prostatitis presents a complex pathogenesis, which has challenged medical research. Experimental studies of prostatitis require appropriate preclinical models. This review aimed to summarize and compare preclinical models of prostatitis based on their methods, success rate, evaluation, and range of application. The objective of this study is to provide a comprehensive understanding of prostatitis and advance basic research.
Topics: Humans; Male; Prostatitis; Semen; Pelvic Pain; Prostate; Spermatozoa
PubMed: 37228599
DOI: 10.3389/fimmu.2023.1183895 -
Current Urology Reports Jun 2020We conducted a review of the literature describing the most up-to-date diagnosis and treatment options of chronic bacterial prostatitis. (Review)
Review
PURPOSE OF REVIEW
We conducted a review of the literature describing the most up-to-date diagnosis and treatment options of chronic bacterial prostatitis.
RECENT FINDINGS
Recurrence after oral antimicrobial therapy is common, due in part to the rising rates of antimicrobial resistance and inability to completely clear the offending bacteria from the prostate following prostatitis. Recent literature has described various treatment options for chronic bacterial prostatitis refractory to conventional antimicrobial agents, including the use of alternative agents such as fosfomycin, direct antimicrobial injections into the prostate, surgical removal of infected prostatic tissue, chronic oral antibiotic suppression, and an emerging novel therapy utilizing bacteriophages to target antibiotic resistant bacteria. Management of chronic bacterial prostatitis, especially recurrence after oral antimicrobial treatment, remains challenging. This review highlights an urgent need for further evidence assessing the efficacy and safety of treatment modalities for chronic bacterial prostatitis refractory to conventional oral antimicrobials.
Topics: Anti-Bacterial Agents; Bacterial Infections; Bacteriophages; Chronic Disease; Drug Resistance, Bacterial; Humans; Male; Prostatectomy; Prostatitis; Recurrence
PubMed: 32488742
DOI: 10.1007/s11934-020-00978-z -
International Journal of Antimicrobial... Oct 2020There has been growing interest in fosfomycin for the treatment of bacterial prostatitis due to evidence suggesting that it achieves adequate prostatic concentrations... (Review)
Review
There has been growing interest in fosfomycin for the treatment of bacterial prostatitis due to evidence suggesting that it achieves adequate prostatic concentrations for antimicrobial effect, has activity against resistant micro-organisms, and has a low-toxicity profile. This review evaluated the current clinical evidence for fosfomycin in acute and chronic bacterial prostatitis to elucidate the clinical implications of fosfomycin in an era of increasing antimicrobial resistance. PubMed, Scopus, EMBASE, Web of Science, Google Scholar and ClinicalTrials.gov were searched for studies published in the English language from January 1984 to November 2019. The inclusion criteria were met if the study reported the use of fosfomycin (more than one dose) to treat bacterial prostatitis. Ten observational studies were identified that met the inclusion criteria. The evidence for the use of fosfomycin in acute bacterial prostatitis is sparse. The majority of the available evidence is for chronic bacterial prostatitis caused by Escherichia coli. Despite the implementation of variable dosing regimens, extended courses of fosfomycin appear to be safe and effective in achieving clinical and microbiological cure. In these studies, the use of fosfomycin was restricted to cases of treatment failure, intolerance to first-line therapy, or multi-resistant organisms. However, given the development of resistant organisms and the undesirable adverse effects of many first-line therapeutic options, fosfomycin has the potential to be considered as an effective first-line alternative for acute and chronic bacterial prostatitis in the future. Further studies, including randomized controlled trials, would be helpful to firmly establish its optimal dosing regimen, efficacy and place in therapy.
Topics: Anti-Bacterial Agents; Antimicrobial Stewardship; Bacterial Infections; Enterobacteriaceae; Enterococcus faecium; Escherichia coli; Fosfomycin; Humans; Male; Prostate; Prostatitis; Pseudomonas aeruginosa; Treatment Outcome
PubMed: 32721595
DOI: 10.1016/j.ijantimicag.2020.106106 -
Clinical Anatomy (New York, N.Y.) Jan 2018Current medical literature does not describe precisely the activation and mechanisms of prostate orgasms. This brief review describes what we know about the anatomy and... (Review)
Review
Current medical literature does not describe precisely the activation and mechanisms of prostate orgasms. This brief review describes what we know about the anatomy and physiology of the prostate and its involvement in reproduction and especially its stimulation for sexual recreation. It is illustrated with a highly relevant case history. Clin. Anat. 31:81-85, 2018. © 2017 Wiley Periodicals, Inc.
Topics: Behavior, Addictive; Ejaculation; Humans; Male; Middle Aged; Orgasm; Postoperative Complications; Prostate; Prostatectomy; Prostatic Neoplasms; Prostatitis; Sexual Dysfunctions, Psychological
PubMed: 29265651
DOI: 10.1002/ca.23006 -
Australian Veterinary Journal Jun 2022To describe clinical signs, diagnostics, treatments and outcomes of prostatitis and prostatic abscesses of dogs in a referral population.
OBJECTIVES
To describe clinical signs, diagnostics, treatments and outcomes of prostatitis and prostatic abscesses of dogs in a referral population.
ANIMALS
Eighty-two dogs diagnosed with prostatitis and/or prostatic abscesses from three referral hospitals.
PROCEDURES
Retrospective case series.
RESULTS
A total of 82 dogs were included, and the median age was nine years. Acute prostatitis was diagnosed in 63% of cases, chronic prostatitis in 37% of cases and 40% of cases had prostatic abscessation. Prostatomegaly was the most common ultrasonographic finding. Mineralisation was identified in 20% of cases. The results of urine and prostatic bacterial culture were concordant in only 50% of cases. Antimicrobial resistance was encountered commonly, with 29% of cultures resistant to one antimicrobial and 52% resistant to two or more antimicrobials. Abscesses were treated with either antimicrobials alone, ultrasound-guided needle drainage or surgical drainage.
CONCLUSIONS AND CLINICAL RELEVANCE
With antimicrobial treatment and castration, the prognosis for canine prostatitis appears good. Prostatic abscessation is commonly encountered and does not appear to infer a worse prognosis and antimicrobials alone, ultrasound-guided needle drainage and surgical drainage all appear to be reasonable treatment options. Antimicrobial resistance is commonly encountered, and the results of urine culture and susceptibility testing are frequently discordant with those from samples from the prostate. Sampling of the prostate is required to confirm a diagnosis and exclude other pathologies such as neoplasia, particularly as mineralisation is seen in a reasonable number of cases of dogs with prostatitis.
Topics: Abscess; Animals; Anti-Bacterial Agents; Anti-Infective Agents; Dog Diseases; Dogs; Male; Orchiectomy; Prostatitis; Retrospective Studies
PubMed: 35176814
DOI: 10.1111/avj.13150 -
Prostate Cancer and Prostatic Diseases Sep 2018The human microbiome may influence prostate cancer initiation and/or progression through both direct and indirect interactions. To date, the majority of studies have... (Review)
Review
BACKGROUND
The human microbiome may influence prostate cancer initiation and/or progression through both direct and indirect interactions. To date, the majority of studies have focused on direct interactions including the influence of prostate infections on prostate cancer risk and, more recently, on the composition of the urinary microbiome in relation to prostate cancer. Less well understood are indirect interactions of the microbiome with prostate cancer, such as the influence of the gastrointestinal or oral microbiota on pro- or anti-carcinogenic xenobiotic metabolism, and treatment response.
METHODS
We review the literature to date on direct and indirect interactions of the microbiome with prostate inflammation and prostate cancer.
RESULTS
Emerging studies indicate that the microbiome can influence prostate inflammation in relation to benign prostate conditions such as prostatitis/chronic pelvic pain syndrome and benign prostatic hyperplasia, as well as in prostate cancer. We provide evidence that the human microbiome present at multiple anatomic sites (urinary tract, gastrointestinal tract, oral cavity, etc.) may play an important role in prostate health and disease.
CONCLUSIONS
In health, the microbiome encourages homeostasis and helps educate the immune system. In dysbiosis, a systemic inflammatory state may be induced, predisposing remote anatomical sites to disease, including cancer. The microbiome's ability to affect systemic hormone levels may also be important, particularly in a disease such as prostate cancer that is dually affected by estrogen and androgen levels. Due to the complexity of the potential interconnectedness between prostate cancer and the microbiome, it is vital to further explore and understand the relationships that are involved.
Topics: Disease Progression; Humans; Male; Microbiota; Prostate; Prostatic Hyperplasia; Prostatic Neoplasms; Prostatitis; Xenobiotics
PubMed: 29795140
DOI: 10.1038/s41391-018-0041-1