Prostatitis

N41.1/N41.9 + (N34.2)


DESCRIPTION

Clinical features include:

  • pyrexia,
  • acute pain in the pelvis and perineum,
  • dysuria and frequency,
  • urinary retention or difficulty, and
  • acutely tender prostate on rectal examination.

Chronic non-bacterial prostatitis

This is a diagnosis of exclusion, i.e. failure to respond to antibiotics. It is associated with perineal, suprapubic, penile and testicular pain.

MEDICINE TREATMENT

Acute bacterial prostatitis

If there are features of associated urethritis (STI regimen):

  • Ceftriaxone, IM, 250 mg as a single dose.

LoEIII [22]

AND

  • Azithromycin, oral, 1 g as a single dose.

LoEIII [23]

If there are no features of associated urethritis:

  • Ciprofloxacin, oral, 500 mg 12 hourly for 14 days.

LoEIII

Chronic/relapse/persistent infection: N41.1

  • Ciprofloxacin, oral, 500 mg 12 hourly for 28 days.

LoEIII

REFERRAL

To urologist if:

  • No response to treatment.
  • Urinary retention present.
  • Chronic/relapsing prostatitis.