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Prostatitis.pptx

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Prostatitis.pptx

  1. 1. Tips on using my ppt. 1. You can freely download, edit, modify and put your name etc. 2. Don’t be concerned about number of slides. Half the slides are blanks except for the title. 3. First show the blank slides (eg. Aetiology ) > Ask students what they already know about ethology of today's topic. > Then show next slide which enumerates aetiologies. 4. At the end rerun the show – show blank> ask questions > show next slide. 5. This will be an ACTIVE LEARNING SESSION x three revisions. 6. Good for self study also. Good for self study also. Display blank slide> Think what you already know about this > Read next slide.
  2. 2. Introduction
  3. 3. Introduction • Prostatitis is an infection or inflammation of the prostate gland that presents as several syndromes with varying clinical features. • The term prostatitis is defined as microscopic inflammation of the tissue of the prostate gland and is a diagnosis that spans a broad range of clinical conditions.
  4. 4. Classification •
  5. 5. Classification • I - Acute bacterial prostatitis • II - Chronic bacterial prostatitis • III - Chronic prostatitis and chronic pelvic pain syndrome (CPPS; further classified as inflammatory or noninflammatory) • IV - Asymptomatic inflammatory prostatitis
  6. 6. CPPS
  7. 7. CPPS • CPPS is characterized primarily by urological pain complaints in the absence of urinary tract infection
  8. 8. Asymptomatic inflammatory prostatitis
  9. 9. Asymptomatic inflammatory prostatitis • Asymptomatic inflammatory prostatitis is characterized by the incidental discovery of prostatic inflammation without genitourinary complaints. This condition is diagnosed during a workup for infertility or elevated prostate-specific antigen (PSA) level
  10. 10. Clinical Features
  11. 11. Clinical Features Acute Prostatitis • Fever • Chills • Malaise • Arthralgias • Myalgias • Perineal/prostatic pain • Dysuria
  12. 12. Clinical Features Acute Prostatitis • Obstructive urinary tract symptoms, including frequency, urgency, dysuria, nocturia, hesitancy, weak stream, and incomplete voiding • Low back pain • Low abdominal pain • Spontaneous urethral discharge • History of sclerotherapy for rectal prolapse
  13. 13. Clinical Features Chronic Prostatitis • Typically have no systemic symptoms. Instead, these patients may present with the following: • Intermittent dysuria • Intermittent obstructive urinary tract symptoms • Recurrent urinary tract infections [
  14. 14. Clinical Features Chronic Prostatitis • Pelvic pain or discomfort, including perineal, suprapubic, coccygeal, rectal, urethral, and testicular/scrotal pain for more than 3 of the previous 6 months without documented urinary tract infections from uropathogens • Obstructive urinary tract symptoms, • Ejaculatory pain • Erectile dysfunction
  15. 15. Clinical Features Acute Prostatitis • Tender, nodular, hot, boggy, or normal- feeling gland on digital rectal examination • Suprapubic abdominal tenderness • Enlarged tender bladder due to urinary retention
  16. 16. Clinical Features Acute Prostatitis • Bladder outlet obstruction/urinary retention • Abscess - Typically in immunocompromised patients • Infertility due to scarring of the urethra or ejaculatory ducts • Recurrent cystitis • Pyelonephritis • Renal damage • Sepsis
  17. 17. Pathophysiology • Although various routes have been postulated, none has been firmly substantiated. • Acutegram-negative organisms (eg, Escherichia coli, Enterobacter, Serratia, Pseudomonas, Enterococcus, and Proteusspecies). • Chronic -cytomegalovirus (CMV). Mycobacteria, such as Mycobacterium tuberculosis, and fungi, such as Candida albicans,
  18. 18. Pathophysiology
  19. 19. Pathophysiology • Neisseria gonorrhoeae and Chlamydia trachomatis • indwelling urethral catheters • Sclerotherapy for rectal prolapse
  20. 20. Complications
  21. 21. Complications • Prostatitis may lead to urosepsis with significant associated mortality in patients with diabetes mellitus, patients on dialysis for chronic renal failure, patients who are immunocompromised, and postsurgical patients who have had urethral instrumentation.
  22. 22. Investigations
  23. 23. Investigations • Laboratory Studies – Routine – Special • Imaging Studies • Tissue diagnosis – Cytology • FNAC – Histology
  24. 24. Diagnostic Studies
  25. 25. Diagnostic Studies Imaging Studies • X-Ray • USG • CT • Angiography • MRI • Endoscopy • Nuclear scan
  26. 26. Diagnostic Studies Lab • Urinalysis and urine culture can confirm the presence of infection and identify pathogens. • Fractional urine examination • Cytology of expressed prostatic secretions • Prostate inflammation can lead to elevation of serum prostate-specific antigen (PSA).
  27. 27. Diagnostic Studies Imaging Studies • On transrectal ultrasonography-capsular thickening and prostatic calculi. • Computed tomography (CT)
  28. 28. Management
  29. 29. Management • acutely ill/evidence of sepsis, or both require hospital admission • parental bactericidal agents such as broad- spectrum penicillin derivatives, third- generation cephalosporins with or without aminoglycosides, or fluoroquinolones. • Patients without a toxic appearance can be treated on an outpatient basis with a 14- to 28-day course of oral antibiotics, usually a fluoroquinolone or trimethoprim- sulfamethoxazole
  30. 30. Management • Suprapubic catheters • Prostatic abscess, the fluctuant site may be drained under local anesthesia either transrectally or transperineally. • A 4- to 6-week trial of antibiotic therapy is indicated in chronic bacterial prostatitis and chronic pelvic pain syndrome with inflammation,
  31. 31. Get this ppt in mobile 1. Download Microsoft PowerPoint from play store. 2. Open Google assistant 3. Open Google lens. 4. Scan qr code from next slide.
  32. 32. Get my ppt collection • https://www.slideshare.net/drpradeeppande/ edit_my_uploads • https://www.dropbox.com/sh/x600md3cvj8 5woy/AACVMHuQtvHvl_K8ehc3ltkEa?dl =0 • https://www.facebook.com/doctorpradeeppa nde/?ref=pages_you_manage

Hinweis der Redaktion

  • drpradeeppande@gmail.com
    7697305442
  • drpradeeppande@gmail.com
    7697305442

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