Complication which commonly accompanies acute prostatitis -

• Acute inflammation of prostate associated with UTI • Caused by ascending urethral infection or reflux of infected urine into prostatic ducts • MC organism: E. coli • Patients present with sudden onset high grade fever with chills and rigors, severe irritative symptoms and enlarged, tender and boggy prostate • Catheterization and prostatic massage is contraindicated • MC used antibiotics are: TMP-SMX and Ciprofloxacin (Both are having better concentration in prostatic tissue)  • Around 4-6 weeks of antibiotic therapy is used to avert chronic bacterial prostatitis. Chronic Bacterial Prostatitis • Due to persistent bacterial infection of prostate • Insidious in onset, characterized by relapsing or recurrent UTI caused by persistence of pathogen in prostatic fluid despite of antibiotic therapy • Diagnosis is made by microscopic examination and culture of prostatic expressate and culture of urine obtained before and after prostatic massage. • Treated by chronic antibiotic suppression (3–4 months) Prostatic Abscess • Most cases result from complications of acute bacterial prostatitis • Fluctuation is a very late sign • Predisposing factors: Diabetes, renal insufficiency, immunosuppression, urethral instrumentation, chronic indwelling catheter • Diagnosis: TRUS or pelvic CT scan is crucial for diagnosis and treatment • Treated by transurethral drainage and antibiotics