genitourinary disorders
Prostatitis
Key Points
Prostatitis can be an acute or chronic bacterial infection or a more poorly understood group of disorders typically characterized by irritative and obstructive urinary symptoms, urogenital diaphragm muscle spasm, and perineal pain. Treat patients who have chronic bacterial prostatitis and nontoxic patients who have acute bacterial prostatitis with a fluoroquinolone and symptomatic measures. Hospitalize patients who have acute bacterial prostatitis and systemic symptoms that suggest sepsis and give broad-spectrum antibiotics such asampicillinplusgentamicin. For men with chronic prostatitis or chronic pelvic pain syndrome, consider anxiolytics (eg, SSRIs, benzodiazepines), sacral nerve stimulation, biofeedback, prostatic massage, and minimally invasive prostatic procedures (eg, microwave thermotherapy). 