Prostatitis

Age: ‍ years old

Gender: male



HISTORY:

Presents with a ‍-‍day history of ‍pelvic painurinary symptomsfever and chills

Symptoms include:

‍pelvic pain

‍perineal pain

‍urinary frequency

‍dysuria

‍urgency

‍nocturia

‍decreased urine stream

‍hematuria

‍painful ejaculation

‍lower back pain

‍abdominal pain, ‍diffuse, ‍dull, ‍mild

‍fever, up to ‍°, over ‍ ‍hoursdays

‍chills



Worsening factors: ‍none

Alleviating factors: ‍none, ‍effectiveineffective



Contributing factors:

‍recent urologic procedure

‍sexual activity

no history of: ‍immunodeficiency, ‍urinary tract infections, ‍sexually transmitted infections, ‍benign prostatic hyperplasia, ‍prostate cancer





EXAM:

General appearance: ‍well-appearing, ‍apparent distress

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Breasts: ‍normal, ‍mass, ‍axillary adenopathy

Abdomen: ‍soft, ‍non-tender ‍, ‍non-distended, ‍guarding, bowel sounds ‍normal, ‍, ‍CVA tenderness ‍

Anorectal: DRE ‍normal, prostate ‍normal, ‍blood, ‍mass, anus ‍

Genital: penis ‍normal, testes and epididymis ‍normal, ‍inguinal hernia





ASSESSMENT:

‍Prostatitis ‍likelysuspectedpossible

DDx: acute prostatitis, chronic prostatitis, chronic pelvic pain syndrome, asymptomatic inflammatory prostatitis, benign prostatic hyperplasia, prostate cancer, urinary tract infection, urethritis, bladder stones, sexually transmitted infections, pelvic floor muscle tension, interstitial cystitis, epididymitis, retrocaecal appendicitis, anal fissure, hemorrhoids, colorectal cancer





PLAN:

Investigations:

- Urinalysis

- Urine culture

- Blood work: ‍CBC, ‍creatinine, ‍CRP, ‍PSA

Treatments:

- ‍Antibiotics

- ‍Analgesics

- Increase fluid intake

Further care:

- Referral to urologist

- Follow-up in ‍ ‍daysweeks

- Return if symptoms worsen or if fever develops