Snapshot A 60-year-old man presents to his urologist for a 4-month history of pelvic pain. He denies fevers or chills and any recent sexual activity. His physical exam reveals a mildly tender prostate on digital rectal exam. His urinalysis is unremarkable. He is started on tamsulosin and ciprofloxacin. Introduction Clinical definition infectious or non-infectious inflammation of the prostate acute prostatitis typically infectious < 35 years of age login to view 1 more bullet > 35 years of age login to view 1 more bullet chronic prostatitis can be due to recurrent infections lasting > 3 months (10% of chronic prostatitis) can be due to chronic pelvic pain (90% of chronic prostatitis) login to view 3 more bullets Epidemiology Incidence 10-15% men have it once in their lifetime Risk factors catheterization benign prostatic hypertrophy Etiology Pathogenesis Presentation Symptoms dysuria urinary frequency urinary urgency straining with urination or interrupted stream (obstruction) lower back pain Physical exam fever chills digital rectal exam enlarged prostate very tender on exam may indicate acute prostatitis less tender on exam may indicate chronic prostatitis Studies Urine studies for bacterial infection urinalysis pyuria hematuria urine culture Differential Urinary tract infection Urethritis Treatment Medical antibiotics indications login to view 1 more bullet drugs chosen empirically based on local resistance patterns login to view 6 more bullets α-blockers indications login to view 2 more bullets drugs login to view 1 more bullet Complications Prostatic abscess