Prostatitis
What is a prostate gland?
-Chestnut shaped gland, lies at base of bladder and surrounds the urethra -Produces alkaline fluid which functions to neutralize seminal fluid and helps propel sperm forward
how do you do a culture of prostatic fluid?
1. have patient void small amount of urine to culture and stop (10-15 mL) 2. Doctor gives prostatic massage 3. have patient void remaining urine to culture
how long is the antibiotics run for chronic prostatitis?
4-16 weeks
Medical management of prostatitis
Antibiotics Analgesia Antispasmodics - ditropan Stool softner Prostatic massage
Diagnostic Tests for prostatitis
Culture of prostatic fluid Prostatic Specific Anitgen PSA Digital Rectal Exam DRE WBC Blood culture ( if fever present)
Nursing management
Hospitalized client - admin. antibiotics Comfort measures - sitz bath Health teaching - complete full course of antibiotics, sitz bath for 10 - 20 min several times a day, avoid fluids with diuretic action, avoid sexual intercourse during acute phase
Prostatitis
Inflammation of the prostate, can be chronic or acute when it is a bacterial infection -not an STI, not infectious
signs and symptoms of prostatitis
Perineal discomfort Burning, urgency, and urinary frequency Pain after ejaculation
complications of prostatitis
Urinary retention Epididymitis Bacteremia pyelonephritis (kidney infection) urinary infections can also occur
Why do you need an antispasmodic for prostatitis?
bladder spasms can occur and can be painful and uncomfortable
what medication do you use for prostatitis?
ciprofloxicin
DRE
digital rectal exam
what kind of antispasmodic is given for prostatitis?
ditropan, it is a smooth muscle relaxant
what else can you reccommend to your patient with prostatitis for comfort measures?
ejaculation will also relieve build up of prostate, sitz bath
An acute infection with prostatitis may result in..
fever, chills, perineal, rectal or low back pain
what should the test for prostatic fluid tell you?
first one should test negative for infection, second one should show infection because it has prostate fluid in it. if first test is positive for infection it probably means patient has a UTI
what do you use for pain with prostatitis?
ibuprofen because it is an anti-inflammatory
What you do if your patient has urinary retention?
if prostate has completely obstructed the urethra you will have to do a suprapubic catheterization, if only partially occluded use in and out coude catheter
epididymitis in prostatitis
it is an inflammation of the coiled tube (epididymis) at the back of the testicle that stores and carries sperm -pressure on seminal vesicles which results in inflammation of the epididymis
How do you get prostatitis?
it is caused by infectious agent - usually the bacteria Escherichia coli Micro-organisms are usually carried to prostate via the urethra
who is at a higher risk for prostatitis?
men who have sex with men
Nursing diagnosis for prostatitis
pain r/t inflammatory proces 2nd to prostatitis AEB pain, enlarged prostate, urinary retention, pain after ejaculation
what do you find with a DRE and prostatitis?
prostate is enlarged, firm and slightly tender when assessed through rectum
What is the most common urological problem in men under 50 yrs?
prostatitis
why give prostatic massages?
relieves congestion of fluid
urinary retention in Prostatitis
swells around urethra making it hard to void, which can result in a UTI or kidney infection
how long is the antibiotics run for acute prostatitis?
up to 4 weeks