Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with symptoms suggestive of chronic prostatitis, including irritative and obstructive voiding symptoms (dysuria, frequency, urgency, nocturia), perineal or suprapubic discomfort, and occasional hematospermia. History often reveals recurrent urinary tract infections or recent intravesical therapy (e.g., BCG).
Clinical Examination Findings
Digital Rectal Examination (DRE) reveals a firm, indurated, or nodular prostate gland, often mimicking prostatic carcinoma. Tenderness may be present. Absence of fluctuance helps rule out prostatic abscess. Systemic examination is typically unremarkable unless associated with systemic granulomatous disease.
Treatment Protocol
Management involves a multimodal approach: 1) Antibiotic therapy if infection is suspected (e.g., fluoroquinolones for 4-6 weeks). 2) Anti-inflammatory agents (NSAIDs) for pain management. 3) Alpha-blockers to alleviate obstructive voiding symptoms. 4) Corticosteroids may be indicated in severe idiopathic cases. Surgical intervention (TURP) is reserved for refractory cases with significant bladder outlet obstruction.