Prostate anatomy

Risk Factors

Genitourinary infection

(1) Human urinary system: (2) kidney; (3) renal pelvis; (4) ureter; (5) urinary bladder (6) urethra.
Additional structures: (7) adrenal gland; (8) renal artery and vein; (9) inferior vena cava; (10) abdominal aorta; (11) common iliac artery and vein; (12) liver; (13) large intestine; (14) pelvis.

"UTI" frequently refers specifically to acute cystitis, but may also be used as a general term for all urinary infections; use location-specific diagnosis.

Clinical Features


  • Dysuria/urgency/frequency, perineal pain/low back pain, pain with ejaculation, fever
  • Rectal exam: Exquisitely tender and boggy prostate


  • Similar to acute prostatitis with exception of fever/chills
  • Rectal exam is often unremarkable

Differential Diagnosis





  • Clinical diagnosis (UA and Urine culture may be normal)



Associated with STD

Target organisms are E. coli, and STDs (GC)

No Associated STD and Chronic Bacterial Prostatitis

Aimed at Enterobacteriaceae, enterococci, Pseudomonas

  • Ciprofloxacin 500mg PO q12hrs x 28 days OR
  • Levofloxacin 500mg PO daily x 28 days OR
  • TMP/SMX 1 DS tablet PO q12hrs x 28 days
  • Consider extension to 6 wks of empiric therapy


Supportive Measures[1]

  • If severe obstruction suspected, may pass a Foley gently
  • If Foley does not pass easily, insert punch suprapubic catheter, to be removed 24-36 hrs later
  • Consider α-blocker for outflow obstruction and urinary reflux
    • Terazosin 5mg/d PO for 4 weeks or long-term
    • OR tamsulosin
  • Prostatic abscesses frequently require surgical aspiration


  • Admit toxic patients or patients with Urinary Retention
  • Urology follow up
    • Should obtain repeat Urinalysis and urine culture in 7 days
    • Ensure follow up to tailor therapy to urine culture and sensitivities
    • Counsel patients on importance of adhering to full course of prolonged therapy


  1. Deem SG et al. Acute Bacterial Prostatitis. eMedicine. Dec 9, 2015.