Medscape is available in 5 Language Editions – Choose your Edition here.


Acute Bacterial Prostatitis Differential Diagnoses

  • Author: Samuel G Deem, DO; Chief Editor: Edward David Kim, MD, FACS  more...
Updated: Dec 09, 2015

Diagnostic Considerations

A prostatic abscess should be suspected when worsening clinical symptoms follow an initial favorable response to treatment of acute bacterial prostatitis or a fluctuant mass is palpable in the prostate gland.

Differential Diagnoses

Contributor Information and Disclosures

Samuel G Deem, DO Faculty, Department of Urology, Charleston Area Medical Center

Samuel G Deem, DO is a member of the following medical societies: American College of Surgeons, American Osteopathic Association, American Urological Association, Endourological Society, Society of Urologic Oncology, American Society of Clinical Oncology, American College of Osteopathic Surgeons

Disclosure: Nothing to disclose.


Michael Piesman, MD Staff Physician, Department of Internal Medicine, Madigan Army Medical Center

Michael Piesman, MD is a member of the following medical societies: American Medical Association

Disclosure: Nothing to disclose.

Raymond A Costabile, MD Jay Y Gillenwater Professor of Urology and Vice Chairman, Senior Associate Dean for Clinical Strategy, University of Virginia Health System

Raymond A Costabile, MD is a member of the following medical societies: Alpha Omega Alpha, American Medical Association, American Society of Andrology, American Urological Association, Phi Beta Kappa

Disclosure: Nothing to disclose.

Jonathan J Rhee, MD Physician, MidAtlantic Urology Associates

Jonathan J Rhee, MD is a member of the following medical societies: Alpha Omega Alpha

Disclosure: Nothing to disclose.

Chief Editor

Edward David Kim, MD, FACS Professor of Surgery, Division of Urology, University of Tennessee Graduate School of Medicine; Consulting Staff, University of Tennessee Medical Center

Edward David Kim, MD, FACS is a member of the following medical societies: American College of Surgeons, Tennessee Medical Association, Sexual Medicine Society of North America, American Society for Reproductive Medicine, American Society of Andrology, American Urological Association

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Repros.


Edmund S Sabanegh Jr, MD Chairman, Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation

Edmund S Sabanegh Jr, MD is a member of the following medical societies: American Medical Association, American Society for Reproductive Medicine, American Society of Andrology, American Urological Association, Society for the Study of Male Reproduction, Society of Reproductive Surgeons, and Southwest Oncology Group

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

  1. Nickel JC. Inflammatory conditions of the male genitourinary tract: prostatitis and related conditions, orchitis, and epididymitis. Wein. AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: WB Saunders: 2005; Chapter 9.

  2. Nickel JC. 5 alpha reductase therapy for chronic prostatitis. Nickel JC, ed. Textbook of Prostatitis. Oxford, UK: ISIS Medical Media; 1999. 333-7.

  3. Collins MM, Stafford RS, O'Leary MP, Barry MJ. How common is prostatitis? A national survey of physician visits. J Urol. 1998 Apr. 159(4):1224-8. [Medline].

  4. Kanamaru S, Kurazono H, Terai A, Monden K, Kumon H, Mizunoe Y, et al. Increased biofilm formation in Escherichia coli isolated from acute prostatitis. Int J Antimicrob Agents. 2006 Aug. 28 Suppl 1:S21-5. [Medline].

  5. Bergman B. On the relevance of gram-positive bacteria in prostatitis. Infection. 1994. 22 Suppl 1:S22. [Medline].

  6. Williamson DA, Freeman JT, Porter S, Roberts S, Wiles S, Paterson DL, et al. Clinical and molecular correlates of virulence in Escherichia coli causing bloodstream infection following transrectal ultrasound-guided (TRUS) prostate biopsy. J Antimicrob Chemother. 2013 Dec. 68(12):2898-906. [Medline].

  7. Lomberg H, Cedergren B, Leffler H, Nilsson B, Carlström AS, Svanborg-Edén C. Influence of blood group on the availability of receptors for attachment of uropathogenic Escherichia coli. Infect Immun. 1986 Mar. 51(3):919-26. [Medline]. [Full Text].

  8. Wagenlehner FM, Pilatz A, Bschleipfer T, Diemer T, Linn T, Meinhardt A, et al. Bacterial prostatitis. World J Urol. 2013 Mar 22. [Medline].

  9. Nagy V, Kubej D. Acute bacterial prostatitis in humans: current microbiological spectrum, sensitivity to antibiotics and clinical findings. Urologia Internationalis. October/2012. 89 (4):445-450. [Medline].

  10. Nickel JC. The Pre and Post Massage Test (PPMT): a simple screen for prostatitis. Tech Urol. 1997 Spring. 3(1):38-43. [Medline].

  11. Magri V, Cariani L, Bonamore R, Restelli A, Garlaschi MC, Trinchieri A. Microscopic and microbiological findings for evaluation of chronic prostatitis. Arch Ital Urol Androl. 2005 Jun. 77(2):135-8. [Medline].

  12. Meares EM, Stamey TA. Bacteriologic localization patterns in bacterial prostatitis and urethritis. Invest Urol. 1968 Mar. 5(5):492-518. [Medline].

  13. Terrone C, Poggio M, Bollito E, Cracco CM, Scarpa RM. [Asymptomatic prostatitis: a frequent cause of raising PSA]. Recenti Prog Med. 2005 Jul-Aug. 96(7-8):365-9. [Medline].

  14. Granados EA, Riley G, Salvador J, Vincente J. Prostatic abscess: diagnosis and treatment. J Urol. 1992 Jul. 148(1):80-2. [Medline].

  15. Barbalias GA, Nikiforidis G, Liatsikos EN. Alpha-blockers for the treatment of chronic prostatitis in combination with antibiotics. J Urol. 1998 Mar. 159(3):883-7. [Medline].

  16. Aravantinos E, Kalogeras N, Zygoulakis N, Kakkas G, Anagnostou T, Melekos M. Ultrasound-guided transrectal placement of a drainage tube as therapeutic management of patients with prostatic abscess. J Endourol. 2008 Aug. 22(8):1751-4. [Medline].

  17. Chou YH, Tiu CM, Liu JY, Chen JD, Chiou HJ, Chiou SY, et al. Prostatic abscess: transrectal color Doppler ultrasonic diagnosis and minimally invasive therapeutic management. Ultrasound Med Biol. 2004 Jun. 30(6):719-24. [Medline].

  18. Barozzi L, Pavlica P, Menchi I, De Matteis M, Canepari M. Prostatic abscess: diagnosis and treatment. AJR Am J Roentgenol. 1998 Mar. 170(3):753-7. [Medline].

  19. Zowawi HM, Harris PN, Roberts MJ, Tambyah PA, Schembri MA, Pezzani MD, et al. The emerging threat of multidrug-resistant Gram-negative bacteria in urology. Nat Rev Urol. 2015 Oct. 12 (10):570-84. [Medline].

  20. Campeggi A, Ouzaid I, Xylinas E, Lesprit P, Hoznek A, Vordos D, et al. Acute bacterial prostatitis after transrectal ultrasound-guided prostate biopsy: epidemiological, bacteria and treatment patterns from a 4-year prospective study. Int J Urol. 2014 Feb. 21(2):152-5. [Medline].

  21. Song W, Choo SH, Sung HH, Han DH, Jeong BC, Seo SI, et al. Incidence and management of extended-spectrum beta-lactamase and quinolone-resistant Escherichia coli infections after prostate biopsy. Urology. 2014 Nov. 84 (5):1001-7. [Medline].

  22. Wagenlehner FM, Pilatz A, Waliszewski P, Weidner W, Johansen TE. Reducing infection rates after prostate biopsy. Nat Rev Urol. 2014 Feb. 11(2):80-6. [Medline].

  23. Kaye KS, Pogue JM. Infections Caused by Resistant Gram-Negative Bacteria: Epidemiology and Management. Pharmacotherapy. 2015 Oct. 35 (10):949-62. [Medline].

  24. Meares EM Jr. Prostatitis. Med Clin North Am. 1991 Mar. 75(2):405-24. [Medline].

  25. Kabay S, Kabay SC, Yucel M, Ozden H. Efficiency of posterior tibial nerve stimulation in category IIIB chronic prostatitis/chronic pelvic pain: a Sham-Controlled Comparative Study. Urol Int. 2009. 83(1):33-8. [Medline].

  26. Lee SH, Lee BC. Electroacupuncture relieves pain in men with chronic prostatitis/chronic pelvic pain syndrome: three-arm randomized trial. Urology. 2009 May. 73(5):1036-41. [Medline].

  27. Liu L, Yang J. Physician's practice patterns for chronic prostatitis. Andrologia. 2009 Oct. 41(5):270-6. [Medline].

  28. Ludwig M. Diagnosis and therapy of acute prostatitis, epididymitis and orchitis. Andrologia. 2008 Apr. 40(2):76-80. [Medline].

  29. Nickel JC, Shoskes D. Phenotypic approach to the management of chronic prostatitis/chronic pelvic pain syndrome. Curr Urol Rep. 2009 Jul. 10(4):307-12. [Medline].

  30. Wagenlehner FM, Naber KG, Bschleipfer T, Brähler E, Weidner W. Prostatitis and male pelvic pain syndrome: diagnosis and treatment. Dtsch Arztebl Int. 2009 Mar. 106(11):175-83. [Medline]. [Full Text].

Leukocytic infiltration of the stroma and glandular lumina during acute bacterial prostatitis (ABP).
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.