eMedicine Specialties > Urology > Infections and Related Inflammatory Conditions

Acute Bacterial Prostatitis and Prostatic Abscess: Follow-up

Author: Jonathan J Rhee, MD, Staff Physician, Department of Urology, University of Virginia
Coauthor(s): Michael Piesman, MD, Staff Physician, Department of Internal Medicine, Madigan Army Medical Center; Raymond A Costabile, MD, Jay Y Gillenwater Professor of Urology, University of Virginia Health System
Contributor Information and Disclosures

Updated: Dec 5, 2008

Outcome and Prognosis

If the initial response to medical therapy is favorable, the patient’s prognosis is very good. Decreased fertility has been reported, but only in cases of massive bacterial inoculation. Decreased sperm viability, including impaired motility and agglutination, was reported in samples that contained more than 106 colony-forming units (CFU)/mL.

Future and Controversies

Despite the fact that prostatitis syndromes are common urologic disease processes, little is known about prostatitis and the factors associated with the condition. Several important questions need to be answered, including the following:

  • Is prostatitis associated with prostate cancer?
  • What are the natural history and the epidemiology of prostatitis?
  • What is the best way to elucidate the exact etiology, diagnosis, and management of prostatitis?

The first question is important considering the recent efforts to find the most accurate and most expedient method of diagnosing and treating prostate cancer. Prostatitis is more common in younger men, whereas BPH and prostate cancer are more common in men older than 50 years. An important research question is whether prostatitis in younger men leads to BPH or prostate cancer later, since approximately 5% of acute bacterial prostatitis (ABP) cases lead to chronic prostatitis. Although one study reported that nearly 50% of prostate specimens resected for prostate cancer showed evidence of prostatitis, no causal association has been demonstrated.18

The exact public health burden of prostatitis should also be addressed. Most urologists agree about the ever-growing need for both community-based cross-sectional and longitudinal epidemiological prostatitis studies. Active research and a more aggressive effort are needed to generate hypotheses regarding the etiology of prostatitis.

Formulating risk factors associated with prostatitis is important. For example, the incidence of prostatitis among men with a history of a prostatic biopsy requires investigation. With increased screening for prostate cancer, more men are undergoing biopsy based on elevated serum PSA levels. These biopsies may trigger an inflammatory response in the prostate, leading to prostatitis, or, alternatively, a biopsy may be a source of transmission of organisms into the prostate gland.

These examples outline potential research directions in the field of prostatitis. Results of these and other studies could promote an increased awareness of the disease and increase the knowledge about prostatitis. This research should improve diagnosis and treatment, promote an appropriate allocation of resources to the management of the disease, and reduce the incidence and public health burden of prostatitis.

 


More on Acute Bacterial Prostatitis and Prostatic Abscess

Overview: Acute Bacterial Prostatitis and Prostatic Abscess
Workup: Acute Bacterial Prostatitis and Prostatic Abscess
Treatment: Acute Bacterial Prostatitis and Prostatic Abscess
Follow-up: Acute Bacterial Prostatitis and Prostatic Abscess
Multimedia: Acute Bacterial Prostatitis and Prostatic Abscess
References
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References

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Further Reading

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Keywords

acute bacterial prostatitis, prostatic abscess, ABP, acute prostatitis, prostatitis, prostate disease, bladder outlet obstruction, benign prostatic hyperplasia, chronic bacterial prostatitis, nonbacterial prostatitis, abacterial prostatitis, prostatodynia, male urinary tract infection, Escherichia coli, Proteus mirabilis, Klebsiella species, Enterobacter species, Pseudomonas aeruginosa, Serratia species, acute infection of the prostate, recurrent urinary tract infection, chronic infection of the prostate, chronic abacterial prostatitis, chronic pelvic pain syndrome, inflammatory chronic pelvic pain syndrome, noninflammatory chronic pelvic pain syndrome, asymptomatic inflammatory prostatitis, intraprostatic urinary reflux

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Contributor Information and Disclosures

Author

Jonathan J Rhee, MD, Staff Physician, Department of Urology, University of Virginia
Jonathan J Rhee, MD is a member of the following medical societies: Alpha Omega Alpha
Disclosure: Nothing to disclose.

Coauthor(s)

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, 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, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Medical Editor

Edmund S Sabanegh, MD, Director, Center for Male Fertility, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation
Edmund S Sabanegh, MD is a member of the following medical societies: American College of Surgeons, 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.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

CME Editor

J Stuart Wolf Jr, MD, FACS, David A Bloom Professor of Urology, Director of Division of Minimally Invasive Urology, Department of Urology, University of Michigan
J Stuart Wolf Jr, MD, FACS is a member of the following medical societies: American College of Surgeons, American Urological Association, Catholic Medical Association, Endourological Society, Society for Urology and Engineering, Society of Laparoendoscopic Surgeons, Society of University Urologists, and Society of Urologic Oncology
Disclosure: Terumo Corporation Consulting fee Consulting; Omeros Corporation Consulting fee Consulting

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, American Society for Reproductive Medicine, American Society of Andrology, American Urological Association, and Tennessee Medical Association
Disclosure: Lilly Consulting fee Consulting; Astellas Consulting fee Speaking and teaching; Indevus Consulting fee Speaking and teaching

 
 
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