Prostatitis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maliha Shakil, M.D. [2], Usama Talib, BSc, MD [3]

Overview

Patients with chronic prostatitis are usually well-appearing. Patients with acute prostatitis may appear ill and have systemic symptoms such as fever, chills, and nausea.

Physical Examination

Physical examination of patients with acute prostatitis may be remarkable for fever and chills. Patients with chronic prostatitis are usually well-appearing.[1][2]

Appearance of the Patient

Appearance may vary in acute and chronic prostatitis patients[1][2]

  • Patients with chronic prostatitis are usually well-appearing.
  • Patients with acute prostatitis may appear ill and have systemic symptoms such as fever, chills, and nausea.

Vital Signs

  • Elevated temperature may be present

Musculoskeletal

  • Lower back tenderness may be present[2]

Genitourinary

  • In acute prostatitis, palpation of the prostate reveals a tender and enlarged prostate[1][3]
  • In chronic prostatitis, palpation of the prostate reveals a tender and soft (boggy) prostate gland[1]
  • A prostate massage should never be done in a patient with suspected acute prostatitis, since it may induce sepsis
  • Digital rectal exam (DRE) is done in cases other than acute bacterial prostatitis to localize the pathology and palpate it.
    • A digital rectal exam is a procedure performed in the office setting. The patient bends on a table or lays on one side with knees touching chest. The physician wears gloves, applies a lubricant to the gloved finger and enters it into the rectum to feel the prostate normally located in front of the rectum.

Cardiovascular

  • Tachycardia (infection)

References

  1. 1.0 1.1 1.2 1.3 Sharp VJ, Takacs EB, Powell CR (2010). "Prostatitis: diagnosis and treatment". Am Fam Physician. 82 (4): 397–406. PMID 20704171.
  2. 2.0 2.1 2.2 Prostatitis: Inflammation of the Prostate. NIDDK 2016. http://www.niddk.nih.gov/health-information/health-topics/urologic-disease/prostatitis-disorders-of-the-prostate/Pages/facts.aspx#sec6. Accessed on March 4, 2016
  3. Stevermer JJ, Easley SK (2000). "Treatment of prostatitis". Am Fam Physician. 61 (10): 3015–22, 3025–6. PMID 10839552.

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