Antibiotics are not beneficial in the management of category III prostatitis: A meta analysis

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Nelson Vergel

Some prostatitis cases are very difficult to treat but most respond to antibiotic treatment. This meta analysis reviewed only advanced cases of prostatitis.

Antibiotics are not beneficial in the management of category III prostatitis: A meta analysis - Abstract

Purpose: To determine whether antibiotics are beneficial in the management of category III prostatitis.

Materials and Methods: The PubMed, Medline and Embase databases were searched for all published documents from January 1, 1965 to September 1, 2012 without language restriction. The randomized controlled trials that mentioned comparable groups of antibiotics treatment versus placebo or other control group for patients with category III prostatitis were included based on specific criteria. The quality of studies was assessed by the modified Jadad scale, and Revman 5.0 software was used for data syntheses and analysis.

Results: Seven studies which met the selection criteria were included in this review. All of them were high quality according to the modified Jadad scale. A random effect model was applied because of the high heterogeneity. The meta-analysis showed that summary association between category III prostatitis and antibiotics were not statistically significant.

Conclusion: Our meta-analysis reveals that antibiotics are not beneficial in the management of category III prostatitis. Therefore, we may reduce the usage of antibiotics in such a population.

Written by:
Zhu Y, Wang C, Pang X, Li F, Chen W, Tan W.
Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou,China; Section 5 Department of Internal Medicine, Guilin TCM Hospital of China, Guilin, China.
Reference: Urol J. 2014 May 6;11(2):1377-85.
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Nelson Vergel

Types of Prostatitis

prostatitis types.jpg

[h=3]CLINICAL PRESENTATION[/b]The diagnosis of acute bacterial prostatitis is often based on symptoms alone. Urinary symptoms may be irritative (e.g., urinary frequency, urgency, dysuria) or obstructive (e.g., hesitancy, poor or interrupted stream, straining to void, incomplete emptying). Pain may be present in the suprapubic or perineal region, or in the external genitalia. Systemic symptoms of fever, chills, malaise, nausea, emesis, and signs of sepsis (tachycardia and hypotension) may be present as well. On physical examination, the prostate should be gently palpated. Prostatic massage should not be performed and may be harmful14; the prostate is tender, enlarged, and boggy. On abdominal examination, a palpable, distended bladder indicates urinary retention.
[h=3]DIAGNOSIS[/b]Midstream urine culture should be obtained. The presence of more than 10 white blood cells per high-power field suggests a positive diagnosis. Other laboratory testing (e.g., CBC, electrolyte levels, blood culture) is determined by the severity of the presentation. Residual urine should be documented if a patient has a palpable bladder or symptoms consistent with incomplete emptying.
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