Prostatitis differential diagnosis
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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
Prostatitis must be differentiated from various other diseases on the basis of symptoms like dysuria. The differential diagnosis includes acute cystitis, benign prostatic hyperplasia, prostatic abscess, bladder cancer, urinary tract stones, and a foreign body within the urinary tract.[1]
Differentiating Prostatitis from other Diseases
Prostatitis must be differentiated from:[1]
- Acute cystitis
- Cervicitis
- Epididymitis
- Syphilis
- Vulvovaginitis
- Benign prostatic hyperplasia
- Prostatic abscess
- Bladder cancer
- Urinary tract stones
- Enterovesical fistula
- Foreign body within the urinary tract
Differential Diagnosis on the basis of Urinary Symptoms
Prostatitis can be differentiated from other diseases that cause lower urinary tract irritation symptoms, such as: dysuria, urgency and frequency in addition to urethral discharge , the differential list include: urethritis, pyelonephritis, cystitis, cervicitis, vulvovaginitis, epididimitis and syphilis.[2][3][4][5]
| Disease | Findings |
|---|---|
| Cystitis | Bladder inflammation, Features with increased frequency and urgency, dysuria, and suprapubic pain. Is more common among women. E.coli is the most common pathogen[6][7][8][9]. |
| Urethritis | infection of the urethra,causes dysuria and urethral discharge[4][10][11] |
| Bacterial vulvovaginitis | Presents with dysuria and pruritus, Vaginal discharge and odor are almost always present, caused by Gardnerella species[12]. |
| Cervicitis | Often asymptomatic,some women have an abnormal vaginal discharge and vaginal bleeding (especially after sexual intercourse)[13] |
| Prostatitis | bacterial infection of the prostate,causes discomfort during ejaculation[14] |
| Epididymitis | Presents with scrotal pain and swelling accompanied by fever and lower urinary tract irritation symptoms(dysuria and frequency)[15]. |
| Syphilis | Presents with generalized systemic symptoms such as malaise, fatigue, headache and fever. Skin eruptions may be subtle and asymptomatic. It is classically described as 1) non-pruritic bilateral symmetrical mucocutaneous rash; 2) non-tender regional lymphadenopathy; 3) condylomata lata; and 4) patchy alopecia.[3] |
References
- ↑ 1.0 1.1 Sharp VJ, Takacs EB, Powell CR (2010). "Prostatitis: diagnosis and treatment". Am Fam Physician. 82 (4): 397–406. PMID 20704171.
- ↑ Kurowski K (1998). "The woman with dysuria". Am Fam Physician. 57 (9): 2155–64, 2169–70. PMID 9606306.
- ↑ 3.0 3.1 Moore, Zack S; Seward, Jane F; Lane, J Michael (2006). "Smallpox". The Lancet. 367 (9508): 425–435. doi:10.1016/S0140-6736(06)68143-9. ISSN 0140-6736.
- ↑ 4.0 4.1 Taylor-Robinson D (1996). "The history of nongonococcal urethritis. Thomas Parran Award Lecture". Sex Transm Dis. 23 (1): 86–91. PMID 8801649.
- ↑ Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 9781455748013.
- ↑ Stephen Bent, Brahmajee K. Nallamothu, David L. Simel, Stephan D. Fihn & Sanjay Saint (2002). "Does this woman have an acute uncomplicated urinary tract infection?". JAMA. 287 (20): 2701–2710. PMID 12020306. Unknown parameter
|month=ignored (help) - ↑ W. E. Stamm (1981). "Etiology and management of the acute urethral syndrome". Sexually transmitted diseases. 8 (3): 235–238. PMID 7292216. Unknown parameter
|month=ignored (help) - ↑ W. E. Stamm, K. F. Wagner, R. Amsel, E. R. Alexander, M. Turck, G. W. Counts & K. K. Holmes (1980). "Causes of the acute urethral syndrome in women". The New England journal of medicine. 303 (8): 409–415. doi:10.1056/NEJM198008213030801. PMID 6993946. Unknown parameter
|month=ignored (help) - ↑ Leonie G. M. Giesen, Grainne Cousins, Borislav D. Dimitrov, Floris A. van de Laar & Tom Fahey (2010). "Predicting acute uncomplicated urinary tract infection in women: a systematic review of the diagnostic accuracy of symptoms and signs". BMC family practice. 11: 78. doi:10.1186/1471-2296-11-78. PMID 20969801.
- ↑ Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 9781455748013.
- ↑ Brill JR (2010). "Diagnosis and treatment of urethritis in men". Am Fam Physician. 81 (7): 873–8. PMID 20353145.
- ↑ Daniel V. Landers, Harold C. Wiesenfeld, R. Phillip Heine, Marijane A. Krohn & Sharon L. Hillier (2004). "Predictive value of the clinical diagnosis of lower genital tract infection in women". American journal of obstetrics and gynecology. 190 (4): 1004–1010. doi:10.1016/j.ajog.2004.02.015. PMID 15118630. Unknown parameter
|month=ignored (help) - ↑ Kimberly A. Workowski & Gail A. Bolan (2015). "Sexually transmitted diseases treatment guidelines, 2015". MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports / Centers for Disease Control. 64 (RR-03): 1–137. PMID 26042815. Unknown parameter
|month=ignored (help) - ↑ Felix Millan-Rodriguez, J. Palou, Anna Bujons-Tur, Mireia Musquera-Felip, Carlota Sevilla-Cecilia, Marc Serrallach-Orejas, Carlos Baez-Angles & Humberto Villavicencio-Mavrich (2006). "Acute bacterial prostatitis: two different sub-categories according to a previous manipulation of the lower urinary tract". World journal of urology. 24 (1): 45–50. doi:10.1007/s00345-005-0040-4. PMID 16437219. Unknown parameter
|month=ignored (help) - ↑ A. Stewart, S. S. Ubee & H. Davies (2011). "Epididymo-orchitis". BMJ (Clinical research ed.). 342: d1543. PMID 21490048.