Download Acute Bacterial Prostatitis and more Thesis Brand Marketing in PDF only on Docsity! Acute Bacterial Prostatitis Walden University Nurs-6501N: Advanced Pathophysiology Introduction Prostatitis refers to a distinct group of prostate inflammation disorders that manifest with a combination of perineal pain, irritative, and obstructive urinary symptoms (Coker &Dierfeldt, 2016). The presence or absence, recurrence, and the onset of the symptoms help the provider distinguish between acute bacterial prostatitis, chronic bacterial prostatitis, chronic prostatitis (chronic pelvic pain syndrome), and asymptomatic inflammatory prostatitis (Xiong et al., 2020). The patient’s diagnosis presented in the scenario is likely acute bacterial prostatitis since he reports a two-day onset of symptoms. In the following paragraphs, I will be discussing acute bacterial prostatitis. Acute bacterial prostatitis (ABP) ABP is a prostatic bacterial inflammation that causes pelvic pain, systemic symptoms (fever, chills, nausea, and vomiting), and voiding symptoms (frequency, urgency, odynuria, dysuria, and urinary retention in severe cases) (Coker &Dierfeldt, 2016). Acute prostatitis often occurs when there is an existing urinary tract infection or a sexually transmitted disease. The prostate’s infection may result from ascending urethral infection or reflux of infected urine into prostatic ducts (Xiong et al., 2020). Medical procedures such as prostate biopsy or tubes inserted into the urethra may introduce bacteria to the ejaculatory and prostate duct (Xiong et al., 2020). Other ways bacteria are introduced into the prostate include lymphatic invasion from the rectal bacteria and hematogenous infection (Xiong et al., 2020). 1 Pathophysiology of Acute Bacterial Prostatitis The presence of urinary pathogens (e.g., Klebsiella, Proteus, Escherichia coli) and possibly by Chlamydia in the prostate triggers an inflammatory response which leads to vasodilation of the prostate epithelial cells allowing neutrophils, phagocytes, T-cells, B-cells, proteins, and red blood cells in the process of extravasation (McCance & Huether, 2019). The exudate build-up and presence of biochemical mediators cause the prostate to swell, warm, and tender to touch, a significant finding in diagnoses during a rectal exam (McCance & Huether, 2019). The prostate’s swelling compresses the urethra leading to obstructing symptoms manifested in difficult, painful urination, and ejaculation (Xiong et al., 2020). Increased perineal pain when standing is consistent with pressure and compression on the inflamed prostate by the pelvic floor muscles (McCance & Huether, 2019). Causes of systemic reactions When local inflammation is unable to combat the bacteria, a systemic inflammatory response is activated. The first stage is marked by the macrophages and neutrophils release of interleukins 1 (fever-causing pyrogens), which trigger the hypothalamus to elevate the body temperature to kill the bacteria (McCance & Huether, 2019). The body compensates for the new temperature demand by muscles rapidly contracting and relaxing (shivers) to produce body heat, experienced as chills (McCance & Huether, 2019). The infection causes increased inflammatory mediators, which act as vasodilators leading to decreased blood pressure and, consequently, inadequate transport of oxygen and nutrients to the cells, causing malaise and fatigue (McCance
