2 Marked inflammatory changes in the prostate gland with sheets of polymorphonuclear leukocytes in and around acini and ducts are characteristic of acute bacterial prostatitis. Macrophages, lymphocytes, plasma cells, diffuse stromal edema, and hyperemia along with microabscesses may be seen. 3 Urine analysis usually shows pyuria and bacteriuria. The pathogen is identified by voided urine culture and sensitivity. Therapy for acute bacterial prostatitis is usually successful.
Preferred treatment is bacteriocidal agents as the newer fluoroquinolone agents.
Other useful antibiotics include trimethoprim- sulfamethoxazole and cephalosporins. Antibiotic therapy should be continued for four to six weeks to maximize prevention of chronic bacterial prostatitis. General measures such as adequate hydration, antipyretics, analgesics, bed rest and stool softeners are also used as needed. Urethral instrumentation should be avoided if possible. 4 Prostatitis imaging is not recommended in evaluation of acute or chronic prostatitis due to nonspecificity of either computed tomography or ultrasonography.