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NURSING 6501 Week 10 Case Study
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Prostatitis-Men’s HealthA 42-year-old male arrives at the Emergency Department with a two-day complaint of
dysuria, lower back pain, unable to fully empty his bladder, perineal pain, fever, and chills. The
patient also explains the pain worsens when he stands up, but decreases when lying down. Vital
signs show the patient to be febrile with a temperature of 104°F, tachycardic with a pulse rate of
138 bpm, and tachypneic with a respiration rate of 24. The digital rectal exam (DRE) reveals the
prostate to be enlarged, incredibly tender, swollen, and warm to touch. The patient is diagnosed
with acute bacterial prostatitis (ABP). The purpose of this paper is to explore the
pathophysiology, system reaction of prostatitis, and its effect on male fertility.
Pathophysiology/System Reaction
Prostatitis is an inflammation of the prostate. Some degree of inflammation of the
prostate is present in 4% to 36% of the male population, increasing to 50% in older men
(McCance & Huether, 2019). Prostatitis can be classified into four categories; acute bacterial
prostatitis (ABP), chronic bacterial prostatitis (CBP), chronic pelvic pain syndrome, and
nonbacterial prostatitis (McCance & Huether, 2019). ABP and CBP are caused mostly by gram-
negative Enterobacteriaceae and Enterococci species, which originate in the gastrointestinal flora
(McCance & Huether, 2019). The most common microorganism is E. Coli. The organisms
responsible for sexually transmitted diseases that can cause prostatic infection includes;
Neisseria gonorrhea, Chlamydia trachomatis, Ureaplasma urealyticum, Mycoplasma hominis,
Trichomonas vaginalis, and Gardnerella vaginalis (Paulis, 2018). In the scenario, the patient
complains of dysuria, lower back pain, inability to entirely empty bladder, perineal pain, fever,
and chills. Upon the digital rectal exam revealed an enlarged, tender, swollen, and warm
prostate. The patient is exemplifying signs and symptoms of acute bacterial prostatitis. ABP is an
, ascending infection of the urinary tract that tends to occur in men between the ages of 30 and 50
years old (McCance & Huether, 2019). Clinical manifestations of ABP are similar to those with
a urinary tract infection or pyelonephritis (McCance & Huether, 2019). The infection stimulates
an inflammatory response in which the prostate becomes enlarged, tender, firm, or boggy
(McCance & Huether, 2019). Other symptoms include malaise, low back pain, perineal pain,
high fever, chills, dysuria, inability to empty bladder, nocturia, and urinary retention (McCance
& Huether, 2019). The patient’s pain worsens in an upright position because the pelvic floor
muscles tighten with standing, and the prostate gland is compressed (McCance & Huether,
2019).
Why does prostatitis happen?
Unfortunately, the cause of prostatitis in men is still a mystery. However, certain factors
can increase the chances of prostatitis, such as dehydration, catheterization, cystoscopy, recent
bladder infection, and the presence of a sexually transmitted disease (STD) (Paulis, 2018). A
healthcare provider should educate the patient on ways to decrease the risks of prostatitis.
Preventative measures include remaining hydrated by drinking water, practicing good perineal
hygiene to reduce infection, reducing caffeine intake to avoid irritating the prostate, practicing
safe sex, proper dieting, and maintaining a healthy weight. Adequate knowledge of prostatitis,
including the causes and preventative factors can help decrease the chances of the patient having
a recurrent infection.
How does prostatitis affect fertility?
The relationship between chronic prostatitis and fertility has been controversial for many
years. Yet, prostatitis is one of the most prevalent healthcare problems in urology practice in
adult males younger than 50 years old and the third most frequent urologic diagnosis in men
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