JAMA Clinical Reviews Diagnosis and Management of Prostatitis
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Aug 11, 2025 In this discussion, Minh N. Pham, an Assistant Professor of Urology at the University of North Carolina and author of a JAMA Review, dives deep into prostatitis, affecting about 9.3% of men. He explores both acute and chronic forms, emphasizing symptoms, risk factors, and important diagnostic methods. Pham highlights the complexities of managing chronic prostatitis, especially chronic pelvic pain syndrome, and addresses the controversies around antibiotic overuse in non-bacterial cases. Listeners gain insight into effective treatment strategies and the importance of accurate diagnosis.
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NIH Prostatitis Classification
- Minh N. Pham explains prostatitis includes four NIH categories with three common clinical types.
- Clinicians should recognize acute, chronic bacterial, and chronic pelvic pain syndrome as distinct entities.
Instrumentation Raises MDR Risk
- Consider recent urinary instrumentation or prostate biopsy as a major risk for multidrug-resistant prostatitis.
- Evaluate such patients for resistant organisms and tailor empiric therapy accordingly.
Use Gentle DRE To Detect Prostatic Tenderness
- Perform a gentle digital rectal examination to check for prostatic tenderness when suspecting acute prostatitis.
- Avoid aggressive palpation to prevent bacteremia and only skip the exam if diagnosis is already clear.