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NURSING 6501 Week 10 Case Study

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NURSING 6501 Week 10 Case Study NURSING6501 Week 10 Case Study

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Prostatitis-Men’s Health

A 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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