Clinical presentation

Prostatitis may present either as an acute or chronic condition. Although in pre-antibiotic days acute prostatitis was a well recognised complication of gonorrhoea, today it is extremely rarely caused by STI organisms, but appropriate STI investigations should still be undertaken. Treatment is similar to epididymo-orchitis if gonorrhoea or chlamydia is identified as the cause. If no STI is identified, treatment is usually directed at the typical urinary tract pathogens, which are mostly associated with prostatitis, and is not within the scope of these guidelines.

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Chronic prostatitis is a difficult condition to treat. It usually presents as pain and discomfort in the pelvis, perineum, penis or inguinal region. Pathogens are uncommonly identified but again, urinary tract organisms are most commonly involved and need to be excluded.

The management of this condition is beyond the scope of these guidelines, and management should be discussed with a sexual health physician, infectious diseases physician or urologist.