Descriptive analysis of prostatitis in the emergency department.

Abstract

INTRODUCTION:

Prostatitis is one of the most common urologic diseases in ambulatory patients. However, prostatitis data are limited from the emergency department (ED) setting.

METHODS:

A data set was examined of patients age 18 years or older who received urinalysis and urine culture or were tested for gonorrhea, chlamydia, or trichomonas in the ED from a health care system in northeast Ohio.

RESULTS:

Of 19,308 ED encounters of male patients, 77 encounters (0.4%) involved the diagnosis of prostatitis. Men with prostatitis were younger (52.4 vs 66.3 years), were less likely to be hospitalized (27.3% vs 43.1%), had shorter clinical encounters (1336.5 vs 3019.3 min), and were less likely to arrive by emergency medical services or police (6.5% vs 45.5%) than men diagnosed with urinary tract infection (UTI) without prostatitis (n = 2527) (P ≤ .007 for all). Of the men with urinalysis, those with prostatitis had less bacteria (0.9+ vs 1.8+), blood (0.9+ vs 1.5+), glucose (4.0% vs 13.0%), leukocyte esterase (0.9+ vs 2.3+), nitrite positive (8.0% vs 21.4%), protein (0.5+ vs 1.2+), squamous epithelial cells (0.6 vs 1.7 per high-power field [HPF]), red blood cells (18.3/HPF vs 29.5/HPF), and white blood cells (31.6/HPF vs 57.6/HPF) than men diagnosed with UTI and no prostatitis (P ≤ .005 for all). Escherichia coli was the most common bacterium growing in the urine (58.8%; n = 10) and the blood (100.0%; n = 2) of men with prostatitis; however 73.0% (n = 17) of urine cultures and 90.9% (n = 22) of blood cultures had no bacterial growth. Of 77 patient encounters with prostatitis, 16 (20.8%) underwent testing for Neisseria gonorrhoeae and Chlamydia trachomatis and 3 (3.9%) for Trichomonas vaginalis. Of those tested, only 1 person was infected, with C trachomatis.

CONCLUSION:

Prostatitis was uncommonly diagnosed in men undergoing urinalysis and urine culture or testing for sexually transmitted infections in the ED.

• Authors: Santiago Cantillo Campos, Justin M Elkins, Johnathan M Sheele
• Journal: The American journal of emergency medicine (Am J Emerg Med) Vol. 44 Pg. 143-147 (06 2021) ISSN: 1532-8171 [Electronic] United States
• PMID: 33618038 (Publication Type: Journal Article, Multicenter Study)
• Copyright: Copyright © 2021 Elsevier Inc. All rights reserved.

Topics

• Adult
• Aged
• Aged, 80 and over
• Chlamydia Infections (diagnosis)
• Emergency Service, Hospital
• Gonorrhea (diagnosis)
• Humans
• Male
• Middle Aged
• Prostatitis (diagnosis, microbiology)
• Sexually Transmitted Diseases (diagnosis, microbiology)
• Trichomonas Infections (diagnosis)
• Urinalysis
• Urinary Tract Infections (diagnosis)