Granulomatous Prostatitis - Manila Genitourinary Clinic

Overview

Is a rare condition that affects the prostate. It account in less than 1% of Benign Inflammatory Conditions of the prostate. We estimate cases seen at our clinic to be in the are of 0.12%. Other authors discussed this condition under the prostatitis classification of non bacterial and prostatodynia presumably due to the presence of inflammatory cells without offending organisms (non bacterial and in some cases the absence of the inflammatory cells, prostatodynia)

Age range reports are from 18 -86 years with a median of 62 years. In our own experience, the median age is 50 years old.

TYPES OF GRANULOMATOUS PROSTATITIS

Infectious
Idiopathic
Post-Surgery
Allergic

OUR OWN IMPRESSION

Previous Illness usually due to Miliary Tuberculosis
Post Surgical Scar (transurethral resection of the prostate )

Signs & Symptoms

Our own cases of Granulomatous Prostatitis are mostly without symptoms but come in because of a previous impression of cancer. Other patients come because of mild urinary condition and non of our patients reported pain. The only bothersome symptoms reported by our patients are decrease volume of ejaculate.

Data from textbooks reports fever, “mild blood” in the urine, urinary frequency, and absence of symptoms.

Diagnosis

PHYSICAL EXAMINATION

Digital Rectal Exam (DRE) always disclosed a prostate that has a non palpable median fissure, non tender, asymmetrical and firm, better described as fixed, indurated and nodular gland. It can give a false impression of prostate cancer. Prostate drainage often yield a scanty prostatic secretion.

Prostate volume will show a prostate gland of less than 40 grams.

MICROSCOPY AND MICROBIOLOGY

Wetmount, often times shows white blood cell counts that are within normal range. Usually, no infectious agents can be demonstrated from microbiologic stains, antigen-antibody reactions, and Polymerase Chain Reaction (PCR) examination.

ULTRASOUND

Ultrasound will demonstrate an irregular shape prostate, mildly enlarge with no urine retention.

PROSTATE-SPECIFIC ANTIGEN (PSA)

PSA do not give significant informations.

Treatment

There are no specific treatment in cases of Granulomatous Prostatitis. If an infectious process is discover through diagnostic workouts, treating the infection will not totally change the patient’s conditions. The best scenario is, the patient become non contagious.

It is important to assure the patient that his present condition will not worsen. They will not encounter urinary obstruction, and most likely will not develop prostate cancer.