The client complains of fever, perineal pain, and urinary urgency, frequency, and dysuria. To assess whether the client’s problem is related to bacterial prostatitis, the nurse would look at the results of the prostate examination, which should reveal that the prostate gland is:
A. Tender, indurated, and warm to the touch
B. Soft and swollen
C. Tender and edematous with ecchymosis
D. Reddened, swollen, and boggy
Correct Answer: A. Tender, indurated, and warm to the touch
The client with prostatitis has a prostate gland that is swollen and tender, but that is also warm to the touch, firm, and indurated. Systemic symptoms include fever with chills, perineal and low back pain, and signs of urinary tract infection (which often accompany the disorder).
Option B: Patients with ABP typically complain of fever, malaise, myalgias, dysuria, urinary frequency/hesitancy, and pelvic pain. On physical exam, the prostate is often enlarged and exquisitely tender to palpation.
Option C: Vigorous manipulation of the prostate gland should not be performed in ABP as this may acutely exacerbate the patient’s condition. The patient should also be evaluated for signs and symptoms of urinary retention, which may present with suprapubic tenderness and suprapubic fullness.
Option D: Patients suspected of having ABP should also be assessed for CVA tenderness, as pyelonephritis is an important differential. The prostate is not acutely inflamed on the exam but may be tender to palpation. Men with CBP may also present with sexual dysfunction.
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