Which maneuver is contraindicated in patients with acute prostatitis?

Massaging the infected prostate is contraindicated in patients with acute prostatitis due to the risk of causing further inflammation and potentially leading to complications such as bacteremia or further spread of the infection. Acute prostatitis is primarily associated with infection, typically bacterial, and the inflamed prostate can become more sensitive and inflamed. Manipulating the prostate through massage can exacerbate these symptoms and may also introduce bacteria into the bloodstream, increasing the risk of systemic infection.

In contrast, the other options are clinical practices that can be safely performed with caution. Serial urine samples may be taken to assess for the presence of bacteria and help guide treatment. Rectal exams, while they require careful technique and consideration given the patient’s acute condition, can help assess the prostate’s size, tenderness, and abnormalities that might be present. Palpation of the epididymis allows healthcare providers to evaluate for signs of epididymitis or other related conditions, which can occur concurrently with prostatitis. Therefore, massaging the prostate is the only maneuver that poses significant risk in the context of acute prostatitis.