In a patient suspected of acute bacterial prostatitis, which specimen collection method is least appropriate?

In the context of acute bacterial prostatitis, the least appropriate specimen collection method is the sterile in-and-out catheter urine specimen. This is primarily because acute prostatitis often leads to swelling and tenderness of the prostate, which can make it difficult to accurately assess the condition or obtain the appropriate specimens using in-and-out catheterization.

Voided urine methods, such as voided urethral urine, voided mid-stream bladder urine, and voided post-prostate massage urine, are generally more effective for diagnosing prostatitis. These methods allow for the collection of urine that can reflect both the condition of the bladder and the prostate. Specifically, post-prostate massage urine specimens can yield prostatic secretions, which are crucial for identifying the presence of bacteria specific to acute bacterial prostatitis.

While in-and-out catheter specimen collection is sterile, it does not necessarily yield the same information about prostatic involvement and could be uncomfortable for the patient, potentially exacerbating inflammation and pain associated with prostatitis. The other methods provide more reliable specimens for assessing bacterial involvement in the urethra and prostate, making them preferable in this clinical scenario.