| Prostatitis | |
| Synonyms: | Prostatosis |
| Field: | Urology |
Prostatitis is an umbrella term for a variety of medical conditions that incorporate bacterial and non-bacterial origin illnesses in the pelvic region. In contrast with the plain meaning of the word (which means "inflammation of the prostate"), the diagnosis may not always include inflammation. Prostatitis is classified into acute, chronic, asymptomatic inflammatory prostatitis, and chronic pelvic pain syndrome.
In the United States, prostatitis is diagnosed in 8% of all male urologist visits and 1% of all primary care physician visits for male genitourinary symptoms.[1]
The term prostatitis refers to inflammation of the tissue of the prostate gland. It may occur as an appropriate physiological response to an infection, or it may occur in the absence of infection.[2]
In 1999, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) devised a new classification system.[3] [4] For more specifics about each type of prostatitis, including information on symptoms, treatment, and prognosis, follow the links to the relevant full articles.
| Category | Current name | Old name | Pain | Bacteria | WBCs | Description | |
|---|---|---|---|---|---|---|---|
| I | Acute prostatitis | Acute bacterial prostatitis | Yes | Yes | Yes | Bacterial infection of the prostate gland that requires urgent medical treatment. | |
| II | Chronic bacterial prostatitis | Chronic bacterial prostatitis | ± | Yes | Yes | A relatively rare condition that usually presents as intermittent urinary tract infections. | |
| IIIa | Inflammatory CP/CPPS | Nonbacterial prostatitis | Yes | No | Yes | Accounts for 90–95% of prostatitis diagnoses,[5] formerly known as chronic nonbacterial prostatitis'. | |
| IIIb | Noninflammatory CP/CPPS | Prostatodynia | Yes | No | No | ||
| IV | Asymptomatic inflammatory prostatitis | (none) | No | No | Yes | No history of genitourinary pain complaints, but leukocytosis is noted, usually during evaluation for other conditions. Between 6 and 19% of men have pus cells in their semen but no symptoms.[6] |
In 1968, Meares and Stamey determined a classification technique based upon the culturing of bacteria.[7] This classification is no longer used.
The conditions are distinguished by the different presentation of pain, white blood cells (WBCs) in the urine, duration of symptoms and bacteria cultured from the urine. To help express prostatic secretions that may contain WBCs and bacteria, prostate massage is sometimes used.[8]