Prostatitis

Prostatitis is inflammation of the prostate gland. 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 urologist visits and 1% of all primary care physician visits for genitourinary symptoms.

Classification

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.

In 1999, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) devised a new classification system. 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, 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.

In 1968, Meares and Stamey determined a classification technique based upon the culturing of bacteria. 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.

See also

  • Interstitial cystitis — a related disease
  • Granulomatous prostatitis
  • IgG4-related prostatitis
  • Male accessory gland infection (MAGI)