Prostatitis

Prostatitis is an inflammation of the prostate gland in men. A prostatitis diagnosis is assigned at 8% of all urologist and 1% of all primary care physician visits in the United States.[1]

Classification

The term prostatitis refers, in its strictest sense, to histological (microscopic) inflammation of the tissue of the prostate gland, although it is loosely (and confusingly) used to describe several completely different conditions. To remedy this, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) devised a new classification system in 1999, comprising four categories of prostatitis:

Category I

Main article: Acute prostatitis

Acute prostatitis is a bacterial infection of the prostate gland that requires urgent medical treatment.

Category II

Main article: Chronic bacterial prostatitis

Chronic bacterial prostatitis is a relatively rare condition that usually presents as intermittent urinary tract infections.

Category III

Main article: Chronic prostatitis/chronic pelvic pain syndrome

Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS), accounting for 90%-95% of prostatitis diagnoses,[2] is also known as chronic nonbacterial prostatitis. The annual prevalence in the population of chronic pelvic pain syndrome is 0.5%.[3] Men in this category have no known infection, but do have extensive pelvic pain lasting more than 3 months.[4] There are no standard diagnostic tests; diagnosis is by exclusion of other disease entities. Multimodal therapy is the most successful treatment option,[5] and includes α-blockers,[6] phytotherapy,[7][8] and protocols aimed at quieting the pelvic nerves through myofascial trigger point release with psychological re-training for anxiety control.[9][10] Antibiotics are not recommended.[11][12]

Category IV

Main article: Asymptomatic inflammatory prostatitis

Asymptomatic inflammatory prostatitis patients have no history of genitourinary pain complaints, but leukocytosis is noted, usually during evaluation for other conditions. Between 6-19% of men have pus cells in their semen but no symptoms.[13]

See also

External links

Footnotes

  1. ↑ Collins MM, Stafford RS, O'Leary MP, Barry MJ (1998). "How common is prostatitis? A national survey of physician visits". J. Urol. 159 (4): 1224–8. doi:10.1016/S0022-5347(01)63564-X. PMID 9507840. 
  2. ↑ Habermacher GM, Chason JT, Schaeffer AJ (2006). "Prostatitis/chronic pelvic pain syndrome". Annu. Rev. Med. 57: 195–206. doi:10.1146/annurev.med.57.011205.135654. PMID 16409145. 
  3. ↑ Taylor BC, Noorbaloochi S, McNaughton-Collins M, et al (May 2008). "Excessive antibiotic use in men with prostatitis". Am. J. Med. 121 (5): 444–9. doi:10.1016/j.amjmed.2008.01.043. PMID 18456041. 
  4. ↑ Luzzi GA (2002). "Chronic prostatitis and chronic pelvic pain in men: aetiology, diagnosis and management". Journal of the European Academy of Dermatology and Venereology : JEADV 16 (3): 253–6. PMID 12195565. 
  5. ↑ Potts JM (2005). "Therapeutic options for chronic prostatitis/chronic pelvic pain syndrome". Current urology reports 6 (4): 313–7. PMID 15978236. 
  6. ↑ Yang G, Wei Q, Li H, Yang Y, Zhang S, Dong Q (2006). "The effect of alpha-adrenergic antagonists in chronic prostatitis/chronic pelvic pain syndrome: a meta-analysis of randomized controlled trials". J. Androl. 27 (6): 847–52. doi:10.2164/jandrol.106.000661. PMID 16870951. "...treatment duration should be long enough (more than 3 months)". 
  7. ↑ Shoskes DA, Zeitlin SI, Shahed A, Rajfer J (1999). "Quercetin in men with category III chronic prostatitis: a preliminary prospective, double-blind, placebo-controlled trial". Urology 54 (6): 960–3. PMID 10604689. 
  8. ↑ Elist J (2006). "Effects of pollen extract preparation Prostat/Poltit on lower urinary tract symptoms in patients with chronic nonbacterial prostatitis/chronic pelvic pain syndrome: a randomized, double-blind, placebo-controlled study". Urology 67 (1): 60–3. doi:10.1016/j.urology.2005.07.035. PMID 16413333. 
  9. ↑ Anderson RU, Wise D, Sawyer T, Chan C (2005). "Integration of myofascial trigger point release and paradoxical relaxation training treatment of chronic pelvic pain in men". J. Urol. 174 (1): 155–60. doi:10.1097/01.ju.0000161609.31185.d5. PMID 15947608. 
  10. ↑ Anderson RU, Wise D, Sawyer T, Chan CA (2006). "Sexual dysfunction in men with chronic prostatitis/chronic pelvic pain syndrome: improvement after trigger point release and paradoxical relaxation training". J. Urol. 176 (4 Pt 1): 1534–8; discussion 1538–9. doi:10.1016/j.juro.2006.06.010. PMID 16952676. 
  11. ↑ Alexander RB, Propert KJ, Schaeffer AJ, et al (2004). "Ciprofloxacin or tamsulosin in men with chronic prostatitis/chronic pelvic pain syndrome: a randomized, double-blind trial". Ann. Intern. Med. 141 (8): 581–9. PMID 15492337. 
  12. ↑ Nickel JC, Downey J, Clark J, et al (2003). "Levofloxacin for chronic prostatitis/chronic pelvic pain syndrome in men: a randomized placebo-controlled multicenter trial". Urology 62 (4): 614–7. PMID 14550427. 
  13. ↑ Korrovits P, Ausmees K, Mändar R, Punab M (June 2008). "Prevalence of asymptomatic inflammatory (National Institutes of Health Category IV) prostatitis in young men according to semen analysis". Urology 71 (6): 1010–5. doi:10.1016/j.urology.2007.12.082. PMID 18455767. 
Diseases of the pelvis and genitals (N40-N99, 600-629)
Female
Adnexa
Ovary
Oophoritis · Ovarian cyst · Ovarian hyperstimulation syndrome · Anovulation · Mittelschmerz
Salpingitis · Hydrosalpinx · Hematosalpinx
Parametrium
Parametritis
Endometrium: Endometriosis (Adenomyosis) · Endometrial polyp

menstruation (Amenorrhoea, Anovulation, Hypomenorrhea, Oligomenorrhea, Menorrhagia, Menometrorrhagia, Metrorrhagia, Dysmenorrhea)

Hematometra · Retroverted uterus · Asherman's syndrome
Cervicitis - Cervical polyp - Nabothian cyst
Vaginitis (Bacterial vaginosis, Atrophic vaginitis) · Leukorrhea · Hematocolpos/Hydrocolpos

intercourse (Dyspareunia, Vaginismus)

Prolapse (Cystocele, Rectocele, Urethrocele) · Fistulae (Vesicovaginal, Rectovaginal)
Vulvitis · Bartholin's cyst
Other/general
Pelvic inflammatory disease · Female infertility (Habitual abortion)
Male
Testicular
Orchitis · Hydrocele testis · Testicular torsion · Male infertility (Azoospermia, Oligospermia)
Epididymis
Epididymitis · Spermatocele · Hematocele
Balanoposthitis/Balanitis · Phimosis · Priapism · Sexual dysfunction (Erectile dysfunction) · Peyronie's disease
Other
Hematospermia · Retrograde ejaculation
See also congenital, neoplasia