- Prostatitis
__NOTOC__Prostatitis is an
inflammation of theprostate gland in men. A prostatitis diagnosis is assigned at 8% of all urologist and 1% of all primary care physician visits in theUnited States .cite journal |author=Collins MM, Stafford RS, O'Leary MP, Barry MJ |title=How common is prostatitis? A national survey of physician visits |journal=J. Urol. |volume=159 |issue=4 |pages=1224–8 |year=1998 |pmid=9507840| doi = 10.1016/S0022-5347(01)63564-X ]Classification
The term "prostatitis" refers, in its strictest sense, to
histological (microscopic)inflammation of the tissue of theprostate 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
Acute prostatitis is a bacterial infection of the prostate gland that requires urgent medical treatment.
Category II
Chronic bacterial prostatitis is a relatively rare condition that usually presents as intermittent
urinary tract infection s.Category III
Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS), accounting for 90%-95% of prostatitis diagnoses,cite journal |author=Habermacher GM, Chason JT, Schaeffer AJ |title=Prostatitis/chronic pelvic pain syndrome |journal=Annu. Rev. Med. |volume=57 |issue= |pages=195–206 |year=2006 |pmid=16409145 |doi=10.1146/annurev.med.57.011205.135654] is also known as "chronic nonbacterial prostatitis". The annual prevalence in the population of chronic pelvic pain syndrome is 0.5%.cite journal |author=Taylor BC, Noorbaloochi S, McNaughton-Collins M, "et al" |title=Excessive antibiotic use in men with prostatitis |journal=Am. J. Med. |volume=121 |issue=5 |pages=444–9 |year=2008 |month=May |pmid=18456041 |pmc=2409146 |doi=10.1016/j.amjmed.2008.01.043 |url=] Men in this category have no known infection, but do have extensive pelvic pain lasting more than 3 months.cite journal |author=Luzzi GA |title=Chronic prostatitis and chronic pelvic pain in men: aetiology, diagnosis and management |journal=Journal of the European Academy of Dermatology and Venereology : JEADV |volume=16 |issue=3 |pages=253–6 |year=2002 |pmid=12195565 |doi=] There are no standard diagnostic tests; diagnosis is by exclusion of other disease entities. Multimodal therapy is the most successful treatment option,cite journal |author=Potts JM |title=Therapeutic options for chronic prostatitis/chronic pelvic pain syndrome |journal=Current urology reports |volume=6 |issue=4 |pages=313–7 |year=2005 |pmid=15978236 |doi=] and includes α-blockers,cite journal |author=Yang G, Wei Q, Li H, Yang Y, Zhang S, Dong Q |title=The effect of alpha-adrenergic antagonists in chronic prostatitis/chronic pelvic pain syndrome: a meta-analysis of randomized controlled trials |journal=J. Androl. |volume=27 |issue=6 |pages=847–52 |year=2006 |pmid=16870951 |doi=10.2164/jandrol.106.000661 |quote=...treatment duration should be long enough (more than 3 months)]
phytotherapy ,cite journal |author=Shoskes DA, Zeitlin SI, Shahed A, Rajfer J |title=Quercetin in men with category III chronic prostatitis: a preliminary prospective, double-blind, placebo-controlled trial |journal=Urology |volume=54 |issue=6 |pages=960–3 |year=1999 |pmid=10604689 |doi=] cite journal |author=Elist J |title=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 |journal=Urology |volume=67 |issue=1 |pages=60–3 |year=2006 |pmid=16413333 |doi=10.1016/j.urology.2005.07.035] and protocols aimed at quieting the pelvicnerves through myofascialtrigger point release with psychological re-training foranxiety control.cite journal |author=Anderson RU, Wise D, Sawyer T, Chan C |title=Integration of myofascial trigger point release and paradoxical relaxation training treatment of chronic pelvic pain in men |journal=J. Urol. |volume=174 |issue=1 |pages=155–60 |year=2005 |pmid=15947608 |doi=10.1097/01.ju.0000161609.31185.d5] cite journal |author=Anderson RU, Wise D, Sawyer T, Chan CA |title=Sexual dysfunction in men with chronic prostatitis/chronic pelvic pain syndrome: improvement after trigger point release and paradoxical relaxation training |journal=J. Urol. |volume=176 |issue=4 Pt 1 |pages=1534–8; discussion 1538–9 |year=2006 |pmid=16952676 |doi=10.1016/j.juro.2006.06.010] Antibiotics are not recommended.cite journal |author=Alexander RB, Propert KJ, Schaeffer AJ, "et al" |title=Ciprofloxacin or tamsulosin in men with chronic prostatitis/chronic pelvic pain syndrome: a randomized, double-blind trial |journal=Ann. Intern. Med. |volume=141 |issue=8 |pages=581–9 |year=2004 |pmid=15492337 |doi=] cite journal |author=Nickel JC, Downey J, Clark J, "et al" |title=Levofloxacin for chronic prostatitis/chronic pelvic pain syndrome in men: a randomized placebo-controlled multicenter trial |journal=Urology |volume=62 |issue=4 |pages=614–7 |year=2003 |pmid=14550427 |doi=]Category IV
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.cite journal |author=Korrovits P, Ausmees K, Mändar R, Punab M |title=Prevalence of asymptomatic inflammatory (National Institutes of Health Category IV) prostatitis in young men according to semen analysis |journal=Urology |volume=71 |issue=6 |pages=1010–5 |year=2008 |month=June |pmid=18455767 |doi=10.1016/j.urology.2007.12.082 |url=]ee also
*
Interstitial cystitis — a related disease.External links
*Dmoz|Health/Men%27s_Health/Conditions_and_Diseases/Prostate/Prostatitis/|Prostatitis
Footnotes
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