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Prostatitis
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{{Infobox medical condition (new) | name = Prostatitis | synonyms = Prostatosis | image = Inflammation of prostate.jpg | caption = [[Micrograph]] showing an [[inflammation|inflamed]] prostate gland, the [[histology|histologic]] correlate of prostatitis. A normal non-inflamed prostatic gland is seen on the left of the image. [[H&E stain]]. | pronounce = | field = [[Urology]] | symptoms = | complications = | onset = | duration = | types = | causes = | risks = | diagnosis = | differential = | prevention = | treatment = | medication = | prognosis = | frequency = | deaths = }} '''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.<ref name="pmid9507840">{{cite journal |vauthors=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}}</ref> ==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, or there may be no inflammation of the prostate at all.<ref>{{Cite journal|author-link1=Roger Kirby|last1=Kirby|first1=Roger|author-link2=Culley C. Carson III|last2=Carson|first2=Culley C.|date=January–February 2015|title=Editor's Comment on Diagnosis and treatment of chronic prostatitis/chronic pelvic pain syndrome|journal=Trends in Urology and Men's Health|volume=6|issue=1|pages=17|doi=10.1002/tre.434|doi-access=free}}</ref> In 1999, the [[National Institutes of Health]] devised a new classification system.<ref name="pmid10422990">{{cite journal |vauthors=Krieger JN, Nyberg L, Nickel JC |title=NIH consensus definition and classification of prostatitis |journal=JAMA |volume=282 |issue=3 |pages=236–7 |date=July 1999 |pmid=10422990 |doi= 10.1001/jama.282.3.236}}</ref><ref name="Nickel1999">{{cite book|author=J. Curtis Nickel|title=Textbook of prostatitis|url=https://books.google.com/books?id=YiZz_xDk7rkC&pg=PA27|access-date=18 April 2010|year=1999|publisher=Taylor & Francis|isbn=978-1-901865-04-2|pages=27–}}</ref> For more specifics about each type of prostatitis, including information on symptoms, treatment, and prognosis, follow the links to the relevant full articles. {| class="wikitable" style="text-align: center; font-size:85%" |- ! Category ! Current name ! Old name ! Pain ! Bacteria ! [[white blood cell|WBC]]s ! Description |- | I | [[Acute prostatitis]] | Acute bacterial prostatitis | Yes | Yes | Yes | style="text-align: left" | Bacterial infection of the prostate gland that requires urgent medical treatment. |- | II | [[Chronic bacterial prostatitis]] | Chronic bacterial prostatitis | ± | Yes | Yes | style="text-align: left" | A relatively rare condition that usually presents as intermittent [[urinary tract infection]]s. |- | IIIa | [[Chronic prostatitis/chronic pelvic pain syndrome|Inflammatory CP/CPPS]] | [[Nonbacterial prostatitis]] | Yes | No | Yes | rowspan="2" style="text-align: left" | Accounts for 90–95% of prostatitis diagnoses,<ref name="pmid16409145">{{cite journal |vauthors=Habermacher GM, Chason JT, Schaeffer AJ |title=Prostatitis/chronic pelvic pain syndrome |journal=Annu. Rev. Med. |volume=57 |pages=195–206 |year=2006 |pmid=16409145 |doi=10.1146/annurev.med.57.011205.135654}}</ref> formerly known as ''chronic nonbacterial prostatitis'. |- | IIIb | [[Chronic prostatitis/chronic pelvic pain syndrome|Noninflammatory CP/CPPS]] | [[Prostatodynia]] | Yes | No | No |- | IV | [[Asymptomatic inflammatory prostatitis]] | (none) | No | No | Yes | style="text-align: left" |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.<ref name="pmid18455767">{{cite journal |vauthors=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 |date=June 2008 |pmid=18455767 |doi=10.1016/j.urology.2007.12.082 }}</ref> |} In 1968, Meares and Stamey determined a classification technique based on the culturing of bacteria.<ref name="pmid4870505">{{cite journal |vauthors=Meares EM, Stamey TA |title=Bacteriologic localization patterns in bacterial prostatitis and urethritis |journal=Invest Urol |volume=5 |issue=5 |pages=492–518 |date=March 1968 |pmid=4870505 }}</ref> This classification is no longer used. The conditions are distinguished by the different presentation of pain, [[white blood cell]]s (WBCs) in the urine, duration of symptoms and [[bacteria]] [[Microbiological culture|cultured]] from the urine. To help express prostatic secretions that may contain WBCs and bacteria, [[prostate massage]] is sometimes used.<ref name="Prostatitis: Benign Prostate Disease: Merck Manual Professional">{{cite web |url=http://www.merckmanuals.com/professional/genitourinary_disorders/benign_prostate_disease/prostatitis.html |title=Prostatitis: Benign Prostate Disease: Merck Manual Professional |access-date=2011-07-11 |archive-date=2011-09-25 |archive-url=https://web.archive.org/web/20110925051318/http://www.merckmanuals.com/professional/genitourinary_disorders/benign_prostate_disease/prostatitis.html |url-status=live }}</ref> ==See also== * [[Interstitial cystitis]] — a related disease * [[Granulomatous prostatitis]] * [[IgG4-related prostatitis]] * [[Male accessory gland infection]] (MAGI) ==References== {{Reflist}} == External links == {{Medical resources | ICD10 = {{ICD10|N|41| |n|40}} | ICD9 = {{ICD9|601}} | DiseasesDB = 10801 | eMedicineSubj = emerg | eMedicineTopic = 488 | MedlinePlus = 000524 | MeshID = D011472 }} * [https://www.ucpps.men/1/cpsi.html Prostatitis Self Assessment Calculator] {{Male diseases of the pelvis and genitals}} [[Category:Inflammations]] [[Category:Inflammatory prostate disorders]] [[Category:Men's health]]
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