Prostatitis

Abstract

Prostatitis is a poorly defined group of syndromes with multiple causes, some of which are not yet determined. Although treatment of acute prostatitis is well defined and almost uniformly successful, chronic prostatitis, either of bacterial or undetermined etiology, remains a perplexing problem in both diagnosis and treatment. Identification of the etiologic agent of chronic "nonbacterial" prostatitis, if one exists, has not yet been accomplished. Undoubtedly, more than one organism may be responsible for these cases. Treatment is ineffective for a high percentage of patients with chronic prostatitis, both from proven bacterial and nonbacterial causes. Few drugs penetrate the prostatic tissues well, and few of those that do have an appropriate antimicrobial spectrum. An excellent, or even adequate, antibiotic for chronic prostatic infections has yet to be developed. Prostatodynia remains as a "wastebasket" syndrome of miscellaneous pains, aches, and pelvic discomforts. With this collection of symptoms, no easy approach to diagnosis or treatment is possible. Only when more detailed diagnosis has been developed can one hope for better therapy of this condition.