Chronic Prostatitis and Chronic Pelvic Pain Syndrome in Men

Excerpt

Symptomatic inflammatory conditions of the prostate are quite common, accounting for about 2 million outpatient visits annually in the United States. These visits are evenly split between primary care and urology.

Prostatitis is clinically divided into acute bacterial prostatitis and various types of chronic prostatic infectious and inflammatory conditions, including chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in men. This review will cover all such symptomatic prostatic conditions except acute bacterial prostatitis (NIH Category I), which will be described separately. (See our companion Statpearls reference article on "Acute Bacterial Prostatitis.")

Chronic prostatitis is the most common urological diagnosis in men younger than 50 and the third most commonly diagnosed male urological condition. This condition accounts for up to 25% of all outpatient urology consults and outpatient visits and is estimated to have affected 5% of all men aged 20 to 50 years.

The term "prostatodynia" is not encouraged or recommended in current practice, as it carries the negative historical connotation of being a "wastebasket" designation for a melange of symptoms.

Chronic prostatitis has a significant negative impact on quality of life and, in this respect, is comparable with other major long-term health conditions (eg, ischemic heart disease and diabetes mellitus). Despite being common in clinical practice, chronic prostatitis is often misdiagnosed, misclassified, and poorly managed, resulting in significant morbidity, prolonged symptoms, and overall patient dissatisfaction. Understanding the classification, presentation, evaluation, and optimal management of the various types of chronic prostatitis is necessary at all levels to improve outcomes. Early recognition and the correct clinical classification of the condition with prompt and appropriate treatment improves outcomes and minimizes patient morbidity.