[Prostatitis]

Abstract

During the last years, diagnosis and therapy of prostatitis have advanced rapidly. A detailed standardized diagnostic procedure is mandatory to delimit inflammatory from noninflammatory variations of the prostatitis syndrome. Whereas Gram-negative pathogens are agreed to be etiologically responsible, the relevance of chlamydia and mycoplasma is still under debate. Further diagnostic work-up should comprise ejaculate analysis, screening of the bladder voiding and transrectal prostatic sonography. The therapy of the inflammatory prostatitis is aimed to the demonstration of relevant pathogens, antibiotic treatment must be suited to expected sensitivity of the pathogen. Surgical procedures may be discussed when antibiotic treatment has failed. If it is not possible to identify relevant pathogens, the therapy remains of experimental character. Prostatodynia as noninflammatory disease often requires psychodynamic exploration.