Prostatitis: Infection, neuromuscular disorder, or pain syndrome? Proper patient classification is key
Jeannette Potts, MD
Glickman Urological Institute, Cleveland Clinic, Cleveland, OH
Richard E. Payne, MD
Clinical Instructor, Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA; Private Practice, North Coast Family Medical Group, Encinitas, CA
Correspondence: Jeannette Potts, MD, Glickman Urological Institute, Cleveland Clinic, 9500 Euclid Avenue, A100, Cleveland, OH 44195; firstname.lastname@example.org
Dr. Potts reported that she has no financial relationships that pose a potential conflict of interest with this article.
Dr. Payne reported that he has received honoraria, consulting fees, and an educational grant from Eli Lilly/ICOS for teaching/speaking, consulting, and contracted research; honoraria and consulting fees from Sanofi-Aventis for teaching/speaking and advisory board membership; consulting fees from Boehringer Ingelheim for teaching/speaking and consulting; consulting fees from Pfizer, Johnson & Johnson, and Thomson Healthcare for consulting; and consulting fees from Reliant Pharmaceuticals for serving on an advisory committee. He also reported having an ownership interest in and receiving consulting fees from MedVantx.
Prostatitis is a broad term used to describe inflammation of the prostate that may be associated with a myriad of lower urinary tract symptoms and symptoms of sexual discomfort and dysfunction. The condition affects 5% to 10% of the male population and is the most common urologic diagnosis in men younger than 50 years. Prostatitis is classified into four categories, including acute and chronic bacterial forms, a chronic abacterial form, and an asymptomatic form. The bacterial forms are more readily recognized and treated, but symptoms in most affected men are not found to have an infectious cause. Indeed, chronic abacterial prostatitis (also known as chronic pelvic pain syndrome) is both the most prevalent form and also the least understood and the most challenging to evaluate and treat. This form of prostatitis may respond to non-prostate-centered treatment strategies such as physical therapy, myofascial trigger point release, and relaxation techniques. Because the various forms of prostatitis call for vastly different treatment approaches, appropriate evaluation, testing, and differential diagnosis are crucial to effective management.