Prostatitis Category IV: Asymptomatic inflammatory prostatitis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Category IV: Asymptomatic Inflammatory Prostatitis

Signs and Symptoms

These patients have no history of genitourinary pain complaints, but leukocytosis or bacteria have been noted during evaluation for other conditions.

Diagnosis

Diagnosis is through tests of semen, EPS, or prostate tissue that reveal inflammation in the absence of symptoms.[1]

Treatment

No treatment required. It is standard practice for men with infertility and category IV prostatitis to be given a trial of antibiotics and/or anti-inflammatory drugs however evidence for efficacy are weak.[2] Since signs of asymptomatic prostatic inflammation may sometimes be associated with prostate cancer, this can be addressed by tests that assess the ratio of free-to-total PSA. The results of these tests were significantly different in prostate cancer and category IV prostatitis in one study.[3]

References

  1. Clemens JQ, Meenan RT, O'Keeffe Rosetti MC, Gao SY, Calhoun EA (2005). "Incidence and clinical characteristics of National Institutes of Health type III prostatitis in the community". J. Urol. 174 (6): 2319–22. doi:10.1097/01.ju.0000182152.28519.e7. PMID 16280832.
  2. "Several inflammatory and reactive alterations of sperm quality seem to be proven; nevertheless, the impact of these findings on male fertility remains in many cases unclear."Weidner W; et al. (1999). "Relevance of male accessory gland infection for subsequent fertility with special focus on prostatitis". Hum Reprod Update. 5 (5): 421-32.
  3. "The ratio of free-to-total PSA is significantly different in PCa and NIH category IV prostatitis." Effect of NIH-IV prostatitis on free and free-to-total PSA Eur Urol. 2004 Dec;46(6):760-4. (Stancik I et al)

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