Prostatitis historical perspective

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

Historical perspective

In 1999, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) devised a new classification system.[1][2] For more specifics about each type of prostatitis, including information on symptoms, treatment, and prognosis, follow the links to the relevant full articles.

Category Pain? Bacteria? WBCs? NIDDK
(Current)
Description Meares/Stamey
(Old)
I yes yes yes Acute prostatitis Acute prostatitis is a bacterial infection of the prostate gland that requires urgent medical treatment. Acute bacterial prostatitis
II ± yes yes Chronic bacterial prostatitis Chronic bacterial prostatitis is a relatively rare condition that usually presents as intermittent urinary tract infections. Chronic bacterial prostatitis
IIIa yes no yes Inflammatory CP/CPPS Chronic prostatitis/chronic pelvic pain syndrome, accounting for 90%-95% of prostatitis diagnoses,[3] used to be known as chronic nonbacterial prostatitis. Nonbacterial prostatitis
IIIb yes no no Noninflammatory CP/CPPS Prostatodynia
IV no no yes Asymptomatic inflammatory prostatitis Asymptomatic inflammatory prostatitis patients have no history of genitourinary pain complaints, but leukocytosis is noted, usually during evaluation for other conditions. Between 6-19% of men have pus cells in their semen but no symptoms.[4] (none)

In 1968, Meares and Stamey determined a classification technique based upon the culturing of bacteria.[5] This classification is no longer used.

The conditions are distinguished by the different presentation of pain, white blood cells (WBCs) in the urine, duration of symptoms and bacteria cultured from the urine. To help express prostatic secretions that may contain WBCs and bacteria, prostate massage is sometimes used.[6]

References

  1. Krieger JN, Nyberg L, Nickel JC (1999). "NIH consensus definition and classification of prostatitis". JAMA. 282 (3): 236–7. doi:10.1001/jama.282.3.236. PMID 10422990. Unknown parameter |month= ignored (help)
  2. J. Curtis Nickel (1999). Textbook of prostatitis. Taylor & Francis. pp. 27–. ISBN 978-1-901865-04-2. Retrieved 18 April 2010.
  3. Habermacher GM, Chason JT, Schaeffer AJ (2006). "Prostatitis/chronic pelvic pain syndrome". Annu. Rev. Med. 57: 195–206. doi:10.1146/annurev.med.57.011205.135654. PMID 16409145.
  4. Korrovits P, Ausmees K, Mändar R, Punab M (2008). "Prevalence of asymptomatic inflammatory (National Institutes of Health Category IV) prostatitis in young men according to semen analysis". Urology. 71 (6): 1010–5. doi:10.1016/j.urology.2007.12.082. PMID 18455767. Unknown parameter |month= ignored (help)
  5. Meares EM, Stamey TA (1968). "Bacteriologic localization patterns in bacterial prostatitis and urethritis". Invest Urol. 5 (5): 492–518. PMID 4870505. Unknown parameter |month= ignored (help)
  6. "Prostatitis: Benign Prostate Disease: Merck Manual Professional". Retrieved 2011-07-11.

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