{{Infobox medical condition (new) | name = Prostatitis | synonyms = Prostatosis | image = Inflammation of prostate.jpg | caption = Micrograph showing an inflamed prostate gland, the histologic correlate of prostatitis. A normal non-inflamed prostatic gland is seen on the left of the image. H&E stain. | pronounce = | field = Urology | symptoms = | complications = | onset = | duration = | types = | causes = | risks = | diagnosis = | differential = | prevention = | treatment = | medication = | prognosis = | frequency = | deaths = }} '''Prostatitis''' is an umbrella term for a variety of medical conditions that incorporate bacterial and non-bacterial origin illnesses in the pelvic region. In contrast with the plain meaning of the word (which means "inflammation of the prostate"), the diagnosis may not always include inflammation. Prostatitis is classified into acute, chronic, asymptomatic inflammatory prostatitis, and chronic pelvic pain syndrome.
In the United States, prostatitis is diagnosed in 8% of all male urologist visits and 1% of all primary care physician visits for male genitourinary symptoms.<ref name="pmid9507840">{{cite journal |vauthors=Collins MM, Stafford RS, O'Leary MP, Barry MJ |title=How common is prostatitis? A national survey of physician visits |journal=J. Urol. |volume=159 |issue=4 |pages=1224–8 |year=1998 |pmid=9507840| doi = 10.1016/S0022-5347(01)63564-X}}</ref>
==Classification== The term ''prostatitis'' refers to inflammation of the tissue of the prostate gland. It may occur as an appropriate physiological response to an infection, or it may occur in the absence of infection, or there may be no inflammation of the prostate at all.<ref>{{Cite journal|author-link1=Roger Kirby|last1=Kirby|first1=Roger|author-link2=Culley C. Carson III|last2=Carson|first2=Culley C.|date=January–February 2015|title=Editor's Comment on Diagnosis and treatment of chronic prostatitis/chronic pelvic pain syndrome|journal=Trends in Urology and Men's Health|volume=6|issue=1|pages=17|doi=10.1002/tre.434|doi-access=free}}</ref>
In 1999, the National Institutes of Health devised a new classification system.<ref name="pmid10422990">{{cite journal |vauthors=Krieger JN, Nyberg L, Nickel JC |title=NIH consensus definition and classification of prostatitis |journal=JAMA |volume=282 |issue=3 |pages=236–7 |date=July 1999 |pmid=10422990 |doi= 10.1001/jama.282.3.236}}</ref><ref name="Nickel1999">{{cite book|author=J. Curtis Nickel|title=Textbook of prostatitis|url=https://books.google.com/books?id=YiZz_xDk7rkC&pg=PA27|access-date=18 April 2010|year=1999|publisher=Taylor & Francis|isbn=978-1-901865-04-2|pages=27–}}</ref> For more specifics about each type of prostatitis, including information on symptoms, treatment, and prognosis, follow the links to the relevant full articles.
{| class="wikitable" style="text-align: center; font-size:85%" |- ! Category ! Current name ! Old name ! Pain ! Bacteria ! WBCs ! Description |- | I | Acute prostatitis | Acute bacterial prostatitis | Yes | Yes | Yes | style="text-align: left" | Bacterial infection of the prostate gland that requires urgent medical treatment. |- | II | Chronic bacterial prostatitis | Chronic bacterial prostatitis | ± | Yes | Yes | style="text-align: left" | A relatively rare condition that usually presents as intermittent urinary tract infections. |- | IIIa | Inflammatory CP/CPPS | Nonbacterial prostatitis | Yes | No | Yes | rowspan="2" style="text-align: left" | Accounts for 90–95% of prostatitis diagnoses,<ref name="pmid16409145">{{cite journal |vauthors=Habermacher GM, Chason JT, Schaeffer AJ |title=Prostatitis/chronic pelvic pain syndrome |journal=Annu. Rev. Med. |volume=57 |pages=195–206 |year=2006 |pmid=16409145 |doi=10.1146/annurev.med.57.011205.135654}}</ref> formerly known as ''chronic nonbacterial prostatitis''. |- | IIIb | Noninflammatory CP/CPPS | Prostatodynia | Yes | No | No |- | IV | Asymptomatic inflammatory prostatitis | (none) | No | No | Yes | style="text-align: left" |No history of genitourinary pain complaints, but leukocytosis is noted, usually during evaluation for other conditions. Between 6 and 19% of men have pus cells in their semen but no symptoms.<ref name="pmid18455767">{{cite journal |vauthors=Korrovits P, Ausmees K, Mändar R, Punab M |title=Prevalence of asymptomatic inflammatory (National Institutes of Health Category IV) prostatitis in young men according to semen analysis |journal=Urology |volume=71 |issue=6 |pages=1010–5 |date=June 2008 |pmid=18455767 |doi=10.1016/j.urology.2007.12.082 }}</ref> |}
In 1968, Meares and Stamey determined a classification technique based on the culturing of bacteria.<ref name="pmid4870505">{{cite journal |vauthors=Meares EM, Stamey TA |title=Bacteriologic localization patterns in bacterial prostatitis and urethritis |journal=Invest Urol |volume=5 |issue=5 |pages=492–518 |date=March 1968 |pmid=4870505 }}</ref> 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.<ref name="Prostatitis: Benign Prostate Disease: Merck Manual Professional">{{cite web |url=http://www.merckmanuals.com/professional/genitourinary_disorders/benign_prostate_disease/prostatitis.html |title=Prostatitis: Benign Prostate Disease: Merck Manual Professional |access-date=2011-07-11 |archive-date=2011-09-25 |archive-url=https://web.archive.org/web/20110925051318/http://www.merckmanuals.com/professional/genitourinary_disorders/benign_prostate_disease/prostatitis.html |url-status=live }}</ref>
==Imaging== Transrectal ultrasound (TRUS) and computed tomography (CT) are usually the first imaging techniques performed in patients with suspected complicated prostatitis or prostatic abscess, mainly because they are readily available and can be obtained rapidly in acute clinical settings.<ref>{{Cite journal |last1=Ackerman |first1=Anne Lenore |last2=Parameshwar |first2=Pooja S |last3=Anger |first3=Jennifer T |date=2018 |title=Diagnosis and treatment of patients with prostatic abscess in the post-antibiotic era |url=https://onlinelibrary.wiley.com/doi/10.1111/iju.13451 |journal=International Journal of Urology |language=en |volume=25 |issue=2 |pages=103–110 |doi=10.1111/iju.13451 |pmid=28944509 |issn=0919-8172}}</ref> TRUS is particularly useful for identifying fluid collections and for image-guided drainage procedures, while CT may help assess extension to adjacent pelvic structures.<ref>{{Cite journal |last1=Barozzi |first1=L |last2=Pavlica |first2=P |last3=Menchi |first3=I |last4=De Matteis |first4=M |last5=Canepari |first5=M |date=1998 |title=Prostatic abscess: diagnosis and treatment. |url=https://www.ajronline.org/doi/10.2214/ajr.170.3.9490969 |journal=American Journal of Roentgenology |language=en |volume=170 |issue=3 |pages=753–757 |doi=10.2214/ajr.170.3.9490969 |pmid=9490969 |issn=0361-803X|url-access=subscription }}</ref> Magnetic resonance imaging, however, offers superior soft-tissue resolution and may better detect small abscesses, multiloculated collections, and inflammatory changes within the prostate.<ref>{{Cite journal |last1=Di Bella |first1=Stefano |last2=Claps |first2=Francesco |last3=Cavallaro |first3=Marco |date=2026-02-03 |title=A Review of Prostatitis |url=https://jamanetwork.com/journals/jama/fullarticle/2843258 |journal=JAMA |language=en |volume=335 |issue=5 |pages=459 |doi=10.1001/jama.2025.21097 |pmid=41460524 |issn=0098-7484|url-access=subscription }}</ref> Recent studies have also highlighted the contribution of diffusion-weighted and contrast-enhanced MRI sequences in differentiating inflammatory lesions from prostate cancer.<ref>{{Cite journal |last1=El-Ghar |first1=Mohamed Abou |last2=Farg |first2=Hashim |last3=Sharaf |first3=Doaa Elsayed |last4=El-Diasty |first4=Tarek |date=2021-01-01 |title=CT and MRI in Urinary Tract Infections: A Spectrum of Different Imaging Findings |journal=Medicina |language=en |volume=57 |issue=1 |pages=32 |doi=10.3390/medicina57010032 |doi-access=free |pmid=33401464 |pmc=7824127 |issn=1648-9144}}</ref>
==See also== * Interstitial cystitis — a related disease * Granulomatous prostatitis * IgG4-related prostatitis * Male accessory gland infection (MAGI)
==References== {{Reflist}}
== External links == {{Medical resources | ICD10 = {{ICD10|N|41| |n|40}} | ICD9 = {{ICD9|601}} | DiseasesDB = 10801 | eMedicineSubj = emerg | eMedicineTopic = 488 | MedlinePlus = 000524 | MeshID = D011472 }} * [https://www.ucpps.men/1/cpsi.html Prostatitis Self Assessment Calculator]
{{Male diseases of the pelvis and genitals}}
Category:Inflammations Category:Inflammatory prostate disorders Category:Men's health