Prostatitis

Prostatitis means inflammation of the prostate. This can be caused by infection (for example bacteria) or by chemical agents. When caused by bacteria, prostatitis can be acute (which is rare but relatively easy to diagnose and treat) or chronic. Chronic prostatitis and chronic pelvic pain syndrome is common but is poorly understood. It is sometimes given the abbreviation CP/CPPS. Patients are often labelled as chronic prostatitis solely by virtue of the presence of symptoms that they have. However this is usually in the absence of any objective tests which may show a definitive cause (and could therefore direct treatment).

Most men present with the chronic form(s) of prostatitis. CP/CPPS is defined as pain in the pelvic region of a male persisting for at least 3 months. Often there are accompanying voiding difficulties and effects on sexual function, particularly with pain related to ejaculation. Due to the broad and vague nature of the definition, it is diagnosed often and symptoms tend to occur intermittently with quiescent periods followed by relapse with symptoms. Treatment is based on controlling symptoms but there are few objective data to guide this. Even the name ‘prostatitis’ is bizarre as it may not be associated with prostate inflammation and may not even be a disease of the prostate. However, antibiotics (the most commonly prescribed treatment) are often used because of the assumption that the cause of the problem is infection. It is because of the uncertainties around this subject that further research might assist with aetiology and possibly diagnosis.