Prostatitis

Prostatitis is inflammation of the prostate, but the label covers several different clinical syndromes. The NIH classification divides it into four categories: - Category I: acute bacterial prostatitis - Category II: chronic bacterial prostatitis - Category III: chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) - Category IV: asymptomatic inflammatory prostatitis Acute bacterial prostatitis develops suddenly. Bacteria trigger inflammation and swelling within the prostate, which can produce dysuria, pelvic pain, urinary hesitancy, and sometimes urinary retention. The infection can extend into the bloodstream, so fever and abnormal perfusion matter as much as the urinary symptoms. Chronic bacterial prostatitis is a persistent or recurrent infection. The typical clue is repeated urinary tract infection with the same organism. Chronic inflammation may continue even when symptoms between episodes are mild. CP/CPPS is different. Pelvic pain lasts at least three months, but cultures do not show an established bacterial infection. Pain may involve the perineum, suprapubic region, penis, testes, or lower back and may be associated with urinary or sexual symptoms. The NIH-CPSI score helps quantify symptom burden; a prolonged pain history does not, by itself,...