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Cho: The Present and Future of Prostatitis
Review Article
Korean Journal of Urology

Korean Journal of Urology 2008; 49(6): 475-489.

Published online: 30 June 2008

DOI: https://doi.org/10.4111/kju.2008.49.6.475

The Present and Future of Prostatitis

In Rae Cho

Department of Urology, Inje University College of Medicine, Gimhae, Korea.

ircho@paik.ac.kr

Copyright © 2008 The Korean Urological Association

Abstract

Prostatitis is a common disease that is confusing and frustrating for urologists. Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is the most common form of prostatitis. The etiology of CP/CPPS is unknown, but possibilities include infectious, autoimmune, neurological, endocrine and psychological causes. Clinical evaluation can aid in diagnosis and follow-up of the patient's response to therapy. Treatment for CP/CPPS is empiric and limited by a lack of randomized, placebo-controlled clinical trials. Antimicrobials are commonly used to treat patients with prostatitis. Other commonly used drugs include α-adrenoceptor antagonists, anti-inflammatory drugs, tricyclic antidepressants, and anticholinergic agents. Also, minimally invasive procedures are considered in patients with CP/CPPS and It is possible to treat intractable patients with invasive treatment. Although much progress has been made in therapy, there is no distinct treatment for patients with CP/CPPS. If the concept of neurogenic inflammation with pain is solved, it is possible to treat patients with CP/CPPS at future.

Keywords: Prostatitis, Chronic pelvic pain syndrome, Etiology, Treatment, Neurogenic inflammation

Figures and Tables

Fig. 1
Interplay of immunological, endocrine, neurological and psychological factors in development of CP/CPPS and proposed mechanism (Pontari and Ruggieri).18 CP/CPPS: chronic prostatitis/chronic pelvic pain syndrome.
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Fig. 2
Management approach for serum PSA elevation. PCa: prostatic carcinoma, BPH: benign prostatic hyperplasia, TRUS: transrectal ultrasound, PBx: prostatic biopsy, PSA: prostate-specific antigen.
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Table 1
Classification of prostatitis
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EPS: expressed prostatic secretion

Table 2
New classification of prostatitis
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Table 3
EAU Classification of CPPS
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NIH: National Institutes of Health

Table 4
Suggestions of guidelines on the treatment of prostatitis (CPCRN)
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