Prostatitis: diagnosis and treatment.
Summary of "Prostatitis: diagnosis and treatment."
Prostatitis ranges from a straightforward clinical entity in its acute form to a complex, debilitating condition when chronic. It is often a source of frustration for the treating physician and patient. There are four classifications of prostatitis: acute bacterial, chronic bacterial, chronic prostatitis/chronic pelvic pain syndrome, and asymptomatic. Diagnosis of acute and chronic bacterial prostatitis is primarily based on history, physical examination, urine culture, and urine specimen testing pre- and post-prostatic massage. The differential diagnosis of prostatitis includes acute cystitis, benign prostatic hyperplasia, urinary tract stones, bladder cancer, prostatic abscess, enterovesical fistula, and foreign body within the urinary tract. The mainstay of therapy is an antimicrobial regimen. Chronic pelvic pain syndrome is a more challenging entity, in part because its pathology is poorly understood. Diagnosis is often based on exclusion of other urologic conditions (e.g., voiding dysfunction, bladder cancer) in association with its presentation. Commonly used medications include antimicrobials, alpha blockers, and anti-inflammatory agents, but the effectiveness of these agents has not been supported in clinical trials. Small studies provide limited support for the use of nonpharmacologic modalities. Asymptomatic prostatitis is an incidental finding in a patient being evaluated for other urologic problems.
Affiliation
University of Iowa Health Care, Iowa City, IA, USA.
Journal Details
This article was published in the following journal.
Name: American family physician
ISSN: 1532-0650
Pages: 397-406
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20704171
- DOI: http://dx.doi.org/
Medical and Biotech [MESH] Definitions
Prostatitis
Infiltration of inflammatory cells into the parenchyma of PROSTATE. The subtypes are classified by their varied laboratory analysis, clinical presentation and response to treatment.
Early Diagnosis
Methods to determine in patients the nature of a disease or disorder at its early stage of progression. Generally, early diagnosis improves PROGNOSIS and TREATMENT OUTCOME.
Diagnosis-related Groups
A system for classifying patient care by relating common characteristics such as diagnosis, treatment, and age to an expected consumption of hospital resources and length of stay. Its purpose is to provide a framework for specifying case mix and to reduce hospital costs and reimbursements and it forms the cornerstone of the prospective payment system.
Quackery
The fraudulent misrepresentation of the diagnosis and treatment of disease.
Radiology
A specialty concerned with the use of x-ray and other forms of radiant energy in the diagnosis and treatment of disease.
PubMed Articles
OBJECTIVES: The prostatitis syndrome is classified into bacterial prostatitis (acute and chronic), chronic pelvic pain syndrome and asymptomatic prostatitis. The aim of this report is to review curren...
The DABBEC Phenotyping System: towards a mechanistic understanding of CP/CPPS.
There is an urgent need to elucidate the mechanistic basis of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), as the current methods of symptom-based diagnosis and treatment have failed. H...
BACKGROUND: It has been known that the National Institutes of Health category IV (NIH-IV) prostatitis increases the serum total prostate-specific antigen (tPSA) in patients with benign prostatic hyper...
The etiology and management of acute prostatitis.
Acute bacterial prostatitis is a common and clinically important genitourinary disorder. Patient populations who are at especially high risk of acute prostatitis include those with diabetes, cirrhosis...
Sexual dysfunction in chronic prostatitis/chronic pelvic pain syndrome.
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), or NIH category III prostatitis, is a common clinical syndrome characterized by genital/pelvic pain and lower urinary tract symptoms in the...
Clinical Trials
An Open-Label Study of CC-10004 for Chronic Prostatitis/Chronic Pelvic Pain Syndrome
Prostatitis is the most common urologic diagnosis in men under the age of 50 and the third most common diagnosis in older men. In Chronic Prostatitis (CP) or Chronic Pelvic Pain Syndrome...
Laparoscopic Prostatectomy for Chronic Prostatitis
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Efficacy Study of Tamsulosin and Tolterodine Treatment for Chronic Prostatitis
The purpose of this study is to determine whether tamsulosin and tolterodine are effective in the treatment of men with lower urinary tract symptoms and chronic prostatitis/chronic pelvic...
The purpose of this study is to determine whether tanezumab is effective in the treatment of pain associated with chronic prostatitis.
Efficacy Study of Acupuncture to Relieve Symptoms of Chronic Prostatitis
Limited evidence suggests that acupuncture may help relieve symptoms of chronic prostatitis/chronic pelvic pain syndrome. This study evaluated if acupuncture twice weekly for 10 weeks woul...
