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Prostatitis The term „prostatitis“ or „prostatitis syndrome“ is used to describe a condition in a large group of men with various urogenital, perineal and perianal complaints, e.g., urethral burning, hemospermia, diffuse pain in the lower abdomen, micturition disorders, sexual dysfunctioning, feeling of pressure on the rectum. This multifaceted syndrome has been classified by Drach et al (1978) into acute bacterial, chronic bacterial, and “abacterial” prostatitis which have to be separated from prostatodynia in which prostatic secretions show neither signs of inflammation nor do they yield infectious agents. Due to difficulties in the separation of infectious, inflammatory, and non-inflammatory forms, a new classification has been based on symptomatology. It differentiates between: (1) acute bacterial prostatitis, i.e., acute infection of the prostate; (2) chronic bacterial prostatitis, i.e., recurrent prostatic infection; (3) chronic “abacterial” prostatitis/chronic pelvic pain syndrome (no conventional microorganisms can be detected although symptoms are present) subdivided into (3a) inflammatory subtype (elevated leukocyte numbers in ejaculate, prostatic secretions, or urine after prostatic massage), (3b) non-inflammatory subtype (no leukocytes in the samples mentioned above); (4) asymptomatic inflammatory prostatitis (no subjective symptoms but leukocytes in prostatic biopsy specimens and/or elevated leukocyte numbers in ejaculate, prostatic secretions, or urine after prostatic massage, i.e., procedures performed after other pathologies, e.g., elevated PSA levels, had been detected. Diagnostic procedures for classification are difficult but an essential basis for causal therapy. top |
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