17/10/2024
3 Definition
The traditional classification of “prostatitis” included acute and chronic bacterial prostatitis, which affect less than 5% of men with prostatitis and for which treatment and management are usually successful [3,6]. The majority of patients with prostatitis were traditionally judged to have either nonbacterial prostatitis or prostatodynia. Both of these conditions are characterized by pelvic pain, but only the former is associated with inflammatory cells in the prostatic fluid.
In 1995, a workshop on chronic prostatitis convened by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the US National Institutes of Health (NIH) created a new working definition and classification of prostatitis syndromes as follows [7].
(I)
Acute bacterial prostatitis, acute infection of the prostate.
(II)
Chronic bacterial prostatitis, recurrent infection of the prostate.
(III)
Chronic nonbacterial prostatitis/chronic pelvic pain syndrome (CP/CPPS), where there is no demonstrable infection. Subgroups of this class are:
(A)
Inflammatory chronic pelvic pain syndrome, where leukocytes are found in the expressed prostatic secretions (EPS), urine obtained after prostate massage (voided bladder urine-3 [VB-3]), or semen.
(B)
Non-inflammatory chronic pelvic pain syndrome, where no evidence of inflammation is found in the EPS, VB-3, or semen.
(IV)
Asymptomatic inflammatory prostatitis (AIP), where there are no subjective symptoms, but white blood cells are found in prostate secretions or in prostate tissue during an evaluation for other disorders.
Unlike patients in categories I and II, patients with category III prostatitis do not have any detectable colonization or infection of the prostate, as determined by conventional microbiological techniques; abnormalities in the EPS are the primary objective feature of category III prostatitis. Chronic pain is the primary subjective symptom. The majority of patients with “prostatitis” are in category III [4].