• Historical classification: acute bacterial prostatitis, chronic bacterial prostatitis, nonbacterial prostatitis, prostatodynia.
• 90% of patients do not have a bacterial infection
• NIDDK classification
  • Class 1: acute bacterial prostatitis
  • Class 2: chronic bacterial prostatitis
  • Class 3: nonbacterial prostatitis and prostatodynia. Renamed chronic abacterial prostatitis-chronic pelvic pain syndrome (CPPS).
    
    3A indicates evidence of inflammation by the presence of leukocytes in the expressed prostatic secretion and/or semen.
    3B denotes an absence of inflammatory cells.
    Patients with 3A may have more severe and more frequent symptoms, particularly with regard to difficulty reaching erection, weak urinary streatm, urinary frequency, and penile pain.
    
    
  • Class 4 recognizes patients without symptoms, but found to have inflammation in the prostatic secretions or semen, or in tissue taken at the time of prostate biopsy or resection. No treatment is indicated for class 4 CPPS.

Suggested Reading

• Selman, HC and Pontari, M: Prostatitis and lower urinary tract infections in men. In: Clinical Manual of Urology, Hanno, PM, Malkowicz, SB, and Wein, AJ (eds); WB Saunders, Philadelphia, pp185-193, 2001.
• Abarbanel, J, Engelstein, D, Lask, D, and Livne, PM: Urinary tract infection in men younger than 45 years of age: is there a need for urologic investigation? Urology, 62:27-29, 2003.
• Scheaffer, AJ, (ed): Advances in the diagnosis and treatment of prostatitis; Urology, 60, number 6A, December 2002 supplement.
• Potts, JM: Diagnosing the prostatitis patient: the dilemma continues. Curr Urol Rep. 2002 Aug; 3(4):319-323.
• Anderson, RU: Management of chronic prostatitis-chronic pelvic pain syndrome. Urol Clin North Am, 29:235-239, 2002.
• Kreiger, JN, Ross, SO, Penson, DF, and Riley, DE: Symptoms and inflammation in chronic prostatitis/chronic pelvic pain syndrome. Urology, 60:959-963, 2002.

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