prostatitischronic

Chronic prostatitis, also known as chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), is a urological condition characterized by pelvic or perineal pain lasting at least three months, often with urinary symptoms such as frequency or urgency, and sometimes with sexual dysfunction. Unlike acute bacterial prostatitis, CP/CPPS typically shows little or no evidence of active infection, and the exact cause is frequently unclear.

Classification commonly divides CP/CPPS into inflammatory (IIIa) and non-inflammatory (IIIb) forms. The broader historical framework also includes chronic bacterial prostatitis and asymptomatic inflammatory prostatitis, but most patients with ongoing pelvic pain are discussed under CP/CPPS. The underlying mechanisms are likely multifactorial, including low-grade inflammation, autoimmune or neurogenic processes, pelvic floor muscle dysfunction, and psychosocial factors. In many cases, no single causative agent is found.

Diagnosis relies on clinical symptoms and the exclusion of other conditions. Evaluation may include urinalysis and urine culture to rule out infection, examination of prostatic secretions, and consideration of Meares-Stamey or related testing in specialized settings. The NIH Chronic Prostatitis Symptom Index (NIH-CPSI) is a commonly used tool to quantify pain, urinary symptoms, and quality of life.

Treatment is multimodal and tailored to the individual. If bacterial infection is suspected, antibiotics may be tried, but many CP/CPPS cases do not respond to antibiotics alone. Other approaches include alpha-blockers to improve urinary symptoms, nonsteroidal anti-inflammatory drugs, neuropathic pain medications, and pelvic floor physical therapy. Additional options include stress management, behavioral therapies, and complementary treatments. Prognosis varies; symptoms may wax and wane, with some improvement over time and some persistence in others. Ongoing research seeks clearer etiologies and more effective therapies.