Evaluation and Treatment of Patients with Prostatitis

Cho, In Rae

Abstract

Prostatitis is a common syndrome that is confusing and frustrating for urologists. Chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS) is the most common form of prostatitis. The etiology of CP/CPPS is unknown, but possibilities include infectious, autoimmune, neurological and psychiatric causes. Clinical, laboratory, and imaging evaluations for the patient presenting prostatitis can be categorized as basic or mandatory evaluations, further or recommended evaluations, and optional evaluations in selected patients. Evaluation can aid in diagnosis and follow-up of the patient's response to therapy. Treatment for CP/CPPS is empiric and limited by a lack of randomized, placebo-controlled clinical trials. Antimicrobials are commonly used to treat patients with prostatitis. Other commonly used drugs include alpha-adrenoceptor antagonists, anti-inflammatory drugs, tricyclic antidepressants, and anticholinergic agents. Also, minimally invasive procedures are considered in patients with CP/CPPS. Although much progress has been made in therapy, there is no distinct treatment for patients with CP/CPPS. It is possible to treat intractable patients with 'care' not 'cure'.