Korean J Urol.  2008 Jun;49(6):475-489.

The Present and Future of Prostatitis

• Cho IR

Abstract

Prostatitis is a common disease 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, endocrine and psychological causes. Clinical 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 and It is possible to treat intractable patients with invasive treatment. Although much progress has been made in therapy, there is no distinct treatment for patients with CP/CPPS. If the concept of neurogenic inflammation with pain is solved, it is possible to treat patients with CP/CPPS at future.

Keyword

Prostatitis; Chronic pelvic pain syndrome; Etiology; Treatment; Neurogenic inflammation

MeSH Terms

Antidepressive Agents, Tricyclic
Cholinergic Antagonists
Follow-Up Studies
Humans
Neurogenic Inflammation
Pelvic Pain
Prostatitis
Antidepressive Agents, Tricyclic
Cholinergic Antagonists

Figure

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  Fig. 1 Interplay of immunological, endocrine, neurological and psychological factors in development of CP/CPPS and proposed mechanism (Pontari and Ruggieri).18 CP/CPPS: chronic prostatitis/chronic pelvic pain syndrome.

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  Fig. 2 Management approach for serum PSA elevation. PCa: prostatic carcinoma, BPH: benign prostatic hyperplasia, TRUS: transrectal ultrasound, PBx: prostatic biopsy, PSA: prostate-specific antigen.

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