Nonbacterial Prostatitis Clinical Presentation

  • Author: Sunil K Ahuja, MD; Chief Editor: Edward David Kim, MD, FACS   more...
 
Updated: Dec 7, 2011
 

History

Patients with abacterial prostatitis/chronic pelvic pain syndrome (CPPS; category III in the 1995 National Institutes of Health prostatitis classification system) have the same symptom complex as those with chronic bacterial prostatitis. The chief symptom reported by patients with abacterial prostatitis/CPPS is pain. Genitourinary symptoms include perineal, penile tip, testicular, rectal, lower abdominal, or back pain.

Patients can also have irritative or obstructive urologic symptoms such as frequency, urgency, dysuria, decreased force of the urinary stream, nocturia, and incontinence. Other symptoms are a clear urethral discharge, ejaculatory pain, hematospermia, and sexual dysfunction.

Many patients with abacterial prostatitis have emotional strife and some psychological difficulties (ie, socially, sexually, or both). Patients should be questioned with regard to their overall social adjustment. Stress level is important because stress is responsible for increased tension of the pelvic floor and the internal urinary sphincter, resulting in the symptoms of prostatitis.

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Physical Examination

In most cases, physical examination findings are nonspecific. Many patients have normal findings, others may have an exquisitely sensitive prostate or other pelvic trigger points on internal and external perianal examination, and still others may have an enlarged, boggy prostate.

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Contributor Information and Disclosures
Author

Sunil K Ahuja, MD  Department of Urology, Kaiser Permanente San Jose Medical Center

Sunil K Ahuja, MD is a member of the following medical societies: American Urological Association

Disclosure: Nothing to disclose.

Chief Editor

Edward David Kim, MD, FACS  Professor of Surgery, Division of Urology, University of Tennessee Graduate School of Medicine; Consulting Staff, University of Tennessee Medical Center

Edward David Kim, MD, FACS is a member of the following medical societies: American College of Surgeons, American Society for Reproductive Medicine, American Society of Andrology, American Urological Association, Sexual Medicine Society of North America, and Tennessee Medical Association

Disclosure: Lilly Consulting fee Advisor; Astellas Consulting fee Speaking and teaching; Watson Consulting fee Speaking and teaching; Allergan Consulting fee Speaking and teaching

Additional Contributors

Peter Langenstroer, MD Associate Professor, Department of Urology, Medical College of Wisconsin

Peter Langenstroer, MD is a member of the following medical societies: American Urological Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

References

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Nonbacterial prostatitis. National Institutes of Health Chronic Prostatitis Symptom Index.
Nonbacterial prostatitis. Comparison of new and old prostatitis classifications.
Treatment algorithm for nonbacterial prostatitis.
 
 
 
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