Chronic Prostatitis / Chronic Pelvic Pain Syndrome
Chronic prostatitis (CP) is a condition associated with a multitude of painful symptoms in men. They include -
• Pain - in the perineum, testicles (orchalgia) or lower back
• Painful ejaculation
• Penile pain
There may also be urinary difficulties -
• Difficulty initiating urination (hesitancy)
• Poor and interrupted urinary flow
• Painful urination (dysuria)
• Frequent urination (frequency and nocturia)
These symptoms can be severe and debilitating resulting in a significantly reduced quality of life, loss of sex drive, sexual dysfunction and depression.
Categorization of Chronic Prostatitis
Type I - Acute prostatitis
This is a severe infection of the prostate gland with urine infection and is associated with a high fever and rigors (shivers/shakes/cold sweats). As well as prostatic pain there may be inability to urinate.
Acute prostatitis may cause septicaemia and may warrant specialist treatment in hospital with intravenous antibiotics
Type II - Chronic Bacterial Prostatitis
This type of CP is characterized by the above symptoms and is typically associated with recurrent proven urinary tract infections. The infection resides deep in the prostate, the bacteria adherent to tiny stones within the gland. The treatment usually involves long courses of specific antibiotics.
Type III - Chronic Pelvic Pain Syndrome (CPPS)
CCPS is the most common type of chronic pelvic pain in men. Overall it is very similar to bladder pain syndrome seen in women. It is divided into two categories
Type IIIa - Non-bacterial prostatitis - Prostatitis symptoms associated with evidence of prostate inflammation but where no bacterial infection can be demonstrated.
Type IIIb - Prostatodynia - Where prostatitis symptoms occur but no prostatic or urinary tract abnormalities can be identified. It is likely to be related to pelvic floor muscle and/or nerve dysfunction. It is commonly associated with other chronic pain syndromes.