Prosta-Q

Prostatitis accounts for approximately 2 million outpatient visits per year in the United States, including 8% of all visits to urologists and 1% of those to primary care physicians. 1 The direct costs of care approach $4,000 per patient per year.2 A classification system for the prostatitis syndromes has been developed by the National Institutes of Health (NIH) .3 About 5 to 10% of men with symptoms of prostatitis have acute or chronic bacterial prostatitis,4 conditions that are well defined according to clinical and microbiologic measures and that usually respond to antimicrobial therapy. Prosta q Acute bacterial prostatitis is a life-threatening systemic infection, and its diagnosis and treatment are relatively straightforward and will not be discussed here. Chronic bacterial prostatitis is characterized by positive results on cultures of expressed prostatic fluid and is usually associated with recurrent urinary tract infections. 5 Men with chronic bacterial prostatitis may be asymptomatic between acute episodes or have mild pelvic pain or irritative symptoms on voiding (frequency, urgency). Escherichia coli cause approximately 75 to 80% of episodes. Enterococci and aerobic gram-negative rods other than E. coli, such as pseudomonas, are isolated in the remainder of the cases. Most men with prostatitis, however, present with pelvic pain without evidence of urinary tract infection. This condition (NIH category III) is called the chronic pelvic pain syndrome and commonly manifests as pain in areas including the perineum, rectum, prostate, penis, testicles, and abdomen.6 It is often associated with symptoms of obstruction (e.g., hesitancy, weak stream) or irritative symptoms on voiding. The symptoms usually remain stable or improve slightly over time, but some men have large fluctuations in the severity of symptoms.7 In cross-sectional studies, the chronic pelvic pain syndrome is associated with reductions in the patient’s quality of life similar to or greater than those associated with angina, congestive heart failure, Crohn’s disease, and diabetes mellitus.8 Both chronic bacterial prostatitis and the chronic pelvic pain syndrome10 have been associated with abnormalities in the semen and infertility.