Rigi10™ Malleable Penile Prosthesis
Also Known As
Prostate inflammation, Prostatic inflammation, CP/CPPS (for chronic prostatitis/chronic pelvic pain syndrome), NIH Category I-IV prostatitis, Bacterial prostatitis (BP), Acute bacterial prostatitis (ABP), Chronic bacterial prostatitis (CBP), Inflammatory prostatitis, Non-bacterial prostatitis
Definition
Prostatitis is a frequently painful condition characterized by inflammation of the prostate gland and sometimes the surrounding areas.1 This condition manifests in four distinct categories according to the National Institutes of Health (NIH) classification system: acute bacterial prostatitis (Category I), chronic bacterial prostatitis (Category II), chronic prostatitis/chronic pelvic pain syndrome (Category III), and asymptomatic inflammatory prostatitis (Category IV).2 Bacterial prostatitis (BP) specifically refers to a bacterial infection of the prostate gland occurring in a bimodal distribution in younger and older men.3 It can be acute (ABP) or chronic (CBP) in nature and, if not treated appropriately, can result in significant morbidity.4 The inflammation process may involve various mechanisms including infectious agents, immune dysregulation, neurological factors, and pelvic floor dysfunction, particularly in cases of chronic prostatitis/chronic pelvic pain syndrome which represents the most common form of the condition.5
Clinical Context
Prostatitis represents a significant urological condition that accounts for approximately 2 million outpatient visits in the United States annually.2 The clinical presentation and management vary considerably depending on the specific category of prostatitis.
Acute bacterial prostatitis (Category I) presents as a severe urinary tract infection with systemic symptoms including fever, chills, pelvic pain, dysuria, and occasionally urinary retention.3 This condition requires prompt antimicrobial therapy and sometimes hospitalization for severe cases. Diagnostic evaluation typically includes urinalysis, urine culture, and in some cases, imaging to rule out prostatic abscess in patients who are immunocompromised or failing to respond to treatment.4
Chronic bacterial prostatitis (Category II) manifests with recurrent urinary tract infections caused by the same bacterial strain, often accompanied by mild to moderate pelvic pain and urinary symptoms.1 Management involves extended courses of antimicrobial therapy, typically with agents that achieve good prostatic penetration such as fluoroquinolones, trimethoprim, tetracyclines, or macrolides.5 The prostate’s unique structural and biochemical characteristics, including its alkaline environment and less permeable capillaries, necessitate specific antibiotic selection.3
Chronic prostatitis/chronic pelvic pain syndrome (Category III) is the most common form, affecting 10-15% of the U.S. male population.2 It is characterized by chronic pelvic pain (perineal, suprapubic, testicular, or penile), variable urinary symptoms, and sexual dysfunction, particularly pain associated with ejaculation.1 The etiology remains incompletely understood but may involve neuroinflammatory processes, pelvic floor dysfunction, psychological factors, and possibly non-bacterial infectious agents.5 Treatment typically requires a multimodal approach addressing pain, urinary symptoms, psychological aspects, and functional rehabilitation of the pelvic floor.4
Asymptomatic inflammatory prostatitis (Category IV) is diagnosed incidentally during evaluation for other conditions and does not require specific treatment.2
Patient selection for various therapeutic approaches depends on accurate categorization, symptom severity, impact on quality of life, and previous treatment responses. The National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) provides a standardized tool for assessing symptom severity and treatment outcomes.1