The Dilemma of Chronic Nonbacterial Prostatitis

Men with pelvic discomfort and unexplained urinary symptoms frequently are diagnosed with chronic prostatitis by primary care physicians and urologists. Although a bacterial cause usually is not identified, many such patients are treated with antibiotics despite the lack of evidence to support this practice (see JW Oct 15 2000, p. 158, accession number 000926001, and Ann Intern Med 2000; 133:367).

To standardize the clinical and research approach to prostatitis, an NIH consensus conference recently developed the following 4 categories (see JAMA 1999; 282:236):

I. acute bacterial prostatitis

II. chronic bacterial prostatitis

III. chronic prostatitis/chronic pelvic pain syndrome

A. inflammatory (leukocytes present in secretions, urine, or semen)

B.…