Prostatitis and Chronic Pelvic Pain Syndrome
The modern description of the clinical presentation of prostatitis was established by the turn of the twentieth century by Young, Gereghty, and Stevens.1 For most of the last century, prostatic massage constituted the mainstay of therapy,2 although with the introduction of sulfonamides and prostate localization techniques by Meares and Stamey,3 antibiotics have taken a more dominant role. Unfortunately, antibiotics did not represent a panacea for this difficult clinical entity, especially for patients without an identified bacterial cause for their symptoms.
Prostatitis is the most common urologic diagnosis in men younger than 50 years and the third most common urologic diagnosis in men older than 50 years after benign prostatic hyperplasia (BPH) and prostate cancer. There were almost two million U.S. physician visits annually from 1990 to 1994 with prostatitis listed as the diagnosis.4 Symptoms of prostatitis wax and wane, with approximately one third to one half of patients experiencing relief of symptoms over a one-year period.
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