Prostatitis is the most common urological diagnosis in men under 50, and it can affect men of any age from adolescence onward. It accounts for approximately 25% of all urological office visits in young and middle-aged men, yet it remains one of the most misdiagnosed and mismanaged conditions in urology.
The Four Categories
Acute bacterial prostatitis (Category I) is a sudden, severe infection causing high fever, chills, low back and genital pain, and difficulty urinating — a medical emergency. Chronic bacterial prostatitis (Category II) causes recurrent urinary tract infections from persistent bacteria. Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS, Category III) is by far the most common, accounting for over 90% of cases — defined by pelvic pain lasting more than three months without evidence of infection.
Symptoms of Chronic Prostatitis
The hallmark is pelvic pain — in the perineum, penis, testes, lower abdomen, or lower back. Pain may worsen with sitting, ejaculation, or bowel movements. Urinary symptoms and sexual dysfunction frequently accompany it. Symptoms fluctuate, with periods of relative relief followed by flares.
Treatment
Treatment of CP/CPPS requires a multimodal approach. Alpha-blockers relax prostate and bladder neck muscles, improving flow and reducing pain. Anti-inflammatory medications, antibiotics, and pelvic floor physical therapy all have roles. Natural remedies including quercetin and saw palmetto have supportive evidence. We incorporate natural approaches alongside conventional medicine where evidence supports their use.