Habermacher Geoffrey M, Chason Judd T, Schaeffer Anthony J
Department of Urology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA.
Annu Rev Med. 2006;57:195-206. doi: 10.1146/annurev.med.57.011205.135654.
We review the diagnosis, categorization, and treatment of prostatitis/chronic pelvic pain syndrome based on the National Institutes of Health (NIH) classification. Prostatitis is an extremely common syndrome that afflicts 2%-10% of men. Formerly a purely clinical diagnosis, prostatitis is now classified within a complex series of syndromes (NIH category I-IV prostatitis) that vary widely in clinical presentation and response to treatment. Acute bacterial prostatitis (category I) and chronic bacterial prostatitis (category II) are characterized by uropathogenic infections of the prostate gland that respond well to antimicrobial treatment. In contrast, chronic prostatitis/chronic pelvic pain syndrome (category III), which accounts for 90%-95% of prostatitis cases, is of unknown etiology and is marked by a mixture of pain, urinary, and ejaculatory symptoms with no uniformly effective therapy. Asymptomatic inflammatory prostatitis (category IV) is an incidental finding of unknown clinical significance. This review describes the current status of prostatitis syndromes and explores the future prospects of new diagnostic tools and therapies.
我们基于美国国立卫生研究院（NIH）的分类方法，对前列腺炎/慢性盆腔疼痛综合征的诊断、分类及治疗进行综述。前列腺炎是一种极为常见的综合征，困扰着2%至10%的男性。前列腺炎过去纯粹依靠临床诊断，如今被归类于一系列复杂的综合征（NIH I-IV类前列腺炎）中，这些综合征在临床表现和对治疗的反应上差异很大。急性细菌性前列腺炎（I类）和慢性细菌性前列腺炎（II类）的特征是前列腺受到尿路致病性感染，对抗菌治疗反应良好。相比之下，慢性前列腺炎/慢性盆腔疼痛综合征（III类）占前列腺炎病例的90%至95%，其病因不明，以疼痛、泌尿及射精症状混合为特征，且没有统一有效的治疗方法。无症状性炎症性前列腺炎（IV类）是一种偶然发现，其临床意义不明。本综述描述了前列腺炎综合征的现状，并探讨了新诊断工具和治疗方法的未来前景。
