Prostatitis.

Classification of patients with prostatic complaints into one of the categories of bacterial or nonbacterial prostatitis or prostatodynia (see Table 3) enables a physician to give rational advice to men with confusing symptoms. By examining the prostatic fluid of patients with prostatic symptoms, a physician may easily identify those men with prostatodynia who will never respond to antimicrobial or anti-inflammatory agents. Carefully obtained fractionated cultures of the urine will usually distinguish patients with bacterial and nonbacterial prostatitis, so that only those men who have bacterial prostatitis are treated with long courses of antimicrobial agents. Although recent measurements documenting elevated IgA and IgG in the EPS of men with nonbacterial prostatitis support theories of an antigenic cause for the prostatic inflammation and symptoms, the causes for this inflammation must still be identified. In addition, the etiology of prostatodynia is also unclear. As a result, the optimal treatment for most patients with nonbacterial prostatitis and prostatodynia remains unknown.