Prostatitis. Work-up and treatment of men with telltale symptoms

Prostatitis describes a spectrum of disorders involving inflammation of the prostate gland. This common yet poorly understood condition produces an array of symptoms, the most common of which are urinary obstruction, perineal pain, and ejaculatory complications. Although several theories have been proposed regarding its etiology, the exact mechanism of disease remains elusive. Definitive diagnosis can be hampered by a somewhat cumbersome testing procedure, but symptomology tends to be a reliable guide for treatment. Although treatment with antibiotics often fails, the fluoroquinolones are among the most effective agents for symptom management. Other interventions that may be appropriate include alpha-1-adrenergic blockers, a 5-alpha reductase inhibitor, or surgery. Chronic prostatitis may result in repeated urinary tract infections and chronic pain syndromes.