Editing Chronic Pelvic Pain Syndrome & Prostatitis (section)

=== Clinical presentation ===

* '''<span style="color:#ff0000">Category I: acute bacterial prostatitis</span>'''
** '''<span style="color:#ff0000">Acute onset of pain combined with LUTS (storage and voiding) and signs of sepsis</span>'''
*** Pain may be perineal and suprapubic, and there may be associated pain or discomfort of the external genitalia.
*** Usually there are significant systemic symptoms including fever, chills, malaise, nausea and vomiting, and even frank septicemia with hypotension.
** '''≈5% of patients with acute bacterial prostatitis may progress to chronic bacterial prostatitis'''
* '''<span style="color:#ff0000">Category II: chronic bacterial prostatitis</span>'''
** '''<span style="color:#ff0000">Associated with a history of documented recurrent UTIs (i.e., cystitis)</span>'''
*** The recurrent UTIs are secondary to areas of focal uropathogenic bacteria residing in the prostate gland
* '''<span style="color:#ff0000">Category III: chronic pelvic pain syndrome</span>'''
** '''<span style="color:#ff0000">The predominant symptom is pain,</span> which was most commonly localized to the perineum, suprapubic area, and penis but can also occur in the testes, groin, or low back.'''
** '''Pain during or after ejaculation is one of the most prominent, important, and bothersome features in many patients.'''
** '''Storage and voiding urinary symptoms including urgency, frequency, hesitancy, and poor interrupted flow are associated with this syndrome in many patients.'''
** '''Presenting symptoms of inflammatory category IIIA are indistinguishable from those of non-inflammatory category IIIB CP/CPPS'''
** '''By definition, <span style="color:#ff0000">the syndrome becomes chronic after 3 months’ duration.</span>'''
** The symptoms tend to wax and wane over time
*** ≈1/3 of patients improve over 1 year (usually patients with a shorter duration of illness and fewer symptoms)
** Quality of life of many patients diagnosed with CP/CPPS is greatly diminished
* '''Category IV: asymptomatic prostatitis'''
** Detected incidentally (e.g. prostate biopsy)