Health Concerns of Patients With Nonbacterial Prostatitis/Pelvic Pain

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Abstract
Nonbacterial prostatitis accounts for about 2 million ambulatory visits annually in the United States.1 Despite its prevalence (estimated at 5%-16%2-6) and negative impact on patients’ quality of life,7,8 little is certain about the etiology, diagnosis, and treatment of this syndrome involving pelvic pain with or without voiding symptoms. Although labels of prostatitis and prostatodynia are commonly applied to these symptoms, associated prostate disease is unproven. Reflecting the unknown etiology in over 90% of cases,9,10 the National Institutes of Health (NIH) classification has labeled chronic male pelvic pain in the absence of bacteriuria as chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).11 Gold standard diagnostic tests and evidence-based treatments are lacking,10,12,13 and little is known about the natural history. Although this syndrome has been the subject of increased attention over recent years in the urology literature, it has received relatively little notice in primary care journals.