Prostatitis: current perspective on diagnosis and management

Prostatitis is a common and important urological problem which affects men of all ages. It is a challenging condition to be diagnosed and treated. It is classified under four categories according to the National Institute of Health Classification (Category 1 - Acute bacterial prostatitis, Category 2- Chronic bacterial prostatitis, Category 3-Chronic prostatitis / chronic pelvic pain syndrome, Category 4 – Asymptomatic inflammatory prostatitis). The most common causative organism for both acute and chronic prostatitis is Escherichia coli. Investigation and treatment of prostatitis depend on the clinical presentation of the respective clinical category. Antimicrobials are the mainstay of treatment of acute bacterial prostatitis according to the culture and sensitivity pattern. Chronic bacterial prostatitis needs a long duration of treatment depending on clinical conditions and treatment response. Surgery is rarely indicated in bacterial prostatitis except for a prostatic abscess. Granulomatous prostatitis is an uncommon inflammatory condition with different management options for morphologically different entities. This review looks at each category's presentation, aetiology, diagnosis, treatment, and prognosis.