What Are The Diagnosis Of Chronic Prostatitis or CPPS?

There are no definitive diagnostic tests for CP/CPPS. This is a poorly understood disorder, even though it accounts for 90%-95% of prostatitis diagnoses. It is found in men of any age, with the peak onset in the early 30s.

CP/CPPS is subcategorized as:

• Category IIIa or inflammatory - urine, semen, and other fluids from the prostate contain pus cells (dead white blood cells or WBCs)
• Category IIIb or non-inflammatory - no pus cells are present

Based on levels of pus cells in expressed prostatic secretions, these subcategories are of limited use clinically.

Recent studies have questioned the distinction between categories IIIa and IIIb, since both categories show evidence of inflammation if pus cells are ignored and other more subtle signs of inflammation, like cytokines, are measured.

In 2006, Chinese researchers found that men with categories IIIa and IIIb both had significantly and similarly raised levels of anti-inflammatory cytokine TGFβ1 and pro-inflammatory cytokine IFN-γ in their expressed prostatic secretions when compared with controls; therefore measurement of these cytokines could be used to diagnose category III prostatitis.

For CP/CPPS patients, analysis of urine and expressed prostatic secretions for leukocytes is debatable, especially due to the fact that the differentiation between patients with inflammatory and non-inflammatory subgroups of CP/CPPS may not be useful. Serum PSA tests, routine imaging of the prostate, and tests for Chlamydia trachomatis and Ureaplasma are not really proven to provide benefit for the patient.

Extraprostatic abdominal/pelvic tenderness is present in half of the patients with chronic pelvic pain syndrome but only 7% of controls.