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Prostatitis is defined as inflammation or infection of the prostate. Simplistically, prostatitis can be divided into two
groups; bacterial and non-bacterial. Bacterial may be divided into acute and chronic while non-bacterial prostatitis is
generally recognized as chronic.
The National Institute of Health developed and accepted the latest definition of prostatitis primarily guided by the
presence of chronic pelvic pain associated with the more traditional acute and chronic clinical presentation.
While I refer you to the formal paradigm presented by the NIH for a complete understanding, the most common presentation
is Type IIIA or non-bacterial, inflammatory prostatitis (reference Figure 1). While prostatitis may be acute,
(associated with systemic findings of fever, chills and rigors (shakes), most cases of prostatitis are chronic and tend
to be incurable, with relatively frequent recurrences despite optimal traditional treatment.
Unfortunately, traditional therapy involves the use of antibiotics, which are effective in less than 5% of cases, as a
remedy for non-bacterial prostatitis, although, antibiotics may improve symptoms temporarily secondary to an
anti-inflammatory mechanism.
NIH Classification and Definitions of Prostatitis
| I. |
Acute bacterial prostatitis: acute infection of the prostate |
| II |
Chronic bacterial prostatitis; recurrent infection |
| III |
Chronic abacterial prostatitis; chronic pelvic pain syndrome –
no demonstrable infection |
| IIIA |
Inflammatory CPPS: WBCs in semen/EPS/voided bladder urine (VB3) |
| IIIB |
Non-inflammatory CPPS: no WBCs in semen/EPS/VB3s |
| IV |
Asymptomatic inflammatory prostatitis: no subjective symptoms;
detected either by prostate biopsy or presence of WBCs in prostatic secretions during evaluation for other disorders |
AUA Symptom Score: Devised by and validated to assist
physicians in determining the importance of voiding symptoms to their present clinical status. A score of 1-7 indicates
mild symptoms, 8-19 indicates moderate symptoms, while 20-35 indicates severe symptoms. The higher the number, the
greater the risk to the patient for a myriad of signs and symptoms that may become incompatible with quality of life.
BPH: Benign Prostatic Hyperplasia. An increase in the number of Prostate Cells believed to be associated with
genetics and hormonal influence.
Double Blind Study: A study where neither the physician nor patient knows the active ingredient from the placebo.
This study format frequently shapes the health care approach to disease.
EPS: Expressed Prostatic Secretion. A procedure performed at the time of Digital Rectal Exam whereby the prostate
is massaged to yield a secretion that is evaluated under the microscope. A culture of the EPS yields a bacterium as the
causative agent in fewer than 10% of cases.
IPSS: The International Prostate Symptom Score reflects 7 questions that validate the importance of voiding
symptoms to the quality of life of patients. While the AUA Symptom Score asks the same questions, the IPSS also asks the
all important and critical lifestyle question. This latter question usually determines the patient's interest in
intervention.
LUTS: Lower Urinary Tract Symptoms
Mid-Stream Clean Catch: The process of providing a urine specimen during the middle of the stream. This technique
is classically inaccurate and should not be used as a basis to treat with antibiotics
PEENUTS: A Patented, Synergistic blend of Antioxidants, Anti-Inflammatories, Beta-Sitosterols, and Immune
Stimulants that has shown to be of Benefit versus the Signs and Symptoms of Prostatitis.
Placebo: A sugar or starch pill/capsule that is intended to make willing subjects believe that it is the active
ingredient. A Placebo is commonly used in double blind studies.
Prostate: A walnut sized organ in health that supplies lubricant to sperm during the fertility years. This organ
is closely tied to urination and sexual abilities.
Prostatitis: An inflammatory response associated with the Prostate. 95% of Prostatitis cases are non-bacterial
and do not require antibiotics. In the case of fever, chills, and shakes (Rigors), associated with voiding symptoms, the
likelihood for a bacterial infection is higher and may support the use of antibiotics. Non-bacterial Prostatitis cases
require a Prostate Nutritional Formula like the Patented PEENUTS formula. Prostatitis is common to almost all adult men
and is associated with an elevated EPS, voiding symptoms, sexual dysfunction, and a PSA of one or greater than one.
Prostate Biopsy: A technique associated commonly with an ultrasound machine whereby, small pieces of tissue are
obtained from the prostate for Pathologic Evaluation. The number one reason that Prostate Biopsy is performed is the PSA
blood test. This test is accurate in diagnosing Prostate Cancer 20-30% of the time on average, nationally. Thus, 70-80%
of all prostate biopsies are negative and likely indicate Prostatitis as the primary reason the biopsy was performed.
PSA: Prostate Specific Antigen, "The Barometer of Prostate Health" is a poor test for Prostate Cancer detection,
but a great test to judge the health of the prostate.
Urethritis: Inflammation, not infection, of the urine tube commonly associated with frequency and urgency of
urination. This inflammatory response in more common in women than men.
UTI: Urinary tract infection typically associated with a bacterial cause.
Voiding Symptoms: Symptoms including frequency, urgency, slow stream and nocturia associated with the disease
processes of Prostatitis and BPH in men. In women these symptoms are more common to inflammation than infection.
White Blood Cells: Indicate an inflammatory response that may or may not be associated with a bacterium.
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