Prostatitis, Orchitis, and Epididymitis

CPSI to assess prostatitis symptoms, from Litwin 1999

Bacterial prostatitis

Acute prostatitis (I)

Chronic prostatitis (II)

Chronic Prostatitis + Pelvic Pain Syndrome (IIIa+IIIb)

Pelvic pain index, from Clemens 2009

Potential causes


Treatment via "UPOINT" system (honestly outdated)

Types of Prostatitis (in table form)

NIH Classification Symptoms Pyuria? Bacteruria? Treatment Key findings
Acute bacterial (I) UTI symptoms
Systemic (fever/chills)
Pelvic pain
Yes Yes PO/IV antibiotics x2-4 weeks
6mo if TB related
Acute infectious + systemic symptoms
Chronic bacterial (II) Recurrent UTIs Yes Yes, 10x increase after prostate massage Antibiotics x4-6 weeks Recurrent UTI with same organism
Chronic prostatitis/pelvic pain
Inflammatory (IIIa)
Pelvic pain without positive urine cultures Yes (especially after prostate massage) No UPOINT Pelvic pain in absence of infectious symptoms
Chronic prostatitis/pelvic pain
non-Inflammatory (IIIb)
No (even after prostate massage)
Asymptomatic inflammatory (IV) None Yes No None Discovered incidentally on biopsy/semenalysis

Other prostatic infection

Prostate abscess

Post-prostate biopsy sepsis

Granulomatous prostatitis

IgG4 prostatitis