Prostatitis is defined as when urethritis, cystitis and tonsillitis inflame prostatic tissue through blood vessels or lymphatic ducts or unknown factors inflame the tissue.
Medical scientists define prostatitis as when leukocytic or lymphocytic infiltration is microscopically observed in prostatic fluid. In some cases the case, where at least 10 abnormal leukocytes are observed by a high-powered microscope (400 times), is defined as prostatitis. In other cases, when patients complain of symptoms such as perineal pain, hypogastric pain, orchialgia, urinary frequency, and urinary inertia, is defined as prostatitis.
Prostatitis is frequently observed to the extent that about 3o% of males in their twenties to fifties suffer from prostatitis, and at least 25% of urologic outpatients complain of the disease. Ordinarily, patients with prostatitis complain of urinary abnormalities such as urinary frequency, pyuria and residual urine, pains such as hypogastric and perineal pains, sexual hypofunction, premature ejaculation, and mental distress.

■ Cardinal Symptoms of Prostatitis
Urinary Abnormalities
In the case of prostatitis, frequent urination, urinary inertia, and residual urine occur. It is because the prostate, which lies right underneath the urinary bladder, causes congestion and irritates the urinary bladder; or because such symptoms occur due to the urethral sphincter that gets out of order.

Pains and Dysphoria
Perineal pain, hypogastric pain and dysphoria, orchialgia, dysuria and lumbago may occur. The prostate is situated deep in the pelvic cavity behind the pubis and blood vessels and nerves run around it. In the case of an inflamed prostate, prostatic tissue is congested and irritates the nerves around it causing pain in the anus, the perineum and the hypogastric region. At the same time, orchialgia, pelycalgia and bubonalgia may occur.

Sexual Hypofunction
Structurally, the ejaculatory duct, connected to the deferent duct, goes through the prostate and is connected to the urethra. In the process of ejaculation, sperm in the seminal vesicles and prostatic fluid are ejected through the ejaculatory duct and the urethra. As it irritates the ejaculatory duct, and urethra, sexual problems such as erectile insufficiency, hyposexuality, and ejaculatory pain occur.

Mental Distress
Prostatitis causes pain to patients mentally, because they become frustrated by the relentlessess of the disease and wonder if they will ever be able to enjoy life again

Other Symptoms
In some cases prostatitis causes urethritis, myalgia all over the body, and chronic fatigue.


■ Classification of Prostatitis
Acute Bacterial Prostatitis
Acute bacterial prostatitis is caused by a bacterial infection, and acutely progresses along with a high fever, rigor and myalgia. In addition, the patient frequently passes urine and will likely feel pain in the process of passing urine. This form of prostatitis is the easiest to cure.

Chronic Bacterial Prostatitis
Chronic bacterial prostatitis is defined as the case where leukocytosis is microscopically observed and causal bacteria are detected as a result of bacterial culture. Urinary frequency, nocturia, hypogastric pain, perineal pain and penile pain may occur. If it is metastasized to the seminal vesicles, hemospermia may be observed.

Chronic Nonbacterial Prostatitis
Approximately 80 to 90% of patients with chronic prostatitis come within this category. No causal bacterium has been discovered, and it has also been reported that the partner is not infected. Patients complain of urinary frequency, urinary inertia, residual urine, hypogastric pain, perineal pain, dysuria, testicular soreness, premature ejaculation, erectile insufficiency and chronic fatigue.

Prostatalgia
Prostatalgia is when inflammatory findings are not observed by microscope or ultrasound but prostatitis like symptoms.

Others
The case, where inflammations are observed in prostatic fluid and tissue but the patient cannot feel any subjective symptoms, is defined as subclinical prostatitis.