Prostate histopathology and the chronic prostatitis/chronic pelvic pain syndrome: A prospective biopsy study

Purpose: The chronic prostatitis/chronic pelvic pain syndrome is a common c linical syndrome characterized by lower genitourinary tract symptoms, parti cularly pain in the perineum or genitalia, voiding symptoms, such as dysuri a or frequency, and sexual dysfunction in the absence of uropathogens in th e urine or prostatic secretions. The term prostatitis is based on the presu mption that prostatic inflammation is important in the pathophysiology of t his syndrome. To our knowledge there has been no systematic characterizatio n of the degree and nature of inflammation in the prostate in symptomatic c ases. Materials and Methods: Prostate histopathology in 368 biopsies from 97 pati ents with the chronic prostatitis/chronic pelvic pain syndrome was characte rized.. Results: Prostatic inflammation was detected in only 33% of patients, inclu ding 29% with mild (less than 10 leukocytes per I mm. field) and 4% with mo derate (between 10 and 200) or severe (more than 200)infiltrate. Of the 3 p atients with moderate inflammation 1 had glandular, 1 periglandular and 3 m ultifocal or diffuse distribution of leukocytes in the interstitium Some pa tients had more than I pattern of inflammation. Conclusions: The finding of moderate or severe inflammation in only 5% of 9 7 patients argues for the need to reevaluate current concepts of the pathop hysiology of the chronic prostatitis/ chronic pelvic pain syndrome.