Consensus development of a histopathological classification system for chronic prostatic inflammation

Objective To develop a standardized histopathological classification system for chronic prostatitis (standardized description of prostatic inflammator y infiltrates) based on a literature review, extensive prospective evaluati ons in two recognized prostatitis research centres and widespread consensus of international urological centres identified as having major expertise o r interest in chronic prostatitis. Methods Relevant articles for review were identified by a Medline search un dertaken by the Cochrane Review Group in Prostate Diseases and Urologic Mal ignancies, and cross-checking bibliographies of retrieved studies, reviews, book chapters and abstracts of the American Urological Association and Int ernational Prostatitis Collaborative Network Annual Meetings. Initial draft s were based on classification systems independently developed by the Prost atitis Research Centers at Queen's University in Canada and University of W ashington in the USA, A collaborative draft was distributed to 20 urologica l/pathological clinical centres who participated in the North American Chro nic Prostatitis Collaborative Research Network and First International Pros tatitis Collaborative Network. A consensus classification system was then d istributed to the participating panel for acceptance. Results The literature review identified a reasonably consistent descriptio n of inflammatory infiltrate locations and patterns that were further incor porated into the draft based on the Queen's University and University of Wa shington proposals. Eighteen (90%) of the identified Prostatitis Centers pa rticipated in the revision of the draft and the final consensus process. Th e final consensus document classifies prostatic inflammation according to i ts extent and grade/severity in each tissue compartment (location). Conclusion The consensus of the expert panel was that this classification s ystem can be used in the evaluation of prostatic inflammation in prostate b iopsies, transurethral resected prostate chips or prostatectomy specimens. A standardized accepted framework to describe histopathological prostate in flammation will prone useful in evaluating prostate disease.