Prostatitis is a common condition that accounts for a significant number of visits to both the emergency department and the urologist. The precise pathogenic mechanism of prostatitis is not known. The most prevalent theory is that reflux of urine from the urethra into the intraprostatic ducts promotes ascending infection and leads to chemical or bacterial prostatitis. Treatment is challenging because many antimicrobial agents do not effectively diffuse into prostatic tissue and many cases of prostatitis are not found to have an infectious etiology. Prostatitis can be divided into different classifications which range from acute severe infections, to chronic indolent infections, to chronic pain syndromes. The differentiation and management of these entities can be difficult. This article seeks to clarify the different infections, and provide a rational approach to treatment and disposition of these patients.
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