ABSTRACT
Chronic prostatitis or chronic pelvic pain syndrome, formerly known as prostatodynia, refers to any unexplained pelvic pain experienced in men. Often this pain is associated with irritative voiding symptoms and/or pain located in the groin, genitalia, or perineum in the absence of pyuria and bacteriuria. The typical patient is a young- to middle-aged man who presents with a variable array of chronic, irritative, and/or obstructive voiding symptoms, accompanied by moderate to severe pain in the pelvis, lower back, perineum, and/or genitalia. Symptoms parallel those experienced by persons with chronic bacterial and nonbacterial prostatitis. Digital rectal examination may reveal a tight anal sphincter. When the anal sphincter tone is hyperactive, an underlying spastic neuropathy must be excluded. Videourodynamic evaluation may uncover evidence of a spastic dysfunction of the bladder neck and prostatic urethra. Formal flow rate studies often show intermittency of flow and weakening of the urinary stream with a diminished peak urinary flow rate.
