Characterization and Treatment of Category III Prostatitis Background: Chronic abacterial prostatitis and prostatodynia (NIH Category III), remains a frustrating enigma for North American physicians and patients. Our definition of the syndrome is unclear, the etiology is obscure, the relevance of the only objective finding we have (leukocytosis) is unknown, symptoms are highly variable, the natural history of the disease has not been adequately studied and the clinical treatment trials are poorly designed, small and inconclusive. Objectives: To collaboratively develop validated NIH assessment instruments for the study of Category III prostatitis, analyze objective microscopic, microbiological, immunological and molecular biological parameters and develop a long term collaborative multicenter study in which a number of potential standardized treatment protocols could be tested. Research Design: Part 1: Retest, revalidate and revise as necessary the Principal Investigator's published prostatitis specific Symptom Frequency Questionnaire (SFQ) and Symptom Severity Index (SSI) in 100 prostatitis patients presently being studied and 100 age matched control patients. These modified indices would be subsequently used as the basis for a consensus and evidence based NIH prostatitis specific symptom assessment instrument to be tested prospectively in 200 prostatitis and 100 control patients. Part 2: Analyze objective microscopic, microbiological, immunological and molecular biological aspects of expressed prostatic secretions, semen and urine specimen after prostatic massage in these 300 patients. of potential standardized treatment protocols (conservative, antibiotic, alpha blockade and repetitive prostatic massage; alone or in combination) will be tested in patients enrolled in part l and part 2. Results from this 3 part study will be analyzed and correlated between groups and within groups, both concurrently and sequentially.
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