Chronic prostatitis called common condition in American men

A new estimate shows that chronic prostatitis, especially nonbacterial prostatitis, is common in American men and that most diagnosis and treatment take place in the primary care setting.

The incidence of chronic prostatitis was 4.9 per 1,000 men per year, and that of chronic nonbacterial prostatitis (chronic pelvic pain syndrome) was 3.3 per 1,000 men per year. That translates to 270,000 new diagnoses of CPPS annually in the United States, said J. Quentin Clemens, MD, of Northwestern University Feinberg School of Medicine, Chicago.

Dr. Clemens and teams from Northwestern and Kaiser Permanente Northwest in Portland, OR, looked for all new diagnoses coded for chronic prostatitis in the HMO's database from May 2002 to May 2004 and reviewed charts of a sample of those patients to determine the proportion of different types of chronic prostatitis among those diagnoses.

The total male population between 25 and 85 years of age in the HMO's files during this time period accounted for 181,949 person-years. The team's database search for ICD-9 codes 601.1 (chronic prostatitis) and 601.9 (prostatitis, not otherwise specified) yielded 1,223 men with the diagnoses. Random review of 413 of these patient charts showed 280 new diagnoses made by HMO physicians. Of these, 189 patients had type III prostatitis (CPPS), 58 had type I or II (attributable to infection), and 33 had type IV (inflammation found incidentally on prostate biopsy).

In this HMO, primary care physicians made about three-fourths of the diagnoses. A majority of patients never saw a urologist. In fact, only one-third of the men who were seen by a primary care physician eventually saw a urologist.

"We in urology feel that prostatitis is a urologic condition, but the diagnosis really is being made much more commonly by primary care physicians," Dr. Clemens said.

Results of the analysis were presented at the AUA annual meeting.