OBJECTIVE:
Chronic Prostatitis is a health risk of unknown proportion to virtually every adult male. Although recent data suggests that the frequency of diagnosis of chronic prostatitis was equivalent to the benign prostatic hyperplasia (BPH) diagnosis; the clinical and economic impact suggested that this topic be more closely scrutinized. Despite the frequency of diagnosis of chronic prostatitis, the accuracy is questioned as few primary care physicians and only one third of urologists use the expressed prostatic secretion (EPS), the definitive diagnostic test. Finally, the treatment of either of these two disease entities is completely different, suggesting the possibility that many patients are treated inappropriately.

MATERIALS & METHODS:
We prospectively evaluated 235 consecutive men who presented at our clinic with any voiding symptoms. All men were queried for voiding concerns using a modified AUA symptom score. All men stating any level of voiding dysfunction underwent a prostate massage to yield and EPS. The EPS was quantified by microscopy by a registered laboratory technologist. A positive EPS was recorded if the slide demonstrated greater than 10 wbcs/high power field (400x).

RESULTS:
235 consecutive men with symptoms of voiding dysfunction were evaluated for chronic prostatitis. Men had an age range of 26-83 years. 81% of men aged 26-50 had chronic prostatitis, while 88% of men aged 50-83 years had chronic prostatitis.

CONCLUSIONS:
Chronic Prostatitis is more common than originally thought. Our data suggests that chronic prostatitis is ubiquitous and of epidemic proportion. It is our belief that voiding symptoms represent chronic prostatitis until proven otherwise. The clinical and economic impact suggests that health care dollars will be better utilized with an improved diagnosis. Without accuracy of diagnosis, application of treatment options make little to no medical economic sense.