Differential Diagnosis Issues

differential diagnosis prostatitis CP/CPPS

The differential diagnosis of CP/CPPS can be a bit complicated, so you should always make sure you’ve seen at least one urologist before deciding that you have chronic prostatitis/CPPS. Here’s why. Patients with supposedly “classic” prostatitis symptoms may turn out to have IC (bladder pain syndrome) or any number of other conditions, including urethral stricture, invasive bladder cancer, prostate cancer (with a normal PSA), varicoceles (pain disappears after repairing them), congenital seminal vesicle obstruction, entrapped nerve pain after inguinal hernia repair and primary bladder dysfunction (complete response to pharmacotherapy aimed at bladder muscle and bladder neck problems). That’s why seeing a urologist is essential as a first step.

Differential diagnosis: sorting one condition from another

For completeness, here is a list of some of the afflictions to which the prostate is prone (in no particular order):

  • urethral stricture (common)
  • a granulomatous condition of the prostate accompanying Wegener’s Granulomatosis
  • allergic granulomatous prostatitis
  • allergic prostatitis (Lopatkin, NA et al 1990)
  • amyloid deposits in the prostate during amyloidosis
  • atypical prostate stromal lesions (e.g. extramedullary hematopoiesis in the prostate)
  • autoimmune pancreatitis-associated prostatitis (IgG4-related autoimmune prostatitis)
  • eosinophilic cystitis (can affect the prostate)
  • fistulae from adjacent organs
  • fungal infections of the prostate (e.g. Aspergillus prostatitis, blastomycosis, coccidioidomycosis, phycomycosis etc), usually seen in the immunocompromised
  • malakoplakia/malacoplakia of the prostate
  • melanosis of the prostate
  • prostate stones (calculi)
  • prostatic sarcoidosis
  • prostatic telangiectasia in von Willebrand’s disease
  • sclerosing adenosis of the prostate
  • seminal vesiculitis may cause prostate symptoms
  • the prostatitis accompanying Reiter’s Syndrome
  • tuberculosis of the prostate
  • various abscesses and cysts (e.g. utricle, Mullerian duct cyst, hemorrhagic prostatic cyst, emphysematous prostatic abscess, hydatid cyst, histoplasma prostatic abscess)
  • various benign and malignant tumors found in the prostate
  • various other forms of Granulomatous Prostatitis (polytetrafluoroethylene (Teflon)–induced prostatitis, silicone-induced prostatitis, and giant cell arteritis).

For frequency and urgency, which are not necessarily part of CPPS, Campbell’s Urology 2002 Edition lists these as some of the causes:

  • Urinary tract infection
  • Bladder pain syndrome/interstitial cystitis (BPS/IC) (now seen as part of CPPS)
  • Upper motor neuron lesion
  • Habit
  • Large fluid intake
  • Bladder calculus
  • Urethral caruncle
  • Radiation cystitis
  • Large postvoid residual
  • Genital condyloma
  • Diabetes mellitus
  • Periurethral gland infection
  • Chemical irritants
  • Detrusor instability
  • Diuretic therapy
  • Bladder cancer
  • Urethral diverticulum
  • Pelvic mass
  • Chemotherapy
  • Bacterial urethritis
  • Renal impairment
  • Diabetes insipidus
  • Atrophic urethral changes

Throw out the antibiotics and try these….

Q-Urol

Q-Urol for prostatitis

Buy 1 get 1 FREE! Remember, use code 50UROL18. There is no better anti-prostatitis medication on the market, period. Q-UROL offers all of the benefits of Prosta-Q, but with time release technology and extra strength anti-inflammatory power. Published studies prove that both quercetin and pollen extract (also known as cernilton) calm CPPS symptoms. The combination is very effective for the majority of patients, and has been shown in published urological studies to help maintain prostate health and specifically target pelvic or genital discomfort.

BP-Qmax

BP-Qmax for prostatitis and BPH

Buy 1 get 1 FREE! Remember, use code 50QMAX19. BPH and Prostatitis share many symptoms. The proprietary blend of clinically proven all-natural ingredients found in BP-Qmax was developed in collaboration with leading urologists at major medical centers to assist men with prostate and urinary health issues and provide support for those seeking powerful, but natural, prostate health support. Contains optimum amounts of Beta-Sitosterol, Saw Palmetto, Flower Pollen and enzymes, as studied by academic urologists. Reduce nighttime urination and sleep through the night with BP-QMax™

TriverexMD and Trinoboost

trinoboost and triverex for libido repair

Buy 1 get 1 FREE! Remember, use code 30TRIN456. Trinoboost increases levels of nitric oxide (NO), vital for erections. TriverexMD contains Panax Ginseng, which has extensive clinical evidence (7 human clinical studies) proving effective for boosting male sexual health, especially erectile dysfunction. Try these natural remedies and avoid harmful ED drugs.

MultiRight

Multiright acide free vitamins

Buy 1 get 1 FREE! Remember, use code 2Multi3295. MultiRight is the only pH neutral, low acid multivitamin which means that it’s more bladder friendly than ever!  Most multivitamins are acidic (usually because of the cheap form of Vitamin C they contain) and can burn inflamed bladders, prostates and urethras. This product won’t do that. Kill the burn now!

Farr Labs

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