Which specialist consultations may be beneficial in the treatment of chronic bacterial prostatitis (CBP)?

Updated: Jan 15, 2019
  • Author: Samantha D Kraemer, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Consultation with a urologist may be appropriate for men with relapsing chronic bacterial prostatitis (CBP) or for situations in which the diagnosis is unclear. A urologist may be able to properly perform the bacterial localization studies necessary to diagnose CBP (see Workup/Urinary Tract Localization Tests).

In the author's experience, most primary care physicians are not comfortable or experienced with obtaining the necessary specimens. Semen cultures or the 2-cup test with urine cultures collected before and following prostatic massage are simpler and represent effective alternatives to the 4-cup test.

Involvement of a multidisciplinary team approach has been recommended by the Prostatitis Expert Reference Group for patients who do not respond to initial treatments. The team may include urologists, pain specialists, nurse specialists, physiotherapists, cognitive behavioral therapists or psychologists, sexual health specialists, and general practitioners. [26]  Especially in patients with persistent pain, referral to pain specialists to target neuropathic pain should be considered.


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