Table 1.

Clinical Utility of Alpha-Blockers in the Various Prostatitis Syndromes

		Clinical Utility of
Category	Clinical Definition	Alpha-Blocker Therapy	Evidence
National Institutes of
Health prostatitis categories
Category I	Acute infection of the prostate	Adjuvant therapy (with antibiotics)	Weak
Acute bacterial prostatitis		to improve obstructive urinary symptoms
Category II	Chronic infection of the prostate	Adjuvant therapy (with antibiotics) to	Weak
Chronic bacterial prostatitis	characterized by recurrent lower	reduce recurrence rate
	urinary tract infections
Category III	Genitourinary pain associated	Long-term therapy for amelioration	Strong
Chronic prostatitis/chronic	with negative bacterial cultures	of symptoms
pelvic pain syndrome
Category IV	Inflammation noted in prostate	No clinical utility; however, may	None
Asymptomatic inflammatory	specimens in men with no	be useful in the future in patients
prostatatis	specific prostatitis symptoms	with co-occurring BPH
Iatrogenic treatment-induced
prostatitis
TUMT induced	Prostatitis-urethritis occurring	Neoadjuvant and adjuvant therapy	Weak
	after TUMT	to decrease post-treatment LUTS
		and risk of acute urinary retention
Radiation therapy induced	Prostatitis-urethritis occurring	Neoadjuvant and adjuvant therapy	Weak
	after external beam radiotherapy	to decrease risk of acute urinary
	or brachytherapy radiation	retention in men with pretreatment LUTS
		Can be used to treat radiation
		cystoprostatourethritis
Co-occurring prostatitis
and BPH
Prostatitis and BPH	Prostatitis-like symptoms (eg,	Ameliorates LUTS associated with	Moderate
	pain on ejaculation) in patient	BPH and prostatitis, including
	with BPH-related LUTS	pain in some men

BPH, benign prostatic hyperplasia; TUMT, transurethral microwave thermal therapy; LUTS, lower urinary tract symptoms.