Chronic prostatitis in Korea: a nationwide postal survey of practicing urologists in 2004

Aim: To examine the diagnosis and treatment of chronic prostatitis by means of a nationwide postal survey of practicing urologists in 2004. Methods: A random sample of 850 Korean urologists from the Korean Urological Association Registry of Physicians were asked to complete a questionnaire that explored practicing characteristics, attitudes and diagnostic and treatment strategies in the management of chronic prostatitis. Results: Of the 850 questionnaires sent, 302 were returned (response rate 35.5%) and 275 were induced in the final analysis. More than 50% believed in a multifactorial etiology for chronic prostatitis and 52% considered chronic abacterial prostatitis to be bacterial in nature. For routine diagnostic assessment, the most commonly used tests were reported to be urinalysis (95.3%), analysis of expressed prostatic secretions (89.5%) and digital rectal examination (81.1%). Only a few urologists use specific lower urinary tract cultures. Symptom assessment according to the National Institute of Health-Chronic Prostatitis Symptom Index was less frequently used (12.7%). First choices for therapy included antibiotics (96.4%), alpha-blockers (71.6%) and sitz baths (70.5%). If unsuccessful, urologists frequently continued to prescribe a second course of either alpha-blockers (69.5%) or antibiotics (57.8%). Conclusion: These data provide a picture of current practice regarding the management of chronic prostatitis in Korea. The diagnostic and treatment practices for prostatitis do not follow standard textbook algorithms. Further studies are needed to elucidate the etiology and pathogenesis of chronic prostatitis and to establish guidelines for its diagnosis and treatment.