The patients indicate a wide array of complaints in chronic prostatitis. They may have distinct pain in the pelvis or perineum, that can be forwarded to the back, the penis, the testicles or the thigh. Most patients indicate more or less LUTS like urgency, frequency, dysuria, nocturia, or reduction of the urine stream. Up to 70 % of the patients may have an erectile dysfunction. The symptoms may occur slow-growing and have typically a characteristic undulated course.

In patients with chronic prostatitis (CP), the etiology of urinary tract infections mainly E. coli is undisputable, while the role of Chlamydia Trachomatis and Mycoplasms are less clear. Other infectious causes are only found in rare cases. One known pathogenetic factor in chronic bacterial prostatitis is the reflux of infected urine into the prostatic ducts. However, in CPPS a lot of etiologic aspects have been discussed (e.g. postinfectious, physical mechanisms, autoimmune, psychogenic, neurogenic, infravesical obstruction) (Table 7.2).