Chronic prostatitis (CP) is a common disease that occurs in young and middle-aged men, with a high prevalence, low cure rate, and easy recurrence, which affects the quality of life of patients. The epidemiology and pathogenesis of the disease have been studied at home and abroad, but there are still no uniform diagnostic criteria, and there are some problems in treatment that should be of concern to clinicians. 1, the epidemiology of chronic prostatitis At present, there are more epidemiological studies of chronic prostatitis abroad, however, due to different diagnostic criteria, ethnicity, region, and social background, the prevalence reported in the literature varies widely, ranging from 2.0% to 16.0% . With the application of the Chronic Prostatitis Symptom Score Index (NIHCPSI), there is a basis for epidemiological investigation of chronic prostatitis-like symptoms. The NIHCPSI method is often used to investigate prostatitis-like symptoms, which mostly uses the Nickel criteria (pain in the perineum and/or after sex and a pain symptom score (total score 0-21) ≥ 4 is diagnosed as prostatitis-like symptoms). The findings on the occurrence of prostatitis-like symptoms in various countries are shown. In China, a questionnaire survey related to prostatitis-like symptoms was completed in 2007~2008 in 15 000 cases of men aged 15~60 years old in five provinces and cities, including Anhui, Beijing, Xi’an, Guangzhou and Gansu, representing the northern, central, southern and western regions of China . The survey included 30 items such as NIHCPSI, lifestyle habits, IIEF5, etc. The results received 12,743 valid questionnaires (84.95%). According to the NIHCPSI prostatitis symptom criteria, 1,071 cases had prostatitis-like symptoms, and the prevalence of prostatitis-like symptoms in China was 8.4%, which was slightly lower than the 9.7% identified by Nickel et al. in 2,987 Canadian community men with prostatitis-like symptoms by NIHSPSI score. Our prostatitis-like symptoms were mostly mild and moderate (47.8%, 48.4%). The results of the study found that 4.5% had been diagnosed with chronic prostatitis, which is close to the findings of Moon et al. who found that about 5% of men aged 20-48 years had been diagnosed with chronic prostatitis in a questionnaire survey. The highest percentage of people with prostatitis-like symptoms (12.0%) was found in those aged 31-40 years, and the incidence of prostatitis-like symptoms was significantly higher in those older than 30 years (11.2%) than in those younger than 30 years (5.3%). It is suggested that age is one of the factors affecting the prevalence of prostatitis-like symptoms, and the prevalence of prostatitis-like symptoms increases with age, which is consistent with the trend of increasing prevalence with age reported by Mehik et al. The relationship between prostatitis-like symptoms and smoking and alcohol consumption was analyzed and it was found that 734 (10.8%) of the 6,825 investigators who smoked regularly had prostatitis-like symptoms, while 337 (5.7%) of the 5,918 investigators who did not smoke had prostatitis-like symptoms; 679 (9.6%) of the 7,082 investigators who drank regularly had prostatitis-like symptoms, while those who did not drink had prostatitis-like symptoms. In the 7,082 cases of frequent drinkers, 679 (9.6%) of them had prostatitis-like symptoms, while 392 (6.9%) of the 5,661 cases of non-drinkers had prostatitis-like symptoms. The study by Nickel, Parsons et al. also suggested that chronic prostatitis is also associated with poor lifestyle habits such as stimulating foods, alcohol consumption and smoking. The analysis of the surveyed subjects with or without other current sexual partners also revealed that the incidence of prostatitis-like symptoms in those with other sexual partners was 26.7% (281/1169), significantly higher than the population incidence of 8.4%. Mehik et al. showed that excessive sexual activity increased the incidence of prostatitis, and they found that the incidence was lower in divorced and single men than in married ones. The study revealed that the occurrence of prostatitis-like symptoms correlates with age, lifestyle habits (smoking, alcohol consumption), sexual partner status, literacy, ethnicity, and mood. It is important to further study the etiology and pathogenesis of the disease, while strengthening science education and reducing the exposure of susceptible factors, which will help prevent and reduce the occurrence of chronic prostatitis. 2, the diagnosis of chronic prostatitis Currently, the diagnosis of prostatitis is recommended NIH typing diagnosis, medical history, physical examination (such as rectal examination) and urinalysis (urine routine and culture) are considered to be the first basic tests that must be performed on any patient with initial onset. Most clinical symptoms of chronic prostatitis include pain and abnormal urination. Pain is mainly manifested as pain in the pelvic region and can be seen in the perineum, penis, perianal region, urethra, pubic bone, lumbosacral region, etc. Urinary abnormalities can be manifested as urinary urgency, frequency, painful urination, increased nocturia, etc. Due to chronic pain that remains untreated, patients have a decreased quality of life and may have sexual dysfunction, anxiety, depression, insomnia, memory loss, etc. In the routine examination of prostate massage fluid, there is diagnostic significance when leukocytes >10/HP and reduced number of lecithin vesicles, which is a criterion to distinguish inflammatory and non-inflammatory prostatitis . The relationship between the leukocyte count in prostate massage fluid and the severity of symptoms in 1,426 patients with chronic prostatitis was analyzed, and it was found that there was no parallel relationship between the leukocyte count in prostate massage fluid and clinical symptoms in patients with chronic prostatitis, which shows that the leukocyte count in prostate massage fluid is not consistent with clinical symptoms. This suggests that the clinical effect of treatment cannot be measured by the condition of the prostate massage fluid . For other tests related to chronic prostatitis, the NIHCPSI is recommended for symptom scoring, the “two-cup” or “four-cup” pathogen localization test, etc. If the patient’s urinary symptoms are predominant, urine flow rate and residual urine measurement are recommended. To make a definitive diagnosis and differential diagnosis, semen analysis or bacterial culture, prostate-specific antigen, urine cytology, transabdominal or transrectal ultrasound, urodynamics, CT, MRI, urethral cystoscopy, and prostate puncture biopsy are some of the tests available. In the diagnosis of chronic prostatitis, prostate massage fluid culture is the recommended item to use, considering the pathogen as the causative factor. In prostatitis culture fluid, the currently recognized pathogens are Gram-negative bacilli such as Escherichia coli spp. and possible pathogens are Gram-positive cocci such as Staphylococcus aureus, in addition to mycoplasma, chlamydia, anaerobic bacteria, and fungi can also be pathogens; and the pathogens that are currently difficult to culture such as viruses, Mycobacterium tuberculosis, and cell wall-deficient microorganisms are subject to further study . In patients with presumed chronic prostatitis and no previous history of urinary tract infection, more than 8% of patients had a positive culture of prostate massage fluid, but in asymptomatic men, the culture positivity rate was similar . It is believed that prostate massage fluid culture has no diagnostic value for chronic non-bacterial prostatitis and prostatodynia. A controlled study of 101 patients with chronic prostatitis and 68 healthy individuals also found that the positive rates of culture of mid-stage urine and EPS/post-massage urine in the group of patients with chronic prostatitis and healthy controls were 37.6%, 39.7% and 35.6%, 35.3%, respectively, with no statistically significant differences, and the differences in their pathogenic microbial species were not statistically significant, presumably bacteria, mycoplasma The difference in pathogenic microorganisms was not statistically significant.