Abstract
BackgroundChronic prostatitis has been a common disease reported with high frequency in ankylosing spondylitis (AS) even from decades ago. Infectious (Chlamydia trachomatis) or non-infectious (uric acid) prostatitis can hypothetically trigger vertebral inflammation in AS. This study aimed to assess the features of chronic prostatitis in patients with AS compared to healthy controls.MethodsA cross-sectional study including male patients with AS and healthy controls who agreed to undergo a prostate examination was conducted. Structured clinical interviews, prostate physical examinations, and cytological, biochemical, and microbiological tests on urinary samples collected before and after standardized prostatic massage (pre- and post-massage test) were performed.ResultsNinety participants (45 AS patients, mean age: 52.5 ± 10.0 years, with longstanding disease, 12.4 ± 6.9 years, and 45 controls, mean age: 52.8 ± 12.1 years) were included. National Institutes of Health - Chronic Prostatitis Symptom Index (NIH-CPSI) scores were similar in the AS and control groups (4.0 [1.0–12.0] vs. 5.0 [1.0–8.5], p = 0.994). The frequencies of symptoms of chronic prostatitis (NIH-CPSI Pain Domain ≥4) were also similar in both groups (23.3% vs. 22.7%, p = 0.953). Results of polymerase chain reaction tests for Chlamydia trachomatis were negative in all tested urinary samples, and uric acid concentrations and leukocyte counts were similar in all pre- and post-massage urinary samples.ConclusionsIn this study, chronic prostatitis occurred in male patients with AS, but its frequency and characteristics did not differ from those found in the healthy male population of similar age.
Highlights
Chronic prostatitis has been a common disease reported with high frequency in ankylosing spondylitis (AS) even from decades ago
An Icelandic survey identified prostatitis in 27% of male patients with AS based on medical record reviews, and the authors suggested that prostatitis was the second most frequent extra-articular manifestation of AS [3]
We aimed to evaluate uric acid concentrations, bacterial growth, and presence of Chlamydia trachomatis in urinary samples obtained after prostatic massage in order to investigate possible causes of chronic prostatitis in this group
Summary
Chronic prostatitis has been a common disease reported with high frequency in ankylosing spondylitis (AS) even from decades ago. Ankylosing spondylitis (AS) is the most common form of spondyloarthritis, mainly affecting the sacroiliac joints and spine. In severe cases, it can even cause progressive calcification and ankylosis, often in an ascending nature through its longitudinal ligaments. In 1958, Mason et al described a strikingly high frequency (83%) of prostatitis in men with AS based on the cytological analysis of urethral fluids obtained after prostatic massage [2]. These results have never been reproduced since . An Icelandic survey identified prostatitis in 27% of male patients with AS based on medical record reviews, and the authors suggested that prostatitis was the second most frequent extra-articular manifestation of AS [3]
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