Abstract
BackgroundAlthough prostatitis syndrome (PS) and irritable bowel syndrome (IBS) are common disorders, information on the prevalence of IBS in infertile patients with PS is relatively scanty. Therefore, this study was undertaken to estimate the frequency of PS and IBS and to evaluate the prevalence of the various diagnostic categories of prostatitis.Methodology/Principal FindingsThis study enrolled 152 patients with PS, diagnosed by the NIH-Chronic Prostatitis Symptom Index (NIH-CPSI) in an andrological setting, and 204 patients with IBS, diagnosed according to the Rome III diagnostic criteria in a gastroenterological setting. The patients with PS were asked to fulfill the Rome III questionnaire for IBS, whereas patients with IBS were asked to complete the NIH-CPSI. The simultaneous presence of PS and IBS was observed in 30.2% and 31.8% of the patients screened by andrologists and gastroenterologists, respectively. Altogether, 111 patients had PS plus IBS (31.2%). They had a total NIH-CPSI and pain subscale scores significantly higher than patients with PS alone. Gastrointestinal symptoms in patients with PS plus IBS were similar to those reported by patients with IBS alone and significantly greater in patients with PS alone. Patients with PS plus IBS had a significantly higher frequency of chronic bacterial prostatitis (category II) and lower of non-inflammatory prostatitis (category IIIB), compared to patients with PS alone. The frequency of inflammatory prostatitis (category IIIA) resulted similar.Conclusions/SignificanceProstatitis syndromes and IBS are frequently associated in patients with PS- or IBS-related symptoms. These patients have an increased prevalence of chronic bacterial and non-inflammatory prostatitis.
Highlights
Prostatitis syndrome (PS) and irritable bowel syndrome (IBS) share some peculiar features: they are functional, somatoform disorders; have a high worldwide prevalence; symptoms have a substantially negative impact on the patients’ quality of life; are defined on the basis of the clinical presentation rather than clear diagnostic markers or findings.prostatitis syndrome (PS), a common syndrome affecting relatively young men, is the most frequent subtype of prostatitis encountered by family physicians, internists, and urologists
Of the 152 infertile patients with prostatitis diagnosed by andrologists, 46 (30.3%) had IBS, whereas 65 (31.9%) out of 204 patients with IBS diagnosed by gastroenterologists had prostatitis, with a median National Institutes of Health (NIH)-CPSI score of 14, and couple’s infertility
It is worth of mention that while IBS diagnosis is based on an international consensus, such a consensus is missing for prostatitis syndromes
Summary
PS, a common syndrome affecting relatively young men, is the most frequent subtype of prostatitis encountered by family physicians, internists, and urologists. It has a prevalence of 11– 16% [1,2], an unclear etiology, and a significant negative impact on the quality of life, comparable to active Crohn’s disease or a recent myocardial infarction [3]. Among all the laboratory test designed to localize bacteria and/or leucocytes in segmented urinary tract specimens, the gold standard is the four glasses test proposed by Meares and Stamey [7] It consists of obtaining the following specimens for microscopy and microbiological culture: the first voided 5–10 ml urine (VB1), midstream urine (VB2), pure prostatic secretion expressed by prostatic massage (EPS) and the first voided 5–10 ml urine after prostatic massage (VB3). This study was undertaken to estimate the frequency of PS and IBS and to evaluate the prevalence of the various diagnostic categories of prostatitis
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