MP58-07 CLINICAL AND PATHOLOGIC RELEVANCE OF A PROSTATE MRI DIAGNOSIS OF "PROSTATITIS"

Abstract

You have accessJournal of UrologyInfections/Inflammation/Cystic Disease of the Genitourinary Tract: Prostate & Genitalia (MP58)1 Apr 2020MP58-07 CLINICAL AND PATHOLOGIC RELEVANCE OF A PROSTATE MRI DIAGNOSIS OF "PROSTATITIS" Sij Hemal*, Lewis Thomas, and Daniel Shoskes Sij Hemal*Sij Hemal* More articles by this author , Lewis ThomasLewis Thomas More articles by this author , and Daniel ShoskesDaniel Shoskes More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000927.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Non-malignant abnormalities in the peripheral zone are common in prostate mpMRI. Such findings include decrease in T2-weighted signal, decrease in diffusion coefficient or enhancement in a diffuse or linear pattern. These abnormalities are often reported as “prostatitis” and lead to patient anxiety and treatment referral. However, the relationship between these MRI findings and clinical prostatitis is unknown. We investigated the relationship between MRI evidence of prostatitis with clinical symptoms and pathology. METHODS: Retrospective review of patients undergoing prostate mpMRI (2016-2017) was performed, and patients were divided into two groups based on the presence of either “prostatitis” or “inflammation” in the radiology report. Patients with prior prostate cancer treatment were excluded. Clinical characteristics included age, PSA, biopsy/intervention history, lower urinary tract symptoms (LUTS), pain, use of urologic medications for LUTS, urinary findings of pyuria or leukocyte esterase positivity), prostate volume, and PIRADS score. Pathologic finding of inflammation on either prior biopsies or biopsy within 6 months was also recorded. Groups were compared using chi-square for dichotomous variables and t-tests for continuous variables. P<0.05 was considered significant. RESULTS: 104 patients were identified with “prostatitis/inflammation” and 119 without. Report of any LUTS was high in both groups (57% and 60% for prostatitis and no prostatitis respectively, p = 0.69), though report of moderate/severe LUTS (physician description or IPSS of 8-19 and 20+) was more common in the no prostatitis group (8% vs 17%, p=0.038). Use of urologic meds was similar between the two groups (66% and 55% for prostatitis and no prostatitis respectively, p = 0.074). Any biopsy finding of inflammation was more common in the prostatitis group (57% vs 35% p =0.002). Reports of pelvic/perineal pain, chronic dysuria, or urinary findings of inflammation/infection were uncommon in both groups (<5% for pain/dysuria and <10% for urinalysis findings in both groups) CONCLUSIONS: MRI findings of prostatitis may be associated with a pathologic finding of inflammation on biopsy, however, such findings did not correlate to reported LUTS, pelvic pain or use of urologic medications. While mpMRI findings of prostatitis may indicate NIH Category IV prostatitis, there is no evidence of correlation with categories I, II or III prostatitis nor with symptomatic LUTS and patients should be reassured that further investigation or treatment is not warranted. Source of Funding: none © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e873-e873 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sij Hemal* More articles by this author Lewis Thomas More articles by this author Daniel Shoskes More articles by this author Expand All Advertisement PDF downloadLoading ...