Chronic Prostatitis-like Symptoms Research Articles

Characterizing CD8+ TEMRA Cells in CP/CPPS Patients: Insights from Targeted Single-Cell Transcriptomic and Functional Investigations.

The specific involvement of the CD8+ T effector memory RA (TEMRA) subset in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) has largely not been explored in the literature. Targeted single-cell RNA sequencing (scRNA-seq) profiles were generated from peripheral blood mononuclear cells (PBMCs) obtained from two CP/CPPS patients and two healthy controls (HCs) in our recent study. Pseudotime series algorithms were used to reveal the differentiation trajectory, CellChat analysis was used to explore the communication between individual cells, and the SCENIC program was used to identify potential transcription factors (TFs). Based on the cosine similarity, clusters of differentially expressed genes (DEGs) were considered to be further enriched in different pathways. To confirm the functional role of the critical clusters, flow cytometry was employed. The results revealed the molecular landscape of these clusters, with TEMRA cells exhibiting pronounced cytokine-mediated signaling pathway enrichment. Pseudotime trajectory analysis further mapped the evolution from naïve T cells to that of TEMRA cells, elucidating the developmental pathways involved in the immune context. A significant finding from CellChat analysis was the differential expression of ligands and receptors, with CD8+ TEMRA cells showing enhanced signaling, particularly in the CP/CPPS context, compared to HCs. Flow cytometry confirmed these results, revealing a heightened proinflammatory cytokine profile in patients with chronic prostatitis-like symptoms (CP-LS), suggesting that TEMRA cells play a significant role in disease pathogenesis. TF profiling across the T-cell clusters identified key regulators of cellular identity, identifying novel therapeutic targets. Elevated TNF signaling activity in CD8+ TEMRA cells underscored the involvement of these cells in disease mechanisms. This study elucidates the pivotal role of the CD8+ TEMRA cell subset in CP/CPPS, which is characterized by increased TNF signaling and proinflammatory factor expression, highlighting potential biomarkers and opening new avenues for therapeutic intervention.

Lower urinary tract symptoms in patients with inflammatory bowel diseases: A cross-sectional observational study

BackgroundInflammatory Bowel Diseases (IBD), Crohn's Disease (CD), and Ulcerative Colitis (UC) may have extraintestinal manifestations, including disorders of the urinary tract. The prevalence of lower urinary tract symptoms (LUTS) in IBD patients remains unclear. AimsAssess the prevalence of LUTS in patients with CD or UC, evaluate the variables implicated in any difference in LUTS prevalence between CD or UC, and assess any relationship between disease activity and LUTS MethodsLUTS were evaluated in 301 IBD patients through standardised questionnaires: Bristol Female Lower Urinary Tract Symptoms (BFLUTS), NIH-Chronic Prostatitis Symptom Index (NIH-CPSI), and International Prostate Symptom Score (IPSS). IBD activity was determined through the Crohn's Disease Activity Index (CDAI), Partial Mayo Score (PMS), and Total Mayo Score (TMS). ResultsBFLUTS total score for females was 6 (3–11). Patients with a higher age at diagnosis had worse filling symptoms (p = 0.049) and a worse quality of life (p = 0.005). In males, 67.1% had mild, 28.5% moderate, and 4.4% severe IPSS symptom grades. The overall NIHCPSI prevalence of chronic prostatitis-like symptoms was 26.8%. The questionnaires revealed some significant differences in the subgroups analysed. ConclusionLUTS should be evaluated in IBD patients by urologic-validated questionnaires for prompt diagnosis and early treatment.

Men with chronic prostatitis-like symptoms experienced lower quality of life: From a nationwide survey in Japan

Men with chronic prostatitis-like symptoms experienced lower quality of life: From a nationwide survey in Japan

Molecular analysis of microorganisms in the semen and their impact on semen parameters.

Chronic genitourinary infections can alter male fertility and even promote carcinogenic processes. This study aimed to evaluate the effect of the presence in the semen of microorganisms on semen quality. Clinical symptoms and conventional and functional seminal parameters of eleven fertile donors and ten volunteers with prostatitis-like symptoms were evaluated. Nitric oxide, antioxidant capacity, and pro-inflammatory cytokines in semen and seminal plasma samples were also quantified. Finally, the expression of the ROR-γT, FoxP3, and T-bet genes in semen and the presence of DNA of microorganisms associated with prostatitis in urine and semen were evaluated. When compared with fertile donors, volunteers with chronic prostatitis-like symptoms reported erectile dysfunction (0% vs. 10%, p = 0.2825) and premature ejaculation (0% vs. 40%; p = 0.0190). No statistically significant differences were observed in seminal parameters, cytokine measurement, antioxidant capacity, nitric oxide concentration and ROR-γT, FoxP3, T-bet. Microorganisms responsible for sexually transmitted infections and some bacteria associated with the microbiota and infections in the prostate gland were detected. In the semen from the subjects with prostatitis-like symptoms T. vaginalis DNA was detected; in addition, N. gonorrhoeae DNA was also detected in semen and urine samples. S. pyogenes was detected in the urine samples from the control group. Prostatitis-like symptoms are a common finding in young men that affect sexual and reproductive health, but not always the seminal parameters or fertility. The presence of prostatitis- like symptoms does not affect seminal quality. However, it appears to be associated with an increased likelihood of erectile dysfunction and premature ejaculation. Thus, affecting the quality of life and sexual and reproductive health.

Low quality of life in men with chronic prostatitis-like symptoms

BackgroundChronic prostatitis (CP) can impair health-related quality of life (QOL), but the full impact of CP, including the impact of CP-like symptoms in men who have no CP diagnosis (CPS), is unknown. We estimated the impact of diagnosed CP (DCP) and CPS on Health-related QOL.MethodsFrom a representative nationwide survey of men aged 20–84 in Japan, we determined the prevalence of DCP and also of CPS. For CPS, we used Nickel’s criteria, which were used previously to estimate the prevalence of CP and are based on the NIH Chronic Prostatitis Symptom Index. To test the robustness of Nickel’s criteria, we used two other definitions of CPS (two sensitivity analyses). We measured QOL with the Short-Form 12-Item Health Survey. We compared the participants’ QOL scores with the national-norm scores, and with the scores of men who had benign prostatic hyperplasia (BPH).ResultsAmong the 5 010 participants, 1.4% had DCP and 3.7% had CPS. The sensitivity analyses resulted in CPS prevalence estimates of 3.1% and 4.5%. CPS was particularly common in younger participants (5.7% of those in their 30 s had CPS). QOL was very low among men with CP: In most areas (domains) of QOL, their scores were more than 0.5 standard deviation below the national-norm mean. Their mental-health scores were lower than those of men with BPH. The lowest scores among all 8 QOL domains were in role-functioning.ConclusionsCP is common, but it is underdiagnosed, particularly in younger men. Whether diagnosed or only suspected, CP’s impact on QOL is large. Because CP is common, and because it substantially impairs individuals’ QOL and can also reduce societal productivity, it requires more attention. Specifically, needed now is a simple tool for urologists and for primary care providers, to identify men, particularly young men, whose QOL is impaired by CP.

Cross-sectional study on the etiological diagnosis of the patients with chronic prostatitis-like symptoms by application of the urine-prostate-semen test.

Background and AimsThe prostatic secretion was considered to be the most important and even only specimen in diagnosis and differential diagnosis of chronic prostatitis like symptoms, but little attention has been paid to other genital organ infections. A urine‐prostate‐semen test (U‐EPS‐S test) was used to investigate the microbial flora of internal genital organs in patients with chronic prostatitis‐like symptoms and their influence on the diagnosis and treatment of the patients.Materials and MethodsWe randomly selected the patients with chronic prostatitis‐like symptoms for this study and used a U‐EPS‐S test to collect urine, prostatic secretion, and semen specimens. The specimens were inoculated respectively into a suitable culture medium for bacteriological/fungal detection, and the number and distribution of colonies in each isolation culture were observed before and after the therapy.ResultsAll of the specimens from the internal genital organs of these patients were shown as microbe‐positive isolation and the infection rate was 100%. Of these, prostatic secretion with microbe‐positive isolation was obtained in 66 cases (33%), semen with microbe‐positive isolation was obtained in 34 cases (17%), and both prostatic secretion and semen with microbe‐positive isolation were obtained in 100 cases (50%). In the isolates, Gram‐positive microbes were shown as the most common pathogens, accounting for 91.1%. In 200 patients, 95 patients were infected with one microbial species infection, of them 36 were prostatic secretion positive‐isolation (18%), 20 were semen sample positive‐isolation (10%), and 39 were positive‐isolation both prostatic secretion and semen samples (19.5%); 104 patients were infected with two microbial species, of them 30 were prostatic secretion positive‐isolation (15%), 14 were semen sample positive‐isolation (7%), and 60 were positive‐isolation both prostatic secretion and semen samples (30%); one patient was infected with three microbial species and them were isolated from the semen sample (0.5%). In the patients with chronic prostatitis‐like symptoms, the multiple microbial infection (MMI) was accounted for 53.5%, and the multiorgan infection (MOI) was accounted for 67%.ConclusionsThe U‐EPS‐S test is not only helpful to accurately identify the pathogens and contaminants in the culture isolates, but also the diagnosis and differential diagnosis and also evaluation of the treatment efficacy of the infection in different genital organs. In the patients with chronic prostatitis symptoms, Gram‐positive microbes were the most common causative agents, and MMI and MOI caused by resistant strains of different microbial species have a high incidence.

Aetiological Diagnosis of the U-EPS-S Test in Patients with Chronic Prostatitis-Like Symptoms

Background: Prostate examination is considered to be most important in the diagnosis and differential diagnosis of patients with chronic prostatitis-like symptoms, and little attention has been given to other genital organ examinations for these patients. We speculate that this may be an important factor affecting the treatment effect of chronic prostatitis. Methods: We randomly selected 200 patients with chronic prostatitis-like symptoms from the clinic services of hospitals in China for this study and used a urine-prostate-semen test (U-EPS-S test) to collect urine, prostatic secretion and semen specimens. The specimens were inoculated into a suitable medium culture for bacteriological/fungal localization detection, and the number and distribution of colonies in each isolation culture were observed. The gene assay by PCR was used to further identify the Chlamydia and the species of Neisseria and Candida. Findings: All of these patients had an infection of the internal genital organs, and the infection rate was 100%. Of these, prostatic secretion-positive isolation cultures were obtained in 66 cases (33%), semen-positive isolation cultures were obtained in 34 cases (17%), and prostatic secretion- and semen-positive isolation cultures were obtained in 100 cases (50%). In these patients, gram-positive microbes were the most common pathogens, accounting for 91.1%. Positive isolation cultures of more than two kinds of microbes occurred in 107 cases, and multiple microbial infections (MMIs) accounted for 53.5%. Positive isolation cultures of semen and both prostatic secretions and semen occurred in 134 cases, and multi-organ infections (MOIs) accounted for 67%. Interpretations: In patients with chronic prostatitis symptoms, there was a high incidence of MMI and MOI caused by resistant strains of different microbial species, and gram-positive microbes were the most common causative agents. Neglecting semen sample collection and posttherapy pathogen redetection are important factors leading to missed diagnosis and misdiagnosis of patients and thus treatment failure. Funding: This study was supported by the Science and Technology Department of Guizhou Province of China (SY[2001]3045) and Health Department of Guizhou Province of China (gzwkj2009-1-028) and State Key Laboratory for Infectious Diseases Prevention and Control, National Institute for Communicable Disease Control and Prevention, National Institute for Viral Disease Control and Prevention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention (2011SKLID302). Declaration of Interest: We declare no competing interests. Ethical Approval: This protocol was evaluated and approved by the ethics committee of Guizhou Medical University.

Body mass index, waist-to-hip ratio, and metabolic syndrome as predictors of middle-aged men's health.

PurposeThere is no reported evidence for an anthropometric index that might link obesity to men's sexual health. We evaluated the ability of an anthropometric index and the symptom scores of five widely used questionnaires to detect men's health problems. We determined the predictive abilities of two obesity indexes and other clinical parameters for screening for lower urinary tract symptoms and sexual dysfunction in middle-aged men.Materials and MethodsA total of 1,910 middle-aged men were included in the study. Participants underwent a detailed clinical evaluation that included recording the symptom scores of five widely used questionnaires. The participants' body mass index and waist-to-hip ratio were determined. Serum prostate-specific antigen, urinalysis, testosterone, estimated glomerular filtration rate, evaluation of metabolic syndrome, and transrectal ultrasonography were assessed.ResultsBy use of logistic regression analysis, age and total prostate volume were independent predictors of lower urinary tract symptoms. Metabolic syndrome was the only significant negative predictive factor for chronic prostatitis symptoms. Age and metabolic syndrome were independent predictive factors for erectile dysfunction. Waist-to-hip ratio had a statistically significant value for predicting erectile dysfunction.ConclusionsOur data showed that total prostate volume is a significant predictor of lower urinary tract symptoms, and central obesity has predictive ability for erectile dysfunction. Metabolic syndrome was the only significant negative predictive factor for chronic prostatitis-like symptoms. The management of correctable factors such as waist-to-hip ratio and metabolic syndrome may be considered preventive modalities against the development of men's health problems.

Effect of the Severity of Chronic Prostatitis Symptoms on Premature Ejaculation among Korean Males in Their 40-50s

Purpose: The purpose of this study was to analyze the effect of the severity of chronic prostatitis symptoms on premature ejaculation among Korean males in their 40-50s. Materials and Methods: From September 2011 to December 2012, we conducted a survey targeting 319 Koreans who had undergone medical examinations in our institution, using National Institute of Health chronic prostatitis symptom index (NIH-CPSI) and premature ejaculation diagnostic tool (PEDT). Results: The average age of 319 volunteers was 50.8 years (40-59), the average total NIH-CPSI score was 8.6±6.2. And total PEDT score was 7.7±5.0. Twenty eight persons had chronic prostatitis-like symptoms (8.8%). Statistically significant differences in the prevalence of premature ejaculation were observed between persons with chronic prostatitis-like symptoms (82%) and those without (37.5%). In the same manner, the prevalence of premature ejaculation was higher in the moderate and severe symptom groups than in the mild symptom groups according to the symptom scale score (pain plus voiding score) and total score of NIH-CPSI (mild: 38.2%, moderate/severe: 59.6% by symptom scale score and mild: 36.7%, moderate/severe: 65.4% by total score). In univariate and multivariate analyses, presence or absence of chronic prostatitis-like symptoms and classification according to total NIH-CPSI score were independent predictive factors for the prevalence of premature ejaculation on PEDT. Conclusions: Significant statistical relationships were observed between NIH-CPSI and PEDT in Korean males in their 40-50s who have chronic prostatitis-like symptoms or were classified into moderate and severe symptom groups according to total NIH-CPSI score.

Midline Prostatic Cysts Presenting with Chronic Prostatitis or Secondary Infertility and Minimally Invasive Treatment: Endoscopic or Laparoscopic Approach?

Backgrounds: Surgical interventions especially minimally invasive treatments are recommended for symptomatic midline prostatic cysts. The endoscopic unroofing of cysts close to urethra is easy and simple, but it has little effect on the large cysts and cysts lying deeply, in contrast with the laparoscopic approach. Therefore, the selection of minimally invasive therapeutic approaches is important. The aim of this study is to describe our experience in the diagnosis and selection of minimally invasive treatment for midline prostatic cyst. Methods: 15 cases of midline prostatic cyst were studied.10 cases presented with prostatitis-like symptoms, 1 with dysuria and acute urinary retention, 3 with secondary infertility and the rest 1 with hemospermia. 6 patients presented with small cysts (≤2 cm × 2 cm) close to urethra and underwent transurethral unroofing. The other 9 patients with large cysts (>2 cm × 2 cm) or cysts lying closely behind the prostate received the laparoscopic excision. Results: The average duration of transurethral unroofing and laparoscopic excision was 39 mins and 118 mins respectively, whereas the average time of hospitalization was 2.7 days and 4.5 days respectively. After a follow-up of 21 months, all cases were treated successfully without complications and recurrence. Their prostatitis-like symptoms disappeared, and the three patients presented with secondary infertility achieved conception within one year after the operation. Conclusions: A midline prostatic cyst can present with chronic prostatitis-like symptoms and secondary infertility. It can be cured by minimally invasive treatments, but these procedures should be carefully selected according to the size and location of the cyst.

UP-2.034: The Prevalence of Chronic Prostatitis-Like Symptoms in China

UP-2.034: The Prevalence of Chronic Prostatitis-Like Symptoms in China

Examination of the Relationship Between Symptoms of Prostatitis and Histological Inflammation: Baseline Data From the REDUCE Chemoprevention Trial

Symptoms of abacterial chronic prostatitis/chronic pelvic pain syndrome are considered to be associated with prostate inflammation. The ongoing Reduction by Dutasteride of Prostate Cancer Events trial is a 4-year, phase III, placebo controlled study to determine whether 0.5 mg dutasteride daily decreases the risk of biopsy detectable prostate cancer. All men underwent biopsy before study entry, allowing review of the relationship between histological prostate inflammation and prostatitis symptoms. Eligible men were 50 to 75 years old with serum prostate specific antigen 2.5 ng/ml or greater and 10 ng/ml or less (ages 50 to 60 years), or 3.0 ng/ml or greater and 10 ng/ml or less (older than 60 years), and an International Prostate Symptom Score of less than 25 (or less than 20 if already on alpha-blocker therapy). Acute prostatitis was an exclusion criterion. The National Institutes of Health Chronic Prostatitis Symptom Index was used to assess prostatitis-like symptoms. Spearman rank correlations were used to assess the relationship between acute and chronic inflammation, and Chronic Prostatitis Symptom Index scores for the pain, urinary symptoms and quality of life domains as well as average pain, total score and prostatitis-like symptoms. Data were available on 5,597 patients. The distribution of inflammation status was similar for those with and without chronic prostatitis-like symptoms. Significant correlations were found between average chronic inflammation, and total Chronic Prostatitis Symptom Index score and subscores for urinary symptoms and quality of life but the magnitude of these correlations was small. A lack of clinically meaningful association was found between prostatitis-like pain symptoms and histological inflammation in the Reduction by Dutasteride of Prostate Cancer Events population, suggesting that the view that symptoms of chronic prostatitis/chronic pelvic pain syndrome and prostate inflammation are associated needs further scrutiny.

Influence of pain and urinary symptoms on quality of life in young men with chronic prostatitis-like symptoms.

Our aims in the present study were to estimate the influences of pain and urinary symptoms on quality of life, and to determine which of these two variables has the most predictive power with respect to quality of life in young men with chronic prostatitis-like symptoms. Chronic prostatitis-like symptoms were measured by the National Institutes of Health-Chronic Prostatitis Symptom Index. Of the 28,841 men aged 20 years who lived in the study community, 18,495 men (a response rate 64.1%) agreed to participate in the study. A total of 1057 men who complained of symptoms indicative of chronic prostatitis were included in the study. The influences of pain and urinary symptoms on quality of life were determined using logistic regression analysis. The receiver operating characteristic (ROC) curve was used to estimate the predictive ability of each of these variables with respect to quality of life. Results from multivariate analysis showed that both pain and urinary symptoms were associated with an increased likelihood of impaired quality of life, although pain contributed more to a reduced quality of life than urinary symptoms. Relative to men who experienced mild pain, men who experienced moderate pain had a 3.9-fold risk of poor quality of life (odds ratio [OR], 3.87; 95% confidence interval [CI], 2.86-5.23; P < 0.001) and those who experienced severe pain had a 15.7-fold risk of reduced quality of life (OR, 15.68; 95% CI, 6.59-37.35; P < 0.001). Moderate urinary symptoms were associated with a 1.4-fold risk of bother (OR, 1.41; 95% CI, 1.01-1.99; P < 0.001) and severe urinary symptoms were associated with 2.4-fold risk (OR, 2.39; 95% CI, 1.37-4.12; P < 0.001), relative to mild urinary symptoms. Comparison of the effects of pain and urinary symptoms showed that pain severity had the most predictive power for bother, quality of life, and quality-of-life impact. The areas under the ROC curves for bother, quality of life, and quality-of-life impact were 71.3%, 69.3% and 72.5%, respectively. Urinary symptoms and pain might be associated with an increased likelihood of impaired quality of life in young men with chronic prostatitis-like symptoms. In addition, our findings suggest that pain severity is the most influential variable for determining quality of life in this population.

Psychological problems in young men with chronic prostatitis-like symptoms.

To take a different perspective in assessing young men with chronic prostatitis-like symptoms, this study was designed since few prospective studies are available to survey a population of young men. One hundred and fifty men aged 20 years dwelling in the community were randomly selected. Chronic prostatitis-like symptoms were measured by the National Institutes of Health-Chronic Prostatitis Symptom Index and the selfreported scores for pain and urinary symptoms were used to identify chronic prostatitis-like symptoms. The psychological methods used were the Beck Depression Inventory, the State-Trait Anxiety Inventory, and the Bem Sex Role Inventory. A total of 87 men (a response rate 58%) completed self-administered questionnaires. As the scores for pain and urinary symptoms increased, those for depression increased (p < 0.001 and p = 0.01, respectively). However, the mean scores for state and trait anxiety were not different according to the scores for pain and urinary symptoms. The mean masculinity scores were not different according to the scores for pain but those were significantly different according to the scores of urinary symptoms (p = 0.042). The mean femininity scores were not different according to the scores of pain and urinary symptoms. Our findings suggest that psychological factors, especially depression and weak masculine identity may be associated with an early stage of chronic prostatitis-like symptoms. Young men with chronic prostatitis-like symptoms also have psychological problems.

Influence of Pain and Urinary Symptoms by Chronic Prostatitis-like Symptoms on Quality of Life in Young Men

Influence of Pain and Urinary Symptoms by Chronic Prostatitis-like Symptoms on Quality of Life in Young Men

Influence of environmental factors on chronic prostatitis-like symptoms in young men: results of a community-based survey

Objectives. To investigate the influence of environmental factors on chronic prostatitis-like symptoms among young men in a community. Methods. Of 28,841 men aged 20 years dwelling in the community, a total of 16,321 men (response rate 56.6%) were included in this study. The National Institutes of Health Chronic Prostatitis Symptom Index was used to identify men with chronic prostatitis-like symptoms. The questionnaire also queried sociodemographic characteristics. The Korean Meteorological Administration provided information on the weather of the community. We determined the risk factors of chronic prostatitis-like symptoms among these environmental factors using univariate and multivariate analyses. Results. Six percent of the men were identified as having significant prostatitis-like symptoms (perineal and/or ejaculatory pain and a total pain score of 4 or greater). The univariate logistic regression analysis indicated that education level, average duration of sunlight, and average temperature were risk factors for chronic prostatitis-like symptoms. As these variables increased, the scores of chronic prostatitis-like symptoms decreased. In the multivariate model used, the likelihood of chronic prostatitis-like symptoms varied by the final educational level, with middle school and high school graduates having 1.8 and 1.4-fold higher odds, respectively, than men attending college. In the same model, the average duration of sunlight was also an independent risk factor of chronic prostatitis-like symptoms (odds ratio 0.85; 95% confidence interval 0.77 to 0.95; P = 0.003), but the average temperature lost statistical significance. Conclusions. Our findings suggest that the community-based prevalence of chronic prostatitis-like symptoms may be high in young men. Higher education and a longer time in sunlight were associated with a decreased likelihood of chronic prostatitis-like symptoms.

The prevalence of chronic prostatitis-like symptoms in young men: a community-based survey.

We surveyed the prevalence of chronic prostatitis-like symptoms in young men using the National Institutes of Health (NIH) Chronic Prostatitis Symptom Index (CPSI) and determined the clinical validity of the NIH-CPSI among men in the community. Of 29,017 men aged 20 years dwelling in the community, 8,705 men were randomly selected at a 30.0% sampling fraction and a total of 6,940 men (a response rate 79.7%) completed a self-administered questionnaire. Six percent reported having pain or discomfort in more than one area . About 5% did not feel that the bladder emptied fully after urinating more than 1 time in 5 and 10.5% had to urinate again within 2 h more than 1 time in 5. As the scores for pain or discomfort increased, those for urinary symptoms and impact on quality of life increased (P < 0.001; Armitage test). As the scores for urinary symptoms increased, those for pain or discomfort and impact on quality of life also increased (P < 0.001; Armitage test). The community-based prevalence of chronic prostatitis-like symptoms were found to be high in young men as well as in older men. Our findings indicate that men with pain or urinary symptoms experience a negative impact on their quality of life and the NIH-CPSI provides a valid measure for the general population.

PREVALENCE OF PROSTATITIS-LIKE SYMPTOMS IN A POPULATION BASED STUDY USING THE NATIONAL INSTITUTES OF HEALTH CHRONIC PROSTATITIS SYMPTOM INDEX

The National Institutes of Health (NIH) chronic prostatitis symptom index was used to determine the prevalence of prostatitis-like symptoms among men (age 20 to 74 years) at risk in a community based study. The study was a cross-sectional postal survey of men age 20 to 74 years in Lennox and Addington counties, which included a large rural area, 1 major town and a suburban area with a stable population of men representative of Canadian demographics. The questionnaire collected information on 2 domains of chronic prostatitis identified in the NIH chronic prostatitis symptom index, including pain (location, severity and frequency), voiding function (irritative, obstructive), demographics, quality of life, general health and health seeking behavior. The self-reported pain score was used to identify prostatitis-like symptoms in the most discriminating domain. Based on analysis of the index final validation study comparing patients with prostatitis to normal controls and those with benign prostatic hyperplasia, the 2 questions most specific for prostatitis, including perineal and/or ejaculatory pain/discomfort, and a total pain score (0 to 21) 4 or greater were used to identify men with significant prostatitis-like symptoms. A total of 2,987 eligible men received the survey, and it was completed by 868 (29%). Of the men 84 (9.7%) were identified as having chronic prostatitis-like symptoms (mean NIH chronic prostatitis symptom index pain score 9.1 +/- 0.3). The average age of the prostatitis population was 50 years compared with 52 years for men without prostatitis-like symptoms. Prevalence was 11.5% in men younger than 50 years and 8.5% in men 50 years or older. Of the sampled population 57 (6.6%) men had prostatitis-like symptoms and an index pain score 8 or greater (moderate to severe). The index voiding score (0 to 10) was 4.1 +/- 0.5 in men younger than 50 years compared with 1.5 +/- 0.1 for normal controls, and 4.7 +/- 0.4 in those 50 years or older compared with 1.9 +/- 0.1 for normal controls. Of the prostatitis group 60% sought medical help for their symptoms. In our opinion this community based study using the new prostatitis symptom index confirms that chronic prostatitis-like symptoms are common.

A study on the role of Chlamydia trachomatis in chronic prostatitis--analysis of anti-Chlamydia trachomatis specific IgA in expressed prostate secretion by western-blotting method

Opinion among researchers is divided as to whether Chlamydia trachomatis is the causative organism of chronic prostatitis. In this study, using enzyme immuno assay, we examined the positive rate of anti-C. trachomatis IgA according to the leukocyte count in expressed prostate secretion (EPS), in a total of 169 patients including 92 patients who showed chronic prostatitis-like symptoms. And we confirmed, by western-blotting, the presence or absence of anti-heat shock protein (HSP: 60 KDa) IgA in EPS, and we investigated the role of C. trachomatis in chronic prostatitis. The total positive rate of anti-C. trachomatis IgA in EPS was 26.0% (44/169). According to the leukocyte count in EPS, the positive rate for the group with more than 10 WBC/hpf was 29.0% (20/69), for the group with 5-9 WBC/hpf was 37.9% (11/29), for the group with less than 5 WBC/hpf was 18.3% (13/71). Accordingly the positive rate of anti-C. trachomatis IgA in EPS was not higher in direct correlation to the severity of the inflammation at the infected site (p = 0.09). But the positive rate for the group with more than 5 WBC/hpf was higher than for the group with less than 5 WBC/hpf. On the other hand, the total positive rate of anti-HSP IgA in EPS was 17.6% (6/34), and according to the leukocyte count in EPS, the positive rate for the group with more than 10 WBC/hpf was 38.5% (5/13), for the group with 5-9 WBC/hpf was 0% (0/12). Accordingly the positive rate of anti-HSP IgA in EPS was higher in direct correlation to the severity of the inflammation at the infected site (p = 0.13). From this results, it was suggested that C. trachomatis was concerned with 29.0% (20/69) of chronic prostatitis with more than 10 WBC/hpf, and also C. trachomatis is the causative organism of chronic prostatis.