INTRODUCTION AND OBJECTIVES: Chronic prostatitis/ chronic pelvic pain syndrome (CP/CPPS) is a debilitating condition characterized mainly by pelvic pain. In addition, many patients report voiding complaints and lower urinary tract symptoms (LUTS). While the mechanism behind these voiding complaints is not well understood, it is possible that inflammation induces fibrosis within the prostate, as has been hypothesized to occur in benign prostatic hyperplasia (BPH). To better understand this process, we developed two transient infectioninduced prostatitis murine models where LUTS can be studied in the presence or absence of chronic pain. METHODS: C57BL/6 (B6) and NOD/ShiLtJ (NOD) mice (5-7 weeks old) were transurethrally infected with Escherichia coli strain CP1, a bacteria from a CP/CPPS patient that clears from the prostate and bladder of mice by 30 days. At post-infection days 5, 14, and 35, the mice were pain tested for referred pain with von-Frey filaments and the prostates and bladders harvested for analysis (4-8 mice per time point). Additionally, urodynamic evaluation was completed at day 35 under urethane anesthesia. Prostate and bladder specimens were analyzed by flow cytometry and real-time quantitative PCR (QT-PCR) for the presence of cells and markers involved in fibrosis. RESULTS: B6 mice did not develop pain, however, NOD mice developed significant pain at all time points. Cystometry showed increased frequency of bladder contractions in CP-1 infected mice of both strains. By flow cytometry, B6 mice developed an increase in fibrocytes (vimentinþ, CD45þ) in the prostate at day 14 which became statistically significant at day 35. A similar but delayed trend was noted in NOD mice with an increase in fibrocytes at day 35, however, this was not statistically significant. NOD mice did develop a significant increase in vimentinþ cells (mesenchymal cells) at day 14. The bladders of B6 mice demonstrated a significant increase in vimentinþ cells at day 35 and at day 14 in the NOD mice. There was no difference in the presence of fibrocytes in the bladders. B6 mice had a >1 fold increase in expression of collagen 1a1, 1a2, aSMA, and CXCL5 at day 14 by QTPCR. A similar increase in these markers was noted in the NOD mice but at the earlier time point of day 5. CONCLUSIONS: We have demonstrated in infection-induced prostatitis murine models that urinary frequency develops in the presence and absence of pain. This is associated with the concurrent suggestion of fibrosis within the prostate, with altered kinetics of development in each model. Further studies are underway to identify the pathogenesis of LUTS in the context of inflammation and pain.
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