【请教】慢性前列腺炎发病率的问题

关于慢性前列腺炎发病率的问题，文献中的报道及引用数据差别很大，从百分之几到百分之几十，但确切的数据是多少呢？
园子内仅一篇讨论到此问题，但仍未能明确之：
【请教】我国的慢性前列腺炎发病率、对性伴侣的影响
http://www.dxy.cn/bbs/actions/archive/post/3895477_1.html
请战友能予赐教？？

1 慢性前列腺炎的国外发病率数据及数据来源
2 该病国内发病率数据及其确切文献来源

先抛砖引玉：
一 CBM
以 主题词=="年患病率/全部副主题/全部树" and 主题词=="前列腺炎/全部副主题" 为检索式检索得：

1 分类号 R195.4; R321.1; R322.64; R36; R697.330.11; R697.330.6; R821.35
标题 早泄病人慢性前列腺炎的发生率调查
著者 邢俊平; 范晋海; 王明珠; 陈兴发; 杨志尚
著者单位 西安交通大学第一医院泌尿外科 710061
文摘 目的:调查早泄男性中慢性前列腺炎的发生率。方法:对106例早泄病人和38例正常人前列腺按摩前后尿液标本及前列腺按摩液(EPS)进行显微镜和/或细菌学检查,并评估120例慢性前列腺炎病人中早泄的发生率。结果:在早泄病人中发现49例(46.2%)有慢性前列腺炎,其中34.7%存在慢性细菌性前列腺炎,与对照组相比均有统计学差异(P<0.05)。120例慢性前列腺炎病人中57例(47.5%)存在不同程度的早泄。结论:本研究结果提示慢性前列腺炎症在某些早泄病人的发病机制中可能具有一定作用,在针对早泄治疗前进行前列腺仔细检查具有重要意义。
出处 中华男科学 2003.09.30; 9(6): 451-453
关键词 发生率; 慢性前列腺炎; 早泄
主题词 发病率; 慢性病; 前列腺/超声检查; 前列腺炎/*流行病学; 前列腺炎/并发症; *射精
特征词 成年人; 男(雄)性; 人类; 中年人
相关文献 主题相关

2 分类号 R195.4; R696.06; R697.330.6; R759.206
标题 淋病与非淋菌性尿道炎患者合并前列腺炎状况研究
著者 刘达新; 丁胜非; 文运香
著者单位 长沙湖南省疾病预防控制中心 410005
文摘 目的:探讨淋病和非淋菌性尿道炎(非淋)患者前列腺炎患病率。方法:取136例淋病与非淋患者前列腺液,常规镜检。结果:136例淋病与非淋患者中,91例(66.91%)患前列腺炎。结论:淋病和非淋患者中,前列腺炎患病率较高,在诊治男性淋病与非淋患者时,应注意诊治可能同时存在的前列腺炎。
出处 实用预防医学 2002.02.25; 9(1): 30-31
关键词 非淋菌性尿道炎; 淋病; 前列腺炎
主题词 患病率; 淋病/*并发症; 尿道炎/*并发症; 前列腺炎/*并发症
特征词 男(雄)性; 人类
相关文献 主题相关 参考文献

3 分类号 R195.4; R322.64; R392.11; R697.306; R697.330.11; R697.330.5; R821.35; RZ267
标题 桂林地区BPH并前列腺炎的发病及治疗情况调查
著者 李学德; 于永纲; 姚华强; 武英杰; 刘东荣; 于洋
著者单位 桂林解放军第181医院泌尿外科 541002
文摘 目的:调查前列腺增生(BPH)患者并发前列腺炎的发病及治疗情况。方法:对桂林地区2152例BPH患者询问病史,并作前列腺液常规、前列腺B超、血清前列腺特异抗原(PSA)及尿常规等检查。结果:2152例患者中只有385例患者存在前列腺炎,占17.9%,其中87例患者有较明显的前列腺炎症状,35例患者曾诊断为前列腺炎并进行过间断治疗。结论:目前对BPH患者并发前列腺炎的诊断及治疗均不理想,应引起临床医师的高度重视。
出处 临床泌尿外科杂志 2001.04.20; 16(4): 173-174
关键词 发病率; 前列腺炎; 前列腺增生; 治疗
主题词 发病率; 广西[壮族自治区]/流行病学; 前列腺/超声检查; 前列腺特异抗原/血液; 前列腺炎/*流行病学; 前列腺炎/*治疗; 前列腺增生/*并发症
特征词 男(雄)性; 人类
相关文献 主题相关 参考文献


二 PubMed
以 "Morbidity"[ MeSH Terms ] and "prostatitis"[ MeSH Terms ] 检索得：

1: J Sex Med. 2006 Jan;3(1):150-4.

Chronic prostatitis in premature ejaculation: a cohort study in 153 men.

Shamloul R, el-Nashaar A.

Department of Andrology, Sexology & STDs, Cairo University, Cairo, Egypt.
rannone74@hotmail.com

INTRODUCTION: Premature ejaculation is a common male sexual dysfunction,
affecting 30-40% of sexually active men in an age-dependent manner. Chronic
prostatitis has been suggested as an important organic cause of premature
ejaculation. AIM: The aim of this study was to confirm previous data reported on
the incidence of chronic prostatitis in a large cohort of patients with primary
and secondary premature ejaculation. METHODS: A total of 153 consecutive
heterosexual men aged 29-51 years with premature ejaculation and another 100
male healthy subjects were included in this study. Sequential microbiologic
specimens were obtained according to the standardized Meares and Stamey
protocol. Nonbacterial prostatitis was defined by the evidence of prostatic
inflammation but negative cultures of urine and prostatic fluids in men with
various genitourinary symptoms. RESULTS: There was no significant difference
between patients and control subjects regarding age, education, or intercourse
frequency. Prostatic inflammation was found in 64% and chronic bacterial
prostatitis in 52% of the patients with premature ejaculation, respectively,
showing statistical significance compared with control subjects (P < 0.05).
CONCLUSIONS: Results in our study showed a high prevalence of chronic
prostatitis in patients with premature ejaculation. Examination of the prostate,
physically and microbiologically, should be considered during assessment of
patients with premature ejaculation.

PMID: 16409229 [PubMed - indexed for MEDLINE]

2: Int J Androl. 2005 Dec;28(6):317-27.

Epidemiologic risk factors for chronic prostatitis.

Ku JH, Kim SW, Paick JS.

Department of Urology, Seoul Veterans Hospital, Seoul, Korea.

Chronic prostatitis/chronic pelvic pain syndrome is a multifactorial problem,
which affects men of all ages and in all demographics. Recent studies have shown
that the prevalence of prostatitis is approximately 2-10% among unselected men
in North America, Europe and Asia. This data clearly indicates that chronic
prostatitis constitutes an important problem in international health care.
Nevertheless, the aetiology and pathogenesis of chronic prostatitis have yet to
be clearly delineated, despite the numerous efforts which have been made, with
regard to both basic and clinical research. In fact, factors other than
leucocytes and bacteria have been shown to contribute to the symptoms typically
associated with prostatitis. Studies of the epidemiology and determinants of
prostatitis risk factors may also provide clues to the general aetiology of
prostatitis. Other epidemiological data appears to indicate that certain
as-yet-unknown factors might be associated with an increased tendency towards
the development of chronic prostatitis. However, findings from most studies are
considered to represent only preliminary data, because of the small sample sizes
or lack of generalizability inherent to most of the studies. The identification
and characterization of these relevant risk factors might accelerate or augment
the development of preventive, diagnostic, and therapeutic strategies for the
treatment of these syndromes.

Publication Types:
Review

PMID: 16300663 [PubMed - indexed for MEDLINE]

3: Urology. 2005 Nov;66(5):964-70.

Correlates and prevalence of prostatitis in a large community-based cohort of
older men.

Daniels NA, Ewing SK, Zmuda JM, Wilt TJ, Bauer DC; Osteoporotic Fractures in Men
(MrOS) Research Group.

Division of General Internal Medicine, Department of Medicine, University of
California, School of Medicine, San Francisco, California 94115, USA.
ndaniels@medicine.ucsf.edu

OBJECTIVES: To describe the prevalence and correlates of self-reported history
of prostatitis in terms of lower urinary tract symptoms and associated
dissatisfaction in community-dwelling older men. METHODS: We performed a
cross-sectional analysis from a prospective cohort study of 5821 men aged 65
years and older recruited from six clinical centers. RESULTS: Overall, 1439 men
(25%) self-reported a history of prostatitis. Men with a history of prostatitis
were more likely to self-report a history of prostate cancer (26% versus 7%; P <
0.0001) and a history of benign prostatic hyperplasia (83% versus 38%; P <
0.0001) within a lifetime compared with men without a history of prostatitis.
Men with a history of prostatitis also had a greater mean American Urological
Association symptom score (mean +/- SD, 10.1 +/- 7.1 versus 7.7 +/- 5.9; P <
0.0001) than men without a history of prostatitis. Also, a greater percentage of
men with a history of prostatitis reported being dissatisfied with their present
urinary condition than did men without a history of prostatitis (21% versus 11%;
P < 0.0001). We found positive associations for a history of prostatitis with a
history of benign prostatic hyperplasia (odds ratio 8.0, 95% confidence interval
6.8 to 9.5), a history of prostate cancer (odds ratio 5.4, 95% confidence
interval 4.4 to 6.6), and dissatisfaction with current urinary condition (odds
ratio 1.2, 95% confidence interval 1.01 to 1.5). CONCLUSIONS: A self-reported
history of prostatitis is common in older men and was associated with
self-reported prostate cancer and benign prostatic hyperplasia and increased
severity of lower urinary tract symptoms and associated dissatisfaction. Because
of the potential detection bias, recall bias, and the cross-sectional nature of
the study, limiting causal inference, the associations among these urologic
conditions require additional study.

PMID: 16286104 [PubMed - indexed for MEDLINE]

4: Urology. 2005 Nov;66(5):935-40.

Prevalence, diagnosis, characterization, and treatment of prostatitis,
interstitial cystitis, and epididymitis in outpatient urological practice: the
Canadian PIE Study.

Nickel JC, Teichman JM, Gregoire M, Clark J, Downey J.

Department of Urology, Queen's University, Kingston, Ontario, Canada.
jcn@post.queensu.ca

OBJECTIVES: To determine the prevalence, diagnostic patterns, and management of
prostatitis, interstitial cystitis, and epididymitis (PIE) in Canadian urology
outpatient practice. METHODS: Representative urologists were randomly selected
from the Canadian and Quebec Urological Associations. Each patient identified
with a PIE diagnosis during a typical 2-consecutive-week period during April
2004 to July 2004 was requested to complete a corresponding Chronic Prostatitis
Symptom Index (CPSI), O'Leary-Sant Symptom Index (OSSI), or a Chronic
Epididymitis Symptom Index (CESI). Each day the participant urologist completed
an outpatient log and a detailed programmed chart review to transcribe
demographics, investigations, and treatments associated with each PIE patient.
RESULTS: Sixty-five urologists were invited to participate. Fifty-seven (88%)
agreed, and 48 (74%) completed the audit. Of the 8712 patients seen in
outpatient practice (average 182 per urologist), 2675 were female and 6037 male.
Prostatitis was identified in 2.7% of the men (n = 166; mean age 50 years; mean
duration 3.1 years; mean CPSI score 19.7), interstitial cystitis in 2.8% of
patients (n = 242; 211 women [7.9%], 26 men [0.4%]; mean age 50.2 years, mean
duration 4.5 years, mean OSSI score 11.8), and epididymitis in 0.9% of men (n =
57; mean age 41.1 years, mean duration 2.5 years, mean CESI score 15.5). There
was wide variance in investigations and treatments. CONCLUSIONS: This
prospective audit indicates that prostatitis might not be as common as
frequently believed and that interstitial cystitis is more common, and it
represents the first estimate of the prevalence of epididymitis in urologic
practice. The wide variance in investigations and treatments confirms the need
for practice management guidelines.

PMID: 16286098 [PubMed - indexed for MEDLINE]

5: J Urol. 2005 Nov;174(5):1939.

Benign prostatic hyperplasia (BPH) and prostatitis: prevalence of painful
ejaculation in men with clinical BPH.

Seftel A.

PMID: 16217352 [PubMed - indexed for MEDLINE]

6: Curr Opin Urol. 2005 Nov;15(6):404-9.

Sexual dysfunction in the patient with prostatitis.

Muller A, Mulhall JP.

Departments of Urology, Memorial Sloan Kettering Cancer Center, New York
Presbyterian Hospital, NY 10021, USA. jpm2005@med.cornell.edu

PURPOSE OF REVIEW: Prostatitis [chronic prostatitis/chronic pelvic pain syndrome
(CP/CPPS)] is a common condition in men that accounts for a significant number
of visits to a medical doctor or urologist. It is one of the most widely
diagnosed conditions in men attending urologic clinics. Erectile dysfunction,
defined as the consistent inability to obtain and/or maintain a penile erection
sufficient for adequate sexual relations, is also a common problem. This review
explores the links between sexual dysfunction and prostatitis. RECENT FINDINGS:
Most of the data linking lower urinary tract symptoms and erectile dysfunction
suggest that lower urinary tract symptoms impair the overall quality of life and
that a low quality of life contributes to or causes erectile dysfunction.
Prostatitis-like symptoms such as perineal, penile, and suprapubic discomfort or
pain during or after ejaculation and voiding complaints such as irritative and
obstructive voiding symptoms: urinary frequency, urgency, and dysuria may affect
the global emotional well-being of a man. Erectile dysfunction is also strongly
associated with a negative impact on the quality of life. SUMMARY: The available
literature demonstrating the influence of CP/CPPS on the incidence of erectile
dysfunction is scant. From the literature, it is known that lower urinary tract
symptoms and benign prostatic hyperplasia are definitely related to erectile
dysfunction. Any kind of pain is likely to be the most significant symptom in
men with CP/CPPS as it relates to sexual dysfunction. Sexual dysfunction like
ejaculation discomfort is described as a symptom of CP/CPPS. Indeed, most of the
data linking the two suggest that CP/CPPS impairs the overall quality of life
and it is this that contributes to or causes erectile dysfunction.

Publication Types:
Review

PMID: 16205492 [PubMed - indexed for MEDLINE]

7: World J Urol. 2005 Feb;23(1):61-6. Epub 2004 Nov 17.

Clinical characterization of the prostatitis patient in Italy: a prospective
urology outpatient study.

Rizzo M, Marchetti F, Travaglini F, Trinchieri A, Nickel JC.

Department of Urology, University of Florence, Florence, Italy.

A prospective multi-center Italian urology outpatient survey, undertaken to
determine the prevalence of prostatitis in Italy, provided an ideal opportunity
to identify and characterize the typical prostatitis patient presenting to
Italian urologists. A total of 70 urologists, representing a cross section of
urologic centers in Italy, counted and recorded the overall total male patients
reported in the clinic and the overall total patients diagnosed with prostatitis
over a 5 week period in late 2001. Data on demographics, previous diagnoses,
symptoms (frequency and severity), quality of life, physical examination and
laboratory data were prospectively collected. A total of 1,148 patients were
identified with prostatitis (12.8%). Of these, 1,074 patients had complete data
and could be included in this characterization analysis. The mean age of the
prostatitis patients was 47.1 years (range 16-83); two thirds had experienced
their first symptom within the last year. A family history of prostatitis was
reported by 20.4%. The most common urinary diseases were benign prostatic
hyperplasia (17.4%), recurrent urinary tract infection (11.2%) and urinary
calculogenesis (11.1%), while the most common concurrent diseases were diabetes
(7.2%) and depression (6.8%). The most frequently reported and most severe
symptoms at the time of evaluation were irritative voiding symptoms, perineal
and suprapubic pain and discomfort. Over three quarters of the patients were
dissatisfied with their quality of life. Bacteria were cultured in 15.6%, 17.7%
and 14.0% of expressed prostatic secretions, urine specimens after prostatic
massage and semen specimens, respectively. Prostatitis is a common outpatient
diagnosis, comprising over 10% of male outpatient visits to urologists in Italy.
This comprehensive characterization of the typical prostatitis patient diagnosed
in routine urological outpatient practice can be employed to generate
hypothesis-driven studies in diagnosis and treatment.

Publication Types:
Multicenter Study

PMID: 15770519 [PubMed - indexed for MEDLINE]

8: BJU Int. 2005 Mar;95(4):571-4.

Benign prostatic hyperplasia (BPH) and prostatitis: prevalence of painful
ejaculation in men with clinical BPH.

Nickel JC, Elhilali M, Vallancien G; ALF-ONE Study Group.

Department of Urology, Queen's University, Kingston, ON, Canada.
jcn@post.queensu.ca

OBJECTIVES: To determine the prevalence and importance of pain/discomfort on
ejaculation (prostatitis-like symptom) in men with lower urinary tract symptoms
(LUTS) diagnosed with clinical benign prostatic hyperplasia (BPH). PATIENTS AND
METHODS: Baseline data from 5096 men reporting LUTS suggestive of BPH, and
enrolled in the ALF-ONE study by general practitioners and urologists in Europe,
Asia, Latin America, the Middle East and Canada, were analysed to determine the
prevalence and significance of pain/discomfort on ejaculation. All the men were
asked to complete the International Prostate Symptom Score (IPSS) questionnaire,
the bother score (IPSS question 8), and the Danish Prostate Symptom Score
sexual-function questionnaire (DAN-PSSsex) which assesses three symptoms
(rigidity of erection, amount of ejaculate and pain/discomfort on ejaculation)
and their bothersomeness. RESULTS: There were 3700 sexually active men who had
an evaluable answer to the DAN-PSSsex question related to pain/discomfort on
ejaculation. Of these, 688 (18.6%) reported pain/discomfort on ejaculation and
609 (88%) considered it was a problem. Patients with painful ejaculation had
more severe LUTS and reported greater bother (P < 0.001). Of men with painful
ejaculation, 72% reported erectile dysfunction, of whom 91% considered it a
problem, and 75% reported reduced ejaculation, of whom 81% considered it a
problem. By contrast, of men with no ejaculatory discomfort, 57% reported
erectile dysfunction, of whom 79% considered it a problem, and 56% reported
reduced ejaculation, of whom 57% considered it a problem. A history of urinary
tract infection was reported by 12% of men in the ejaculatory pain group,
compared with 7% in the LUTS-only group, while 5% of men in the ejaculatory pain
group reported macroscopic haematuria, compared to 3% in the LUTS-only group.
Men with ejaculatory pain were slightly younger, but there were no significant
differences in duration of LUTS, history of acute urinary retention,
prostate-specific antigen concentrations or maximum urinary flow rate compared
to the LUTS-only group. CONCLUSIONS: Of sexually active men with LUTS suggestive
of BPH, approximately 20% complain of specific prostatitis-like symptoms of
pain/discomfort on ejaculation, and these men clearly differ from those who
present with LUTS only. For most the symptom is a significant bother. Men with
BPH and painful ejaculation have more severe LUTS and reported greater bother,
and had a higher prevalence of erectile dysfunction and reduced ejaculation,
than men with LUTS only. Evaluation and treatment strategies should address this
population of men with symptoms suggestive of both prostatitis and BPH.

Publication Types:
Multicenter Study

PMID: 15705082 [PubMed - indexed for MEDLINE]

9: Zhonghua Yi Xue Za Zhi. 2004 Mar 2;84(5):369-71.

[Prevalence of chronic prostatitis and its effects on male infertility]

[Article in Chinese]

Li HJ, Xu P, Liu JS, Xing GW, Pan TM, Yang BL, Song YX, Huang YF.

Laboratory of Reproduction & Genetics, Nanjing General Hospital of Nanjing
Command, People's Liberation Army, Nanjing 210002, China.

OBJECTIVE: To investigate the prevalence of chronic prostatitis (CP) in male
infertility patients and its effects on male infertility. METHODS: 534 male
patients with complaints of male infertility were interviewed for the history of
prostatic disease and underwent digital rectal examination of prostate, analysis
of semen and express prostatic secretions (EPS). Bacterial culture of urine was
done in 40 randomly selected inflammatory CP patients by pre- and post-message
method (pre- and post-massage test, PPMT). RESULTS: 209 out of the 534 patients
with male infertility were diagnosed as chronic prostatitis with a prevalence
rate of 39.1%, among which 46 with CP type II and IIIA with the prevalence rate
of 8.6%, 28 with CP type IIIB (5.2%), and 135 with CP type IV (25.3%)
respectively. Positive bacterial culture was found in 10 out of the 40 cases of
inflammatory chronic prostatitis (25.0%). The bacterial infection rate was 24.2%
(8/33) in the cases of CP type IV. The prevalence rate of liquefaction
dysfunction was much higher in the patients of male infertility with CP (22.7%)
than in those without CP (14.3%, P < 0.05), however, it had little influence on
the quality of semen, pH value, sperm density, and sperm motility. CONCLUSION:
Quite common in patients with male infertility, CP prolongs the time of
liquefaction, but has no other reverse influence on semen.

PMID: 15061985 [PubMed - indexed for MEDLINE]

10: BJU Int. 2004 Mar;93(4):568-70.

Prevalence of sexual dysfunction in Chinese men with chronic prostatitis.

Liang CZ, Zhang XJ, Hao ZY, Shi HQ, Wang KX.

Department of Urology, First Affiliated Hospital of Anhui Medical University,
Anhui, China. ahykdxcz@mail.hf.ah.cn

OBJECTIVE: To investigate the prevalence and risk factors of sexual dysfunction
in Chinese men with chronic prostatitis. PATIENTS AND METHODS: A questionnaire
survey was conducted among 2000 men diagnosed as having chronic prostatitis
using the National Institutes of Health Chronic Prostatitis Index and analysis
of expressed prostatic secretions. The survey was designed to elicit information
about age, height, weight, occupation and history of disease and treatment. The
erectile capacity of the men was assessed using the five-question version of the
International Index of Erectile Function. RESULTS: Of the 2000 men with chronic
prostatitis selected, 1786 completed the survey; the overall prevalence of
sexual dysfunction in these patients was 49%. The prevalence of premature
ejaculation and erectile dysfunction accounted for 26% and 15%, respectively;
7.7% had both premature ejaculation and erectile dysfunction. There was a
negative correlation between prevalence and age, and with the duration of
chronic prostatitis (both P < 0.001). CONCLUSIONS: The prevalence rate of sexual
dysfunction in Chinese men with chronic prostatitis is high and related to age.

Publication Types:
Multicenter Study

PMID: 15008731 [PubMed - indexed for MEDLINE]

11: Zhonghua Nan Ke Xue. 2003 Sep;9(6):451-3.

[Survey of the prevalence of chronic prostatitis in men with premature
ejaculation]

[Article in Chinese]

Xing JP, Fan JH, Wang MZ, Chen XF, Yang ZS.

Department of Urology, First Hospital of Xi'an Jiaotong University, Xi'an,
Shaanxi 710061, China. xingjpen@yahoo.com.cn

OBJECTIVE: To investigate the prevalence of chronic prostatitis in men with
premature ejaculation. METHODS: The segmented urine specimens before and after
prostatic massage and the expressed prostatic secretion specimens from 106
patients with premature ejaculation and 38 controls were evaluated by
microscopic and/or bacteriological studies. The prevalence of premature
ejaculation was also investigated in 120 patients with chronic prostatitis.
RESULTS: Prostatic inflammation was found in 46.2% and chronic bacterial
prostatitis in 34.7% of the subjects with premature ejaculation, respectively.
Compared with the controls, the findings were statistically significant (P <
0.05). The prevalence of premature ejaculation in the patients with chronic
prostatitis was 47.5% (57/120). CONCLUSIONS: Chronic prostatic inflammation may
play a role in the pathogenesis of some cases of premature ejaculation and it is
important to give a careful examination of the prostate before initiating any
therapy for premature ejaculation.

PMID: 14574813 [PubMed - indexed for MEDLINE]

12: Andrologia. 2003 Oct;35(5):252-7.

Epidemiology and demographics of prostatitis.

Schaeffer AJ.

Department of Urology, Feinberg School of Medicine, Northwestern University,
Chicago, IL 60611, USA. ajschaeffer@northwestern.edu

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a multifactorial
problem affecting men of all ages and demographics. Currently, there is a
relative dearth of epidemiological information on CPPS. It is clear that
patients with CPPS have a dismal quality of life and many have benefited only
minimally from empiric, goal-directed therapy. Long-term follow-up of the CPPS
cohort will answer important questions about the natural and treated history of
this syndrome. Similarly, ongoing and future studies will provide
community-based and prevalence estimates for CPPS, morbidity rates for men with
CPPS, and the rates of symptom improvement and symptom deterioration for these
men, as well as the probability of benefits and harm from different treatments.
Although men with CP routinely receive anti-inflammatory and antimicrobial
therapy, recent studies suggest that leucocyte and bacterial counts do not
correlate with severity of symptoms. These findings suggest that factors other
than leucocytes and bacteria contribute to the symptoms associated with CPPS.
The probability of benefits and harm from different treatments for CPPS, and
reliable and valid measures to define these outcomes are eagerly awaited.

Publication Types:
Review

PMID: 14535850 [PubMed - indexed for MEDLINE]

13: Infect Dis Clin North Am. 2003 Jun;17(2):395-409.

Prostatitis revisited: new definitions, new approaches.

Krieger JN.

Department of Urology, University of Washington School of Medicine, VA Puget
Sound Health Care System, Section of Urology (112-GU), 1660 South Columbian Way,
Seattle, WA 98108, USA. jkrieger@u.washington.edu

Prostatitis syndromes represent an important health care problem resulting in
considerable morbidity and expenditure of health care resources. Comparison of
the traditional and consensus classification schemes demonstrates no changes in
the traditional categories of acute bacterial prostatitis and chronic bacterial
prostatitis. Examining only the EPS, however, results in diagnosis of half of
the patients with inflammatory CP/CPPS. An optimal diagnostic strategy required
evaluation of the VB3 and SFA in addition to the traditional EPS examination.
Such precision is necessary for research studies, but whether such precision is
important clinically remains unproved. The new interest in optimal evaluation
and characterization of patients with chronic prostatitis and related conditions
has resulted in important research initiatives examining the etiology and
optimal treatment for this large group of patients.

PMID: 12848476 [PubMed - indexed for MEDLINE]

14: Arch Pathol Lab Med. 2003 Jul;127(7):840-4.

Inflammatory atrophy of the prostate. Prevalence and significance.

Billis A, Magna LA.

Department of Anatomic Pathology, School of Medicine, State University of
Campinas (UNICAMP), Campinas, Brazil. athanase@fcm.unicamp.br

CONTEXT: Recently, prostatic atrophy associated with chronic inflammation has
been linked to carcinoma either directly or indirectly by first developing into
high-grade prostatic intraepithelial neoplasia. OBJECTIVE: The purpose of our
study was to test this hypothesis in autopsies. DESIGN: A step section method
was used to cut the posterior lobe in coronal planes at intervals of 0.3 to 0.5
cm in 100 consecutive autopsies of men older than 40 years. Prostatic atrophy
was classified as simple, hyperplastic (or postatrophic hyperplasia), and
sclerotic and was analyzed for the presence of chronic inflammation. Prostatic
atrophy without (group A) and with inflammation (group B) was correlated with
the following variables: age, race, histologic (incidental) carcinoma,
high-grade prostatic intraepithelial neoplasia, and extent of both these
lesions. RESULTS: Of the 100 prostates examined, 12%, 22% and 66%, respectively,
had no atrophy, atrophy without inflammation (group A), and atrophy with
inflammation (group B). There was no statistically significant difference
between groups A and B for age (P =.55), race (P =.89), presence of histologic
(incidental) carcinoma (P =.89), extensive carcinoma (P =.43), presence of
high-grade prostatic intraepithelial neoplasia (P =.65), extensive high-grade
intraepithelial neoplasia (P =.30), or subtypes of prostatic atrophy. Neither a
topographical relation nor a morphologic transition was seen between prostatic
atrophy and histologic carcinoma or high-grade intraepithelial neoplasia.
Sclerotic atrophy either alone or combined with other subtypes was more frequent
in the group with inflammation. A striking morphologic finding was a
topographical relation of focal inflammation with sclerotic atrophy in areas
with erosion of the epithelium. CONCLUSIONS: Inflammatory prostatic atrophy does
not appear to be associated with histologic (incidental) carcinoma or high-grade
intraepithelial neoplasia. One possible cause of inflammatory infiltrate
associated with prostatic atrophy may be the extravasated prostatic secretions,
which were noted in areas of eroded epithelium, a common finding in the
sclerotic type of prostatic atrophy.

PMID: 12823038 [PubMed - indexed for MEDLINE]

15: Urology. 2003 Jan;61(1):60-4.

Chronic prostatitis: symptom survey with follow-up clinical evaluation.

Cheah PY, Liong ML, Yuen KH, Teh CL, Khor T, Yang JR, Yap HW, Krieger JN.

University of Science Malaysia School of Pharmaceutical Sciences, Penang,
Malaysia.

OBJECTIVES: To determine the prevalence of chronic prostatitis/chronic pelvic
pain syndrome (National Institutes of Health Category III prostatitis) in
Penang, Malaysia and estimate the proportion of cases ascertained by population
survey that met consensus clinical criteria for "chronic prostatitis." METHODS:
One percent of 20 to 50-year-old men in Penang, Malaysia were surveyed using the
National Institutes of Health Chronic Prostatitis Symptom Index. A clinical
evaluation that included lower urinary tract localization studies was
recommended for symptomatic subjects who met the survey definition to identify
bacterial prostatitis and other diagnoses that would exclude them from the
consensus clinical definition for chronic prostatitis (Category III). RESULTS:
Of 3147 subjects surveyed, 275 (8.7%) met the survey criteria for chronic
prostatitis. The prevalence of chronic prostatitis was 8.0% among Malays, 8.9%
among non-Malays, and 16% among noncitizens (P = 0.025). The prevalence
increased with age: 6.3% in 20 to 30-year-old men, 8.9% in 31 to 40-year-old
men, and 12.6% in 41 to 50-year-old men (P <0.001). Of 87 subjects evaluated
clinically, 65 (75%) met the consensus clinical criteria for chronic
prostatitis. CONCLUSIONS: Chronic prostatitis represents an important,
international healthcare problem. A thorough clinical evaluation is necessary to
verify that chronic prostatitis is indeed responsible for a patient's pelvic
pain and lower urinary tract symptoms.

PMID: 12559266 [PubMed - indexed for MEDLINE]

16: J Urol. 2003 Feb;169(2):589-91.

Comment in:
J Urol. 2003 Feb;169(2):597-8.

The prevalence of men with National Institutes of Health category IV prostatitis
and association with serum prostate specific antigen.

Carver BS, Bozeman CB, Williams BJ, Venable DD.

Department of Urology, Louisiana State University Health Sciences Center,
Shreveport, Louisiana, USA.

PURPOSE: We evaluated the prevalence and relationship of serum prostate specific
antigen (PSA) levels in a screening population of men diagnosed with National
Institutes of Health (NIH) category IV prostatitis. MATERIALS AND METHODS: In
September of 2001, 300 men were randomly selected from our prostate cancer
awareness screening program to be evaluated for NIH category IV prostatitis.
After informed consent was obtained all patients completed the NIH prostate
cancer awareness survey and had a serum sample obtained for PSA before
examination. Expressed prostatic secretions were obtained from 227 of the 300
participants. Patients were classified according to findings on examination of
the expressed prostatic secretions. The records were entered into our data base
and subsequently reviewed. RESULTS: The prevalence of NIH category IV
prostatitis was 32.2% in our population of men. Patient age, American Urological
Association symptom scores and clinical prostate gland size did not differ
between men with or without evidence of prostatitis on expressed prostatic
secretion examination. Men with NIH category IV prostatitis had a mean serum PSA
level of 2.3 which was significantly higher (p <0.0004) than those without
prostatitis (mean PSA 1.4). CONCLUSIONS: These data suggest that NIH category IV
prostatitis is fairly prevalent (32.2%) among men in the general population who
present for prostate cancer screening and appears to contribute to increased
serum PSA levels in some men.

PMID: 12544313 [PubMed - indexed for MEDLINE]

17: Urology. 2002 Dec;60(6 Suppl):8-12; discussion 13.

Chronic prostatitis: epidemiology and role of infection.

Krieger JN, Ross SO, Riley DE.

Department of Urology, University of Washington School of Medicine, Seattle,
Washington, USA.

We review the epidemiology of chronic prostatitis/chronic pelvic pain syndrome
(CP/CPPS) and the role of infectious agents, emphasizing critical data necessary
to define current research issues. The epidemiologic literature is limited, but
the worldwide prevalence appears to be in the range of 2% to 10%, indicating
that CP/CPPS represents an important international health problem. Recent
molecular studies have documented bacterial DNA sequences in prostate tissue
from CP/CPPS patients. These data suggest that colonization and/or infection
occurs in the prostates of many patients with CP/CPPS. Further molecular
research is needed to define the role of bacteria in the etiology of CP/CPPS.

Publication Types:
Review

PMID: 12521579 [PubMed - indexed for MEDLINE]

18: Urology. 2002 Dec;60(6 Suppl):5-6; discussion 6-7.

Classification (traditional and National Institutes of Health) and demographics
of prostatitis.

Schaeffer AJ.

Department of Urology, Northwestern University Medical School, Chicago,
Illinois, USA. ajschaeffer@northwestern.edu

This article reviews the National Institutes of Health (NIH) classification
system for prostatitis and summarizes the baseline analysis of the Chronic
Prostatitis Cohort Study, a longitudinal study, which has enrolled 488 patients
diagnosed with category III prostatitis. The prevalence of category IIIA in this
cohort was 54% to 90%, depending on the cut points used. In all, 8% (37 of 488)
had > or =1 localizing uropathogen. However, leukocyte and bacterial counts did
not correlate with severity of symptoms as assessed by the NIH Chronic
Prostatitis Symptom Index. Continued follow-up study of this cohort will likely
answer important questions about the natural and treated history of this
syndrome.

Publication Types:
Review

PMID: 12521577 [PubMed - indexed for MEDLINE]

19: Curr Opin Urol. 2003 Jan;13(1):23-9.

Erratum in:
Curr Opin Urol.2003 Mar;13(2):177. Batstone D [corrected to Batstone G
Richard D].

Chronic prostatitis.

Batstone GR, Doble A.

Department of Urology, Addenbrooke's Hospital NHS Trust, Hills Road, Cambridge,
CB2 2QQ, UK. grd@batstoner.fsnet.co.uk

PURPOSE OF REVIEW: This review covers recent developments in the classification,
epidemiology, aetiology, diagnosis and treatment of patients diagnosed with
chronic prostatitis (NIH classification types II, IIIa/IIIb and IV prostatitis)
in the period of review (2001-2002). RECENT FINDINGS: Recent studies highlight
some of the problems with the 1995 NIH classification. Epidemiological studies
have confirmed that "prostatitis" is common, with a prevalence of 10-15%.
Associations of prostatitis include benign prostatic hyperplasia, sexually
transmitted disease, lower urinary tract symptoms, stress, and reduced sunlight
exposure. Elevated levels of cytokines in the seminal plasma and prostatic
secretions have been detected in men with chronic prostatitis compared with
normal individuals, suggesting an active inflammatory process in the male
genital tract. This inflammatory reaction may be mediated by an adaptive immune
response directed against a genital tract antigen(s) (autoimmunity). Increased
levels of bacterial 16S ribosomal DNA in the prostates of men with chronic
prostatitis compared with controls are compatible with the notion that a
bacterial inflammatory event initiates an auto-immune process; however, the role
of bacteria in the continuation of symptoms is unknown. SUMMARY: The aetiology
of chronic pelvic pain syndrome is still not certain, although an auto-immune
process is favoured. Further research is required to determine the putative
auto-antigen, the immune responses of patients, the role of bacteria in the
inflammatory process, and the patients' pain response to genitourinary insults.
As yet no diagnostic tests (other than to eliminate other pathology) and few
treatments for chronic prostatitis can be recommended on the basis of scientific
evidence.

Publication Types:
Review

PMID: 12490812 [PubMed - indexed for MEDLINE]

20: Arch Esp Urol. 2002 Oct;55(8):907-14.

[Multi-core prostatic biopsy]

[Article in Spanish]

Rodriguez Duarte C.

Servicio de Urologia, Policlinica Metropolitana, Caracas, Venezuela.

OBJECTIVE: A brief revision of the history of the prostate biopsy is done, and
emphasis is made in the importance of seek deeply in the diagnostic of small
lesions, PIN and atypical prostate hyperplasia. METHODS: A total of 221
patients, are presented. A description of the two groups of patients is made.
group I with 148 patients in which the sextant type was performed, and the group
II, in which our technique of 12 cores was done, using separated bottles for
each core. The complete technique used is described and we used the "T" and Rank
Sum Test for the statistical analysis of the results. RESULTS: We found a global
22.9% positive biopsies in the group I. This grew up as we took out more cores,
with 25.9% with more than six cores. The global result in group II was 37.1% of
positive biopsies (p = 0.03). There were 25 patients with 12 cores, and the rate
of positive was 34.2%. Tumor in one core was found in eight patients and also in
two to four cores, in the group of ten cores tumor was found in ten patients. No
side effects were reported. DISCUSSION: We review the results, and emphasis was
made in the necessity of have multiple cores biopsies of the prostate, studying
them separate. CONCLUSION: Multi-core biopsy of the prostate is a very useful
procedure in the diagnosis of cancer of the prostate with better specificity
results, statistically significative, and without side effects.

Publication Types:
Evaluation Studies

PMID: 12455281 [PubMed - indexed for MEDLINE]

21: J Urol. 2002 Dec;168(6):2467-71.

Prevalence of prostatitis-like symptoms in a community based cohort of older
men.

Roberts RO, Jacobson DJ, Girman CJ, Rhodes T, Lieber MM, Jacobsen SJ.

Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota 55905,
USA.

PURPOSE: We describe a community based study to estimate the prevalence of
prostatitis-like symptoms using questions similar to the National Institutes of
Health Chronic Prostatitis Symptom Index (NIH-CPSI). MATERIALS AND METHODS:
Study subjects were a randomly selected sample of Olmsted County, Minnesota
white men 40 to 79 years old in January 1990 who participated in a longitudinal
study of lower urinary tract symptoms. Subjects were evaluated biennially using
self-administered questionnaires. In 2000 questions similar to the NIH-CPSI were
incorporated into the questionnaire and questionnaire responses were used to
categorize men as having prostatitis-like symptoms. RESULTS: Of 1,541 men 182
(12%) had at least 1 urogenital pain symptom. Pubic (76 men, 4.9%) and
testicular (73, 4.7%) pain were the most frequent pain symptoms. A total of 34
men with prostatitis-like symptoms (2.2%) had higher mean pain (6.7 versus 0.5),
urinary symptom (3.5 versus 2.1) and quality of life impact (3.7 versus 1.9)
scores compared to men who did not (all p <0.001). Pain frequency (OR 39.2, 95%
CI 18.8, 81.9) and pain intensity (OR 21.5, 95% CI 8.7, 52.9) were more strongly
associated with prostatitis-like symptoms than urinary symptom score (OR 2.8,
95% CI 1.4, 5.6) or quality of life impact score (OR 4.5, 95% CI 1.9, 10.7).
CONCLUSIONS: Although urogenital pain is common among community dwelling men,
prostatitis-like symptoms based on the modified questions from the NIH-CPSI are
less common. While pain measures may be useful in distinguishing between men
with and without prostatitis-like symptoms, the urinary symptom and quality of
life impact scores could partly reflect benign prostatic hyperplasia.

PMID: 12441942 [PubMed - indexed for MEDLINE]

22: Urology. 2002 Sep;60(3):442-8.

Impact of urinary symptoms on bothersomeness and quality of life in young men.

Ku JH, Kim ME, Jeon YS, Lee NK, Park YH.

Department of Urology, Military Manpower Administration, Taejeon, South Korea.

OBJECTIVES: To examine the impact of urinary symptoms on bothersomeness and
quality of life among young men in a community. METHODS: The National Institutes
of Health-Chronic Prostatitis Symptom Index was used to identify men with
urinary symptoms. The questionnaire also queried about sociodemographic
characteristics. A total of 15,264 men without pain or discomfort suggestive of
prostatitis were included in this study. RESULTS: Of the 15,264 subjects, 43.6%
reported that they experienced urinary symptoms. With regard to symptom
severity, 3.4% did not believe their bladder emptied fully after urinating more
than one time in five, and 9.7% had to urinate again within 2 hours more than
one time in five. Men in major towns had more severe symptoms, including
incomplete emptying and frequency, than those in other areas. Men with a high
educational level were less likely to report that they experienced severe
frequency. Multivariate logistic regression analyses indicated that urinary
symptoms significantly affected bothersomeness and quality of life of young men.
CONCLUSIONS: In a community-based population of healthy 20-year-old Korean men,
the prevalence of urinary symptoms was 43.6%. The results of the study indicated
that demographic variables might influence the prevalence of urinary symptoms in
young men. In addition, our findings suggest that young men with urinary
symptoms experience a negative impact on their quality of life.

PMID: 12350481 [PubMed - indexed for MEDLINE]

23: Scand J Urol Nephrol. 2002;36(4):296-301.

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

Ku JH, Jeon YS, Kim ME, Lee NK, Park YH.

Department of Urology, Military Manpower Administration, Taejeon, Korea.
randyku@hanmail.net

OBJECTIVE: 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. MATERIAL AND METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

PMID: 12201923 [PubMed - indexed for MEDLINE]

24: Singapore Med J. 2002 Apr;43(4):189-93.

Prevalence of prostatitis-like symptoms in Singapore: a population-based study.

Tan JK, Png DJ, Liew LC,