OBJECTIVETo investigate the pathogenic infection and its drug resistance in expressed prostatic secretion (EPS) and its correlation with serum PSA, and provide some evidence for the systematic and normalized diagnosis and treatment of prostatitis.

METHODSThree EPS swabs were collected from each of the 320 prostatis patients following measurement of the serum PSA level, 1 for bacterial culture and identification, 1 for detection of Mycoplasma and drug sensitivity, and the other for examination of Chlamydia trachomatis antigen by colloidal gold immunoblot.

RESULTSTotally 244 strains were isolated from the 320 EPS samples, including 188 bacterial strains (dominated by Staphylococcus and sensitive to vancomycin or linezolid) and 44 Mycoplasma and Chlamydia strains (mainly Ureaplasma urealyticum and susceptible to josamycin or doxycycline). The serum PSA level was significantly higher in the pathogen-positive than in the pathogen-negative group ([6.98 +/- 0.56] microg/L vs [2.32 +/- 0.12] microg/L, P < 0.05).

CONCLUSIONProstatitis may lead to the elevation of the serum PSA level and the pathogens involved vary in their resistance to different antibacterial spectrums. Therefore, appropriate and individualized antibiotic therapy should be selected according to etiological diagnosis and the results of drug sensitivity test.

Adult ; Humans ; Male ; Middle Aged ; Prostate ; microbiology ; secretion ; Prostate-Specific Antigen ; blood ; Prostatitis ; blood ; microbiology ; Young Adult

The prostate gland, like other glandular organs, is rich in blood and lymphatic vessels and nerves, which are the important histological factors for obtaining nutrition as well as for the endocrine and exocrine functions of the glands. Antimicrobial and non-antimicrobial drugs administered to patients by the oral, IM, IV or even topical routes are absorbed into the blood and transported to the prostate and other organs, where they can diffuse into the extravascular tissues through the walls of normal and damaged capillaries. The permeability of the prostate is enhanced by inflammatory reactions in the prostatic tissue, which is responsible for exudation or leakage of leukocytes and red blood cells, and drugs in the blood can enter the extravascular tissue of the prostate as well as diffuse into the prostatic secretions. The prostate lesions in patients with prostatitis or other prostatic diseases are caused by different types of pathogenic agents with various properties, and these diseases are characterized by a longer process of damage and a variety of pathological changes. Therefore, the diagnosis and treatment of prostatitis are relatively complex and difficult challenges hut meanwhile simple and easy matters for clinicians, and the difficulty or easiness is related not to the drug penetrability of the prostate, but largely to the understanding of the biological properties of the pathogenic agents, the physiological and pathological conditions of the patient's body and prostate, and the properties of drugs. The common factors that cause difficult treatment of prostatitis include clinical and laboratory misdiagnoses, release of pathogenic agents within pyogenic or necrotic prostatic tissues, variation of pathogenic agents, reinfection by other pathogens, and choice and administration of drugs.
Anti-Bacterial Agents ; pharmacokinetics ; therapeutic use ; Humans ; Male ; Prostate ; drug effects ; microbiology ; pathology ; Prostatitis ; diagnosis ; microbiology ; pathology

OBJECTIVETo investigate the efficacy of the double-balloon and triple-channel catheter (DBTC) in the treatment of chronic bacterial prostatitis (CBP).

METHODSOne hundred and three CBP patients were randomly assigned to three different groups and received three different therapies, respectively: 1. 61 cases by transurethral perfusion and drainage with antibiotics with DBTC catheter; 2. 29 cases by intravenous antibiotics, and 3. 13 cases by transurethral irrigation with 0.9% saline. The lecithin, white blood cells (WBC) in expressed prostatic secretion (EPS) and Meares-Stamey's test fractionary urine culture pre- and post-therapies were compared.

RESULTSThe improvement rates of clinical symptoms and lecithin corpuscles were 81.9% and 68.9%, respectively. And the decline rate of WBC and bacteriological efficacy rate were 75.4% and 91.8%, respectively. There was a significant statistical difference between the DBTC group and the intravenous group in the lecithin, WBC and bacterial culture (P < 0.05, < 0.01 and < 0.01, respectively), and so was there between the saline group and the intravenous group in the decline of WBC(chi 2 = 5.6, P < 0.05), but with no difference in lecithin and bacterial culture. Among 61 patients treated with DBTC, 3 developed mild allergic reaction in urethra.

CONCLUSIONSTransurethral DBTC has a better clinical efficacy than traditional intravenous treatment for CBP. DBTC perfusion combined with other hypurgia holds obvious advantages of being safe, effective, easy and repeatable in the treatment of CBP.

Adolescent ; Adult ; Bacterial Infections ; complications ; therapy ; Catheterization ; methods ; Chronic Disease ; Humans ; Male ; Middle Aged ; Perfusion ; methods ; Prostate ; microbiology ; Prostatitis ; microbiology ; therapy

OBJECTIVETo investigate the effects of Prostate Water Pellets (PWP) on the number of colonies, NO concentration and NOS activity in the prostate tissues of rats with chronic bacterial prostatitis (CBP).

METHODSA total of 120 healthy adult male Wistar rats weighing 250-300 g were equally randomized into 6 groups: blank control, model control, positive control, high-dose PWP, medium-dose PWP and low-dose PWP. The CBP rat models were established by injecting colibacilli (10(7)/ml) into the prostate. A month later, the high- , medium- and low-dose PWP groups were treated intragastrically with PWP at 4.4 g/kg, 2.2 g/kg and 1.1 g/kg per day respectively, the positive controls with levofloxacin at 0.018 g/kg per day, and the blank and model controls with normal saline, all for 35 days. Then the numbers of colonies in the prostate tissues were measured, and the changes in NO concentration and NOS activity detected by the nitrite reductase method.

RESULTSCompared with the model controls, the number of colonies, NO concentration and NOS activity were significantly reduced in the prostate tissues of the rats of the high- , medium- and low-dose PWP groups (P < 0.01).

CONCLUSIONPWP was proved to be efficacious for CBP in rats, whose mechanism might be related with its inhibitory effect on bacterial growth and decreasing effect on NO concentration and NOS activity in the prostate tissues.

Animals ; Drugs, Chinese Herbal ; therapeutic use ; Male ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase ; metabolism ; Phytotherapy ; Prostate ; metabolism ; microbiology ; Prostatitis ; drug therapy ; metabolism ; microbiology ; Rats ; Rats, Wistar

OBJECTIVETo explore the significance of clue cells in the diagnosis of male urogenital infection.

METHODSUrethra swabs or prostatic fluid of 264 male outpatients were collected and smeared directly on the slice to find clue cells under the ultramicroscopy. Meanwhile, the positive patients' spouses were detected for bacterial vaginosis (BV).

RESULTSThe positive rates of the urethra swabs and the prostatic fluid were 5.1% (11/215 ) and 2.0% (1/49), respectively. Nine cases in 11 of the patients' spouses (81.8%) were diagnosed as BV.

CONCLUSIONBV pathogen can attack and attach to the epithelia of male genitals to form clue cells. Clue cells positive, along with clinical symptoms, contribute to the diagnosis of male urogenital bacterial infection.

Adult ; Bacterial Infections ; diagnosis ; microbiology ; pathology ; Cervix Uteri ; microbiology ; Epithelial Cells ; microbiology ; Female ; Gardnerella vaginalis ; isolation & purification ; Humans ; Male ; Middle Aged ; Mycoplasma hominis ; isolation & purification ; Prostate ; microbiology ; Sensitivity and Specificity ; Spouses ; Ureaplasma urealyticum ; isolation & purification ; Urethra ; microbiology ; Urinary Tract Infections ; diagnosis ; microbiology ; pathology ; Vagina ; microbiology

OBJECTIVETo study the incidence of benign prostatic hyperplasia (BPH) complicated by chronic prostatitis.

METHODSWe performed routine examinations and bacterial culture of the expressed prostate secretion (EPS) for 213 cases of BPH, detected mycoplasma, chlamydia and serum PSA, and compared the results of IPSS of those complicated with chronic prostatitis before and after a 4-week anti-inflammatory treatment.

RESULTSOf the total cases, 69 (32.4%) were complicated by chronic prostatitis, 27 (12.7%) EPS positive and 15 (7.0%) mycoplasma and chlamydia positive. Among the 69 cases of chronic prostatitis, 7 were found with an elevated level of PSA (> 4 microg/L), and 43 with the mean IPSS score decreased from (12.2 +/- 2.6) before anti-inflammatory treatment to (10.5 +/- 2.3) after it (P < 0.01).

CONCLUSIONEPS examination should be performed for patients with BPH, which is highly significant for the diagnosis of prostatitis, choice of medical or surgical treatment, improvement of therapeutic effect and reduction of complications.

Aged ; Aged, 80 and over ; China ; epidemiology ; Chlamydia ; isolation & purification ; Chronic Disease ; Humans ; Incidence ; Male ; Middle Aged ; Mycoplasma ; isolation & purification ; Prostate ; drug effects ; microbiology ; pathology ; Prostate-Specific Antigen ; blood ; Prostatic Hyperplasia ; complications ; drug therapy ; epidemiology ; Prostatitis ; blood ; complications ; microbiology

Bacterial Infections ; complications ; diagnosis ; Biomarkers ; analysis ; Chronic Disease ; Endotoxins ; metabolism ; Humans ; Male ; Prostate ; secretion ; Prostatitis ; diagnosis ; microbiology ; Proteomics

Emphysematous prostatic abscess is a very rare form of prostatitis. Emphysematous prostatic abscess due to Klebsiella pneumoniae may have a poor prognosis according to a few previous reports. We report a rare case of successfully treated emphysematous prostatic abscess with cystitis due to Klebsiella pneumoniae in a 50-yr-old man with 15-yr history of diabetes mellitus. The patient was referred to the emergency room of our hospital. The KUB film revealed gas shadows in the lower pelvic area suggestive of emphysematous cystitis or emphysematous prostatic abscess. The gas was mainly occupying the prostate and was also seen in the bladder on pelvic CT. The patient was successfully treated with long-term antibiotic use and additional percutaneous drainage of the abscess. Emphysematous prostatic abscess may be misdiagnosed as emphysematous cystitis due to the similar location of gas shadows on radiography. Computerized tomography and transrectal ultrasonography are helpful in making the diagnosis of emphysematous prostatic abscess. Appropriate use of effective antibiotics with drainage of pus is the best treatment. This case emphasizes the importance of timely and accurate diagnosis followed by appropriate treatment in emphysematous prostatic abscess in diabetic patients.
Abscess ; Anti-Bacterial Agents/therapeutic use ; Cystitis/diagnosis ; Diabetes Mellitus/complications ; Drainage ; Emphysema/diagnosis/*microbiology ; Human ; Klebsiella Infections/*diagnosis/drug therapy ; Klebsiella pneumoniae/*metabolism ; Male ; Middle Aged ; Prostate/*microbiology ; Prostatic Diseases/*diagnosis/microbiology/radiography

AIMTo evaluate the clinical significance of the quantitative determinations of endotoxins in the expressed prostatic secretions (EPS) of chronic prostatitis (CP) patients.

METHODSThe EPS of 45 patients with CP and 15 normal volunteers were obtained for microscopic examination, bacterial culture and endotoxin determination. The level of endotoxins was determined by the Limulus-amebocyte-lysate test with chromogenic substrate.

RESULTSPatients with CP had higher mean levels of endotoxins in EPS than normal volunteers [52.06 +/- 32.83 EU/L vs. 4.77 +/- 4.14 EU/L (P <0.05)]. The levels of endotoxins in CP type II, type IIIa and type IIIb were 68.62 +/- 34.78 EU/L, 45.30 +/- 23.33 EU/L and 15.83 +/- 5.31 EU/L, respectively [type II vs. type IIIa (P >0.05), type IIIb vs. normal controls (P <0.05), type II/type IIIa vs. normal controls P >0.05)].

CONCLUSIONCP patients have elevated levels of endotoxins in the EPS, which suggests that inflammation is a feature of this disease. EPS endotoxin determination is not only helpful in diagnostic confirmation, but also in evaluating the response to treatment in CP patients.

Adult ; Bacterial Infections ; complications ; diagnosis ; Case-Control Studies ; Chronic Disease ; Endotoxins ; metabolism ; Humans ; Male ; Prostate ; secretion ; Prostatitis ; diagnosis ; microbiology ; Sensitivity and Specificity

OBJECTIVETo investigate the role of bacteria in the etiology of chronic prostatitis.

METHODSA total of 162 complete prostate specimens were obtained at autopsy from organ donors (aged 20 -38 yr) who died of non-prostatic diseases. Each of the samples from the peripheral zone of the prostate was divided into two parts, one for routine pathological examination and immunohistochemical studies of interleukin (IL)-1beta, tumor necrosis factor-alpha (TNF-alpha) and the nerve growth factor (NGF), and the other for PCR assay to detect the bacterial 16S rRNA gene (16S rDNA).

RESULTSFifty-one (31.5%) of the total specimens presented pathological changes of chronic prostatitis, of which 44 had mild focal stromal, 5 mild focal stromal and periglandular and 2 mild focal periglandular inflammation. The positive rate of 16S rDNA was 19.1% (31/162), 51.0% (26/51) in the chronic prostatitis and 4.5% (5/111) in the non-prostatitis specimens (chi2 = 29.783, P < 0.01). In the specimens with chronic prostatitis, the expressions of IL-1beta, TNF-alpha and NGF were significantly higher in the 16S rDNA positive than in the 16S rDNA negative group (P < 0.01).

CONCLUSIONBacterial inflammation may play an important role in the etiology of chronic prostatitis.

Adult ; Chronic Disease ; Genes, rRNA ; Humans ; Interleukin-1beta ; metabolism ; Male ; Nerve Growth Factor ; metabolism ; Prostate ; metabolism ; microbiology ; pathology ; Prostatitis ; metabolism ; microbiology ; pathology ; RNA, Bacterial ; genetics ; RNA, Ribosomal ; RNA, Ribosomal, 16S ; genetics ; Tumor Necrosis Factor-alpha ; metabolism ; Young Adult