This is the report of 75 cases of chronic prostatitis, confirmed by microscopic examination of the 3 glass test of urine and the prostatic secretion and bacterial culture of the prostatic secretion, who visited Department of Urology, St. Mary's Hospital from 1 December 1980 to 30 June 1981. The results were as follows: 1. The result of microscopic examination of the 3 glass test of urine revealed that the first and second glass urine were within normal limit (over 90%), but on the third glass urine, 69 cases (92.0%)showed WBC more than 10/HPF. 2. Microscopic examination of the prostatic secretion showed WBC more than 10/HPF in 69 cases (92.0%)and second glass in 6 cases (8.0%)showed normal findings, but many bacteria were isolated on bacterial culture of the prostatic secretion. The positive findings of prostatic secretion culture were noticed in 63 cases (84.0%). Microorganism was not grown in culture of 12 cases (16.0%), which was shown over WBC 10/HPF on microscopic examination of the prostatic secretion. Therefore, if chronic prostatitis is suspected, both methods should be used in combination because many bacteria could be detected in bacterial culture even when no inflammatory findings were shown in the microscopic examination of the prostatic secretion. In diagnosis of chronic prostatitis, the combined use of the microscopic examination and bacterial culture of the prostatic secretion were more significant than urinalysis alone.
Bacteria ; Bacteriology ; Diagnosis ; Glass ; Prostatitis* ; Urinalysis ; Urology

Quantitative determination of immunoglobulin was used in the diagnosis of prostatitis in seminal fluid and serum by radial immunodiffusion method. The study was performed in 11 normal healthy men and 20 prostatitis patients and they were compared with each other. Significant elevation of IgA in seminal fluid of patients with prostatitis was obtained.
Diagnosis ; Humans ; Immunodiffusion ; Immunoglobulin A ; Immunoglobulins* ; Male ; Prostatitis*

Provocation test made no 90 cases of chronic prostatitis using prednisolone with a dose of 20-30 mg. per day for 1~2 weeks, was done. The results are as follows. 1. In provocation group the incidence of cases with 10/HPF or more of WBC was 10~21% as compared to 0~10 % of control group. 2. There was no difference between the two groups in the number and species of bacteria found in the prostatic secretion. 3. On palpation no remarkable difference was found between the two groups except the tenderness which was less in incidence in the provocation group. 4. As mentioned above the prostatic secretion of the provocation group disclosed increasing tendency in WBC appearance and the prednisolone provocation test was proved to de valuable for the diagnosis of chronic prostatitis.
Bacteria ; Diagnosis ; Incidence ; Palpation ; Prednisolone* ; Prostatitis*

PURPOSE: Chronic prostatitis is clinically defined by symptoms consisting of pain, voiding complaints and sexual dysfunction. Determination of the severity and progression over time of the disease and an evaluation of the results of various therapies may be best assessed and monitored by a valid and reliable symptom scoring instruments. We evaluated the reliability, validity and responsiveness of the Korean version of NIH-CPSI and the characteristics of symptom index on chronic prostatitis. MATERIALS AND METHODS: All patients underwent a complete clinical evaluation and completed the Korean version of NIH-CPSI. The reliability of CPSI was examined by test-retest reliability and internal consistency for 41 chronic prostatitis patients. And the results in chronic prostatitis group were compared with those in 2 groups including 36 benign prostate hyperplasia patients and 46 healthy men. In 41 chronic prostatitis group including 28 IIIA and 13 IIIB patients, CPSI was reassessed after 6 weeks treatment and compared with those of pretreatment state. RESULTS: The Korean version of NIH-CPSI had excellent test-retest reliability (r=0.76 to 0.95) and high internal consistency (Crobach's alpha=0.86 to 0.97) during a 1 week period. The symptom score had significant difference in the each items and domains between chronic prostatitis and healthy control subjects (p<0.05). And the symptom score of each domains was sensitive to change with decreasing score after treatment (p<0.01). Chronic prostatitis had higher score of pain domain and BPH had higher score of urinary symptom domain. But the score of QOL domain was similar in both group. CONCLUSIONS: The NIH-CPSI is clinically reliable, valid, and responsive means of capturing the symptoms and impact of chronic prostatitis. It may be useful in clinical diagnosis and treatment of chronic prostatitis.
Diagnosis ; Humans ; Hyperplasia ; Male ; Prostate ; Prostatitis*

Determination of immunoglobulin in prostatic secretion and serum by radial immunodiffusion method was used in the diagnosis of prostatitis. The study was performed in 16 normal healthy men and 45 prostatitis patients. The results were as follows; 1 Significant elevation of IgG and IgA in Prostatic fluid of patients with prostatitis was obtained. 2. Ratio of IgA in prostatic secretion to immunoglobulin in serum was increased in patients with prostatitis than normal healthy men.
Diagnosis ; Humans ; Immunodiffusion ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulins* ; Male ; Prostatitis*

Prostatitis is a common syndrome that is confusing and frustrating for urologists. Chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS) is the most common form of prostatitis. The etiology of CP/CPPS is unknown, but possibilities include infectious, autoimmune, neurological and psychiatric causes. Clinical, laboratory, and imaging evaluations for the patient presenting prostatitis can be categorized as basic or mandatory evaluations, further or recommended evaluations, and optional evaluations in selected patients. Evaluation can aid in diagnosis and follow-up of the patient's response to therapy. Treatment for CP/CPPS is empiric and limited by a lack of randomized, placebo-controlled clinical trials. Antimicrobials are commonly used to treat patients with prostatitis. Other commonly used drugs include alpha-adrenoceptor antagonists, anti-inflammatory drugs, tricyclic antidepressants, and anticholinergic agents. Also, minimally invasive procedures are considered in patients with CP/CPPS. Although much progress has been made in therapy, there is no distinct treatment for patients with CP/CPPS. It is possible to treat intractable patients with 'care' not 'cure'.
Antidepressive Agents, Tricyclic ; Cholinergic Antagonists ; Diagnosis ; Humans ; Pelvic Pain ; Prostatitis*

In recent years, significant progress has been achieved in the epidemiological, basic and clinical researches on prostatitis in China. From the perspective of clinical practice, Chinese Urological Association (CUA) Guidelines on Prostatitis has been applied nationwide and promoted the standardization of the diagnosis and management of prostatitis in China.
China ; Humans ; Male ; Practice Guidelines as Topic ; Prostatitis ; diagnosis ; therapy

OBJECTIVETo investigate the differential diagnosis of type III prostatitis and interstitial cystitis so as to improve the efficiency of diagnosis and treatment of the two diseases.

METHODSBased on the clinical data of 4 cases of type III prostatitis and 3 cases of interstitial cystitis, we analyzed the characteristics of the two diseases in such aspects as clinical symptomatology, urodynamics, prostatic fluid microscopy, microbiology and treatment.

RESULTSThe common clinical characteristics of type III prostatitis and interstitial cystitis were indisposition or pain in the subabdomen and/or pelvic floor, but their differences were quite obvious. In interstitial cystitis, longer urine accumulation could cause worse pain in the subabdomen, which could be relieved after micturation, and the bladder capacity was obviously decreased, but with normal prostatic fluid and negative result of microbial culture. It responded to behavior therapy, resiniferatoxin, sodium hyaluronate and water dilation of the bladder under anaesthesia. While type III prostatitis, with white blood cells > 10/HP or < or = 10/HP in the prostatic fluid and negative result of microbial culture, did not respond to the above therapeutic methods that were effective for interstitial cystitis.

CONCLUSIONType III prostatitis and interstitial cystitis, although clinically confusable, can be definitely differentiated from each other according to their characteristic causes and locations.

Adult ; Aged ; Cystitis, Interstitial ; diagnosis ; etiology ; Diagnosis, Differential ; Humans ; Male ; Middle Aged ; Prostatitis ; complications ; diagnosis

OBJECTIVETo explore the diagnosis and treatment of xanthogranulomatous prostatitis.

METHODSA 75-year-old man presented with a 3-month history of difficult urination and frequent micturition, which was exacerbated for 2 days. Digital rectal examination indicated an enlarged prostate size of II degrees with hard texture but no tenderness. Serum total PSA was 172.5 microg/L. TRUS revealed 200 ml of post-micturition residual urine, thickened bladder wall, prostate size of 4.3 cm x 3.8 cm x 5.0 cm and no isochrones. MRI showed an enlarged prostate gland, with marked enlargement of the central zones and low-signal intensity of the peripheral gland, part of the prostate gland protruding to the bladder with no clear dividing line. It was diagnosed as prostate cancer initially, and confirmed by needle biopsy.

RESULTSHistopathological examination revealed large numbers of "foamy macrophages" in the lesion, with a few multinucleated giant cells, leukocytes, mononuclear, plasmocytes and fibroplasia. Immunohistochemistry showed CD68 (+) and PSA (-). The patient was treated with oral Tamsulosin and glucocorticoid and by temporary catheterization, and followed up for 20 months. Urination symptoms began to alleviate and serum PSA to decrease at 4 months. The PSA level was 9.2 microg/L at 13 months and 3.6 microg/L at 17 months.

CONCLUSIONXanthogranulomatous prostatitis is a rare clinically, which can be confirmed by histopathological examination. It is treated mainly by supportive therapy and, for the cases with severe lower urinary tract obstruction, TURP can be employed. Follow-up must be performed by possible examination of PSA and necessary needle biopsy of the prostate.

Aged ; Humans ; Male ; Prostatitis ; diagnosis ; pathology ; therapy ; Xanthomatosis ; diagnosis ; pathology ; therapy

OBJECTIVETo investigate the application of the Chinese Urological Association (CUA) Guidelines on Prostatitis and its effects on the clinical practice patterns of diagnosing and treating chronic pelvic pain syndrome (CPPS) among Chinese urologists and andrologists.

METHODSWe conducted a questionnaire investigation on the application of the CUA Guidelines on Prostatitis among the urologists and andrologists of 173 hospitals in 21 cities of China, and performed statistical analyses on all the eligible questionnaires collected.

RESULTSOf the 1 056 questionnaires distributed, 851 (80.6%) were eligible, of which 71.6% were from the urologists or andrologists in grade 3 hospitals, 80.7% of them with senior or intermediate professional titles and 97.5% had studied the CUA Guidelines. Most of the subjects agreed that Type III prostatitis is a clinical syndrome, whose diagnosis should exclude other conditions with similar symptoms, and whose treatment should aim at relieving pain, alleviating urination symptoms and improving the quality of life. Those who had and those who had not studied the CUA Guidelines differed in their viewpoints on CPPS as illustrated in the book. In clinical practice, the most common treatment options for CPPS were psychological therapy (80.7%), medication (80.4%) and life style adjustment (79.6%), and the most frequently used drugs were phytotherapy (80.0%), alpha-blockers (68.9%) and antibiotics (61.0%).

CONCLUSIONCUA Guidelines on Prostatitis has gained a nationwide application and promoted the standardization of the management of CPPS in China.

Humans ; Male ; Pelvic Pain ; diagnosis ; therapy ; Physicians ; Practice Guidelines as Topic ; Prostatitis ; diagnosis ; therapy ; Surveys and Questionnaires