Symptoms and inflammation in chronic prostatitis/chronic pelvic pain syndrome

  • John N Krieger
    Reprint requests: John N. Krieger, M.D., Urology Section, 112-GU, Veterans Affairs Puget Sound Health Care System, 1660 South Columbian Way, University of Washington Campus Mail Box 358280, Seattle, WA 98108-1597, USA
    Department of Urology, School of Medicine, University of Washington, Seattle, Washington, USA
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  • Susan O Ross
    Department of Urology, School of Medicine, University of Washington, Seattle, Washington, USA
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  • David F Penson
    Department of Urology, School of Medicine, University of Washington, Seattle, Washington, USA
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  • Donald E Riley
    Department of Urology, School of Medicine, University of Washington, Seattle, Washington, USA

    Department of Pathobiology, School of Public Health and Community Medicine, University of Washington, Seattle, Washington, USA
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      To evaluate the possibility that patients with inflammatory and noninflammatory chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) might present with different symptoms. Patients with CP/CPPS present with characteristic symptoms without bacteriuria. The new National Institutes of Health consensus suggests that CP/CPPS can be divided into inflammatory and noninflammatory categories.


      Standardized symptom surveys were completed by 130 subjects who met the criteria for CP/CPPS after clinical examination and urethral, urine, expressed prostatic secretion (EPS), and seminal fluid analysis evaluations.


      When classified by either EPS or postprostatic massage urine (VB3) findings, subjects with and without inflammation had similar symptoms. However, when classified using the combination of EPS, VB3, and seminal fluid analysis, subjects with inflammatory CP/CPPS had more severe (P <0.02) and more frequent symptoms, in particular, difficulty reaching erection (P <0.01), weak urinary stream (P <0.01), urinary frequency (P = 0.03), and penile pain (P = 0.04).


      The increased severity and frequency of symptoms among patients with inflammatory CP/CPPS provide empirical support for the new consensus classification on the basis of the combination of EPS, VB3, and seminal fluid analysis findings.
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