The most important study to be presented at AUA 2002
AMB
regarding the role of bacteria in CPPS. I think this study
convincingly demonstrates that a positive localizing culture is an
unimportant finding, as prostate "infections" are just as common in
asymptomatic controls as they are in CPPS patients.
LEUKOCYTE AND BACTERIA LOCALIZATION COMPARISONS IN MEN WITH CHRONIC
PELVIC PAIN SYNDROME AND ASYMPTOMATIC MEN: A CASE-CONTROL STUDY
J Curtis Nickel*, Kingston Ontario, Canada; Richard B Alexander,
Baltimore, MD; Anthony J Schaeffer, Chicago, IL; J Richard Landis,
Jill Knauss, Kathleen J Propert, Cpcrn Study Group, Philadelphia, PA
Introduction and Objectives:
To determine if leukocyte counts and localization rates for bacterial
cultures of segmented urine samples (VB1, VB2, VB3), expressed
prostatic secretion (EPS) and semen are different in men diagnosed
with chronic prostatitis/chronic pelvic pain syndrome (CPPS) compared
to men without urinary symptoms ("controls").
Methods:
Men (n=463) enrolled in the NIH Chronic Prostatitis Cohort (CPC) Study
and age-matched men without urinary symptoms (n=121) had leukocyte
counts performed and 5-day bacterial cultures on specimens obtained
from a standard 4 glass test (VB1, VB2, EPS, VB3) and semen. All
analyses are adjusted for clinical center using generalized
Mantel-Haenszel methods.
Results:
The frequency of leukocytes by various cutpoints (1+ = 1 or more
leukocytes in specimen etc) and bacterial culture localization in
segmented urine specimens, EPS and semen are shown in the table below
as are selected composite criteria for classification of Category
IIIA.
Conclusions:
Men with CPPS have statistically higher leukocyte counts in all
segmented urine samples and EPS, but not in semen, compared to
controls. However, the clinical significance of these elevated
leukocyte counts requires further investigation, particularly because
of the high prevalences among the controls. There is no difference in
rates of localization of cultures for men with CPPS compared to
control men.
A. Melon
> In this newsgroup and elsewhere, there
> is a lot of discussion regarding the role of
> bacteria in CPPS. I think this study
> convincingly demonstrates that a
> positive localizing culture is an
> unimportant finding, as prostate
> "infections" are just as common in
> asymptomatic controls as they are in
> CPPS patients.
> LEUKOCYTE AND BACTERIA LOCALIZATION
> COMPARISONS IN MEN WITH CHRONIC
> PELVIC PAIN SYNDROME AND
> ASYMPTOMATIC MEN: A CASE-CONTROL
> STUDY ...snip...... "There is no difference in
> rates of localization of cultures for men
> with CPPS compared to control men."
I see the website has already picked it up at:
http://www.chronicprostatitis.com/bacteria.html
I'm thankful at least one website on this subject keeps up to date!
-------
Prostatitis Supermall: http://www.chronicprostatitis.com
Nomen Nescio
> In this newsgroup and elsewhere, there is a lot of discussion
> regarding the role of bacteria in CPPS. I think this study
> convincingly demonstrates that a positive localizing culture is an
> unimportant finding, as prostate "infections" are just as common in
> asymptomatic controls as they are in CPPS patients.
Pow! Comin' at ya!
The Bacteria Brigade are on the ropes, punch-drunk and woozy. Miami
heads for a hot bath to recuperate, Pullacheck puts his clinic on the
market, SS-Obersturmbannführer Kenneth vön Smithstein whimpers softly
to himself, and the Feliciano Gang put out a "contract" on the CPCRN
Study Group!
Isn't life wonderful?
Rhemium
>regarding the role of bacteria in CPPS. I >think this study
>convincingly demonstrates that a positive >localizing culture is an
>unimportant finding, as prostate >"infections" are just as common in
>asymptomatic controls as they are in >CPPS patients.
Mark one up for the good guys!
Derek
"Nomen Nescio" wrote....
> The Bacteria Brigade are on the ropes, punch-drunk and woozy.
Or it could be the Bacterial Brigade are mimicing the Muhammad Ali rope a
dope maneuver.
Jim
CP is an autoimmune disorder than there is no cure and your in for a life
long use of potent anti-inflammatory drugs that have many side effects as
well. I seriously doubt that most people will tolerate these drugs in the
long run.
Jim Boy
prostateman
> In this newsgroup and elsewhere, there is a lot of discussion
> regarding the role of bacteria in CPPS. I think this study
> convincingly demonstrates that a positive localizing culture is an
> unimportant finding, as prostate "infections" are just as common in
> asymptomatic controls as they are in CPPS patients.
Yes, the study is interesting. However, it does not say anything about
what kind of bacteria that was found in CPPS-men compared to the
control group.
Another point is that CPPS-men may not tolerate bacterias in the
prostate the same way as asymptomatic men may do. Thus, antimicrobal
treatment (abx. etc.)
may still be the right treatment for some men with CPPS.
prostateman
AMB
There's actually a table that accompanies this abstract, which I did
not include in the original post. You can check it out at
chronicprostatitis.com. from the table, you'll notice that there was
not a significant difference in the rate of positive cultures for any
type of bacteria, uropathogens or otherwise, between the patients and
controls. It could be that men with CPPS are experiencing an
"unusual" reaction to bacteria, but I doubt it. Nickel's study
published in the May 2001 Journal of Urology showed that men with
positive cultures do no better with antibiotics than culture-negative
patients, though both groups showed some degree of improvement, likely
due to the anti-inflammatory effects of quinolones.