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Symptoms and Chronic Prostatitis: Results of a National Survey of Physician Visits

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Mary McNaughton Collins
Randy S. Stafford
Michael P. O'Leary
Michael J. Barry, Boston, MA
Introduction and Objectives:
Chronic prostatitis causes morbidity through a constellation of genito-urinary symptoms. A recent study (Krieger, Urol 48:715,1996) classified 21 of these symptoms into 3 categories: pain, voiding complaints, and sexual dysfunction; pain symptoms predominated among patients. We re-examined these categories to describe the most common symptoms reported by men at chronic prostatitis visits, as well as visits for benign prostatic hyperplasia (BPH).
We analyzed 71,203 visits by men aged 18+ to office-based physicians of all specialties in the National Ambulatory Medical Care Surveys (NAMCS) of 1990-95, using sampling weights to make national estimates. US physicians selected by random stratified sampling completed visit forms that included patients' reasons for visits and physicians' diagnoses. All but 3 of 21 symptoms in the study cited were in NAMCS; blood in semen, pain with ejaculation, and stopping/starting during urination were not included.
In 1990-95, there were 535 visits (national estimate 6.7 million) with a primary chronic prostatitis diagnosis (excluding 36 visits with acute prostatitis). Among chronic prostatitis visits, 23% were for pain, 17% voiding complaints, and 0.5% sexual dysfunction. For comparison, among BPH visits, 2% were for pain, 33% voiding complaints, and 1% sexual dysfunction. The 5 most common reasons coded for chronic prostatitis visits were: painful urination (14%), symptoms of the prostate (12%), diseases of the male genital organs (9%), frequency/urgency of urination (8%), and other urinary dysfunction (5%).
Understanding the symptom profile of men with chronic prostatitis is an integral part of studying this complex condition. Pain was slightly more common than voiding complaints, but much more common than sexual dysfunction among chronic prostatitis visits. Since 2 missing symptoms reflected sexual dysfunction and 1 voiding dysfunction, these categories may have been under-represented. Nevertheless, the most common reason for chronic prostatitis visits was painful urination, which was uncommon among BPH
Source: 1998

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