The Female Prostate, Prostatitis, and Recurrent Urinary Tract Infection

M Zaviacic,1 RJ Ablin2

1Institute of Pathology, Comenius University
School of Medicine, Bratislava, Slovakia (MZJ,
2Innapharma, Inc., Suffern, NY (RM)

In contrast to the almost 2 million office visits annually in the United States for male prostatitis, in excess of 5 million office visits by women have been noted for the urethral syndrome, the commonest urologic complaint among female patients, attributed to infection in the distal paraurethral glands ("the female prostate"). Given the general misconception that the prostate gland is exclusively a male organ, the failure to recognize the existence of the female prostate and to investigate its pathology have resulted in the misdiagnosis and inappropriate treatment of female prostatitis. In consonance with earlier anatomical and embryological data, our extensive anatomical, light and electron microscopic, biochemical, and immunohistochemical studies of the normal and pathologic adult human female prostate substantiate the unambiguous existence of the female prostate. The female homologue of the male prostate is susceptible to the same diseases, including prostatitis. Within this framework, it appears rational, in the interim of further studies, to apply knowledge gained from immunobiological studies of the male prostate suggesting the existence of what has been termed the "prostatolymphoreticular system," to the female prostate. If the female prostate exhibits the similar immunopermissiveness of its male counterpart, it may also serve as a nidus for various infectious agents, inclusive of HIV. Of particular significance in this regard, as elucidated from our studies, are the substantially increased number of mutually communicating ducts and intraepithelial glands with the urethra and anterior wall of the vagina in the female vs. male prostate. Providing an environment exceptionally favorable for the long-term survival of uropathogens, it is suggested that this may not only explain relapses of female prostatitis, but also the recurrent episodes of urinary tract infections diagnosed as acute cystitis.