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Abstract 21

Comparison of Expressed Prostatic Secretions with Urine After Prostatic Massage: A Means To Diagnose Chronic Prostatitis/ Inflammatory Chronic Pelvic Pain Syndrome

M Ludwig, I Schroeder-Printzen, G Ludecke, W Weidner

Department of Urology, Justus-Liebig University, Giessen, Germany

Introduction The analysis of urine after prostatic massage (VB 3) was compared with expressed prostatic secretions (EPS) to assess the significance of leukocyte analysis in VB 3 and to give a first hint for the diagnosis of inflammatory chronic pelvic pain syndrome (CPPS) when EPS cannot be obtained.

Material and Methods Three hundred twenty-eight (328) men with expressable prostatic secretions were investigated. EPS was stained utilizing Papanicoleau stain and analyzed for leukocytes/high power field (HPF) (1OOOX). Additionally, identical aliquots of first voided urine (VB 1), midstream urine (VB 2), and VB 3 were centrifuged, stained (Papanicoleau), and analyzed for leukocytes (400X). Patients with increased numbers of leukocytes in VB 1 and VB 2 (>2/400X) were excluded. For statistical analysis Spearman's correlation coefficient for nonparametric tests was used.

Results The distribution of leukocytes in EPS and VB 3 according to previously published thresholds are shown in table below. The presence of elevated leukocytes in VB 3 predicts the presence of increased leukocytes in EPS with a high certainty: sensitivity 91.9%, specificity 98.9%, accuracy 95.7%, positive and negative predictive value 98.6% and 93.7%, respectively.

Conclusions The determination of leukocytes in VB 3 is a feasible and reliable method as compared to the analysis of EPS. However, though this association does not directly prove the significance of VB 3 in those cases where EPS cannot be obtained, we suggest this method to be taken in account as an indirect indicator in the diagnosis of inflammation.


VB 3 <10

VB 3 >210

EPS <10 leukocytes/HPF



EPS >10 leukocytes/HPF