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Abstract 29

Histopathology and Cytology of Chronic Prostatic Urethritis (CPU)

J Polacheck, E Vega

Prostatitis Center and Carondelet St. Joseph's Hospital, Tucson, AZ

In order to learn more about the pathophysiology of "chronic" prostatitis, we examined the cytology of expressed prostatic secretions (EPS) from patients with chronic prostatitis while they were being treated with antibiotics and frequent prostatic massages.

Based on preliminary studies, we have made the following observations:

  • Prostatic inflammatory aggregates (PlAs), as described in the previous abstract, decline in number or disappear in the EPS of most patients during treatment. These patients usually experience a decrease in or a disappearance of their pelvic pain.
  • Frequently, reactive squamoid/urethral cells are observed in the EPS. As a clinical correlation, we have noted that these patients then usually have prominent urethral symptoms.

It is not uncommon to observe short, bipolar, rodlike bacteria in association with reactive squamoid cells. In several of these cases, we have been able to isolate corynebacteria (diptheroids) using special bacteriologic techniques. These bacteria may display a unique antibiotic sensitivity profile and, therefore in some cases, specific antibiotics are required to eradicate them.

Histopathologic examination of prostate tissue removed surgically demonstrates that the most likely origin of these squamoid cells is from the most distal portions of the prostatic ducts and/or the prostatic urethra itself.

Therefore, what is called "chronic prostatitis" may actually be two separate, albeit closely related, disease entities, one: "chronic active prostatitis" (CAP) and the other: "chronic prostatic urethritis"" (CPU).