Pharmacology and Microbiology of Chronic Active Prostatitis (CAP)

J Polacheck, D Michaud, B Hennenfent, A Espinosa-Feliciano, E Vega

Prostatitis Center and Carondelet Hospitals, Tucson, AZ

In preliminary studies, we have made the following observations:

Blank filter, discs soaked in expressed prostatic secretion (EPS) obtained while patients are taking oral antibiotics, show antibacterial activity (Kirby-Bauer method); control discs, soaked in EPS when no oral antibiotics are being taken, show no such activity. It is hoped that this can be developed into a clinical test to manage patients with chronic prostatitis.

Fungi do not play a major role in chronic active prostatitis (CAP). If they ever do, it is only very rarely.

• We have isolated corynebacteria (diptheroids) from the EPS of patients with CAP on sheep blood, tellurite, and/or horse serum agar. No consistent species were found, and no consistent sensitivity pattern was observed (KirbyBauer method). Most patients with corynebacteria had prominent urethral symptoms suggesting a chronic prostatic urethritis (CPU). Also, corynebacteria were associated with reactive squamoid cells seen histologically in EPS from patients with CPU (p< 0.02).
• We have isolated Ureaplasma urealyticum from the EPS of patients with CAP and/or from their sexual partners. Ureaplasma were associated with chronic epididymal pain in patients (p<0.02). We refer to this as chronic epididymal syndrome (CES).
• Patients and/or their regular sexual partners have increased levels of IgG antibodies to a chlamydia species in their serum. About half of these are to C. trachomatis and half to C. pneumoniae. The clinical significance has not been proven, especially for C. pneumoniae, but we did obtain a history of oral sex in all cases. Remarkably, nearly all patients decreased their titer of chlamydia antibodies after they were treated for several weeks with antibiotics (p<0.01).

Further studies are needed.