RE Wheeler, RG Selah
Urology Associates of the Great San Juans, Durango, CO
Objective Chronic Prostatitis is a health risk of unknown proportion to
virtually every adult male. Although recent data suggests that the frequency of diagnosis of chronic prostatitis was equivalent to the benign prostatic hyperplasia diagnosis; the clinical and economic impact suggest
that this topic be more closely scrutinized. Despite the frequency of diagnosis of chronic prostatitis, the accuracy is questioned as few primary care physicians and only one third of urologists use the expressed
prostatic secretion (EPS), the definitive diagnostic test to make the diagnosis. Finally, the treatment of either of these two disease entities is completely different, suggesting the possibility that many patients are
treated inappropriately.
Materials and Methods We prospectively evaluated 121 consecutive men who presented at our clinic with any voiding symptoms. All men were queried for voiding concerns using the modified
AUA symptom score. All men stating any level of voiding dysfunction underwent a prostate massage to yield an EPS. The EPS was quantified by microscopy by a registered laboratory technologist. A positive EPS was recorded
if the slide demonstrated greater than 10 WBCs/high power field (400x).
Results One hundred twenty-one (121) consecutive men with symptoms of voiding dysfunction were evaluated for chronic prostatitis. Men had
an age range of 26-83 years. Eighty-one percent (81%) of men ages 26-50 had chronic prostatitis, while 79% of men ages 50-83 years had chronic prostatitis.
Conclusions Chronic prostatitis is more common than
originally thought. Our data suggests that chronic prostatitis is ubiquitous and of epidemic proportion. It is our belief that voiding symptoms represent chronic prostatitis until proven otherwise. The clinical and
economic impact suggests that health care dollars will be better utilized with an improved diagnosis. Without accuracy of diagnosis, application of treatment options make little medical or economic sense.
