Prostate Blood Flow Characteristics in Chronic Prostatitis/Chronic Pelvic Pain Syndrome

IR Cho,3 TS Keener,2 HV Nghiem,2 JN Krieger1

Prostatitis Clinic, Departments of 1Urology and 2Radiology, University of Washington School of Medicine, Seattle, WA; Prostate Clinic, 3Department of Urology, Inje University School of Medicine, Seoul, Korea

Purpose To determine if chronic prostatitis/chronic pelvic pain syndrome (CPPS) is associated with abnormal prostate blood flow.

Materials and Methods We used color Doppler ultrasonography to examine 123 patients (53 with inflammation and 80 without inflammation) and 22 healthy controls. Images were recorded and scored using standardized criteria to characterize the degree and distribution of prostatic vascularity.

Results Flow was observed to the entire prostatic capsule in 77% of patients but only 18% of controls (p < 0.0001). Parenchymal flow was evaluated using several criteria. On a two-point scale, 74% of

patients were classified as grade 2 compared to 27% of controls (p < 0.0001). Similar findings were noted on a Doppler spot scale (47% of patients had grade 2 flow compared to 14% of controls (p < 0.004), and patients also had more parenchymal Doppler spots (p < 0.01). Diffuse blood flow throughout the prostatic parenchyma was observed in 63% patients compared to 36% of controls (p < 0.03).

Conclusions Chronic prostatitis/CPPS was associated with increased blood flow to the prostatic capsule and diffusely throughout the prostatic parenchyma. Despite technical limitations, color Doppler ultrasonography may provide an objective tool to document prostate blood flow abnormalities in patients with chronic prostatitis/CPPS.