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Prostatitis Foundation

Third International Chronic Prostatitis Network

A beneficial effect of prostate massage for patients with chronic prostatitis:

The expression of intraglandular prostatic inflammatory aggregates
J.W. Polacheck, L.E. Vega
The Prostatitis Center and Carondelet St. Joseph’s Hospital, Tucson, AZ
We decided to obtain objective evidence that digital-rectal massage of the prostate has a bene-ficial effect. The following study has been initiated: In patients with signs and symptoms of chronic prostatitis, we compared the cytopathology of their expressed prostatic secretions (EPS) obtained by prostatic massage to that of their semen obtained by ejaculation. We would like to report our preliminary findings from a small sample (N=10) of patients (mean age 42 years, range 29-66). Semen was collected shortly after patients woke-up in the morning, and in each case they were instructed to void before collecting their sample. Immediately after obtaining the sample, 35 ml of preservative (50 percent isopropyl alcohol) was added, and the mixture was kept cool. Smears and cell blocks were prepared and staining was done with a modified Wright’s, PAS, H & E and Papanicolau stains. For the EPS, two slides were made and stained with a modified Wright’s stain and PAS.
In 8 cases (80%), the EPS showed signs of acute inflammation, containing both individual polymorpho-nuclear leukocytes (PMNs) and cohesive aggregates of PMNs. We call these aggregates "PIAs," prostatic inflammatory aggregates.
By sharp contrast, the semen from all the patients showed either no findings of inflammation (no PMNs nor PIAs) or only very mild changes (rare PMNs). In this small series, we did not observe PIAs in semen. Our observations suggest that the muscular force of ejaculation is not sufficiently strong to express PIAs from the prostate, at least in the majority of patients with chronic prostatitis. PIAs can, however, beexpressed by digital-rectal prostate massage. Furthermore, we see scanty amounts of PAS positive protein in the total ejaculate specimens whereas it is prominent in EPS specimens. This suggests the total ejaculate of prostatitis patients contains only a minimal amount of prostate secretions. Additional studies are in progress.

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