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Diagnosing and treating chronic prostatitis: do urologists use the four-glass test?
M McNaughton Collins1, F J Fowler, D B Elliott
1General Medicine Unit, Medical Services, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
Urology
|March 4, 2000
Summary
Urologists often diagnose chronic prostatitis but rarely use the Meares-Stamey four-glass test. Antibiotic use remains high, regardless of diagnostic test practices, warranting further investigation into prostatitis treatment.
Area of Science:
- Urology
- Medical Diagnostics
- Pharmacology
Background:
- Chronic prostatitis is a common condition diagnosed by urologists.
- Current diagnostic and treatment practices for chronic prostatitis vary among practitioners.
Purpose of the Study:
- To investigate the diagnostic methods and treatment strategies employed by urologists for chronic prostatitis.
- To assess the utilization of the Meares-Stamey four-glass test and antibiotic prescribing patterns.
Main Methods:
- A national mail survey was conducted in 1998 targeting practicing urologists.
- Probability samples were drawn from the American Medical Association Registry of Physicians.
Main Results:
- A majority of urologists (80%) rarely or never performed the Meares-Stamey four-glass test.
- A significant proportion of urologists (over 80%) treated most or all patients with antibiotics.
- Performance of the four-glass test did not correlate with reduced antibiotic use but was associated with increased use of other treatments like alpha-blockers.
Conclusions:
- Urologists frequently diagnose chronic prostatitis but seldom use the recommended four-glass diagnostic test.
- Antibiotic prescribing patterns appear largely unaffected by the use of the four-glass test.
- High rates of antibiotic use for prostatitis, despite the rarity of bacterial prostatitis, suggest that current diagnostic and treatment approaches, including empiric antibiotic use, require critical evaluation.