Intravesical potassium sensitivity in patients with prostatitis

Prostatitis and interstitial cystitis encompass similar symptoms and may be manifestations of a single pathophysiological process in the lower urinary tract. Most patients with interstitial cystitis have urinary epithelial dysfunction, as indicated by a positive intravesical potassium sensitivity test. We used the potassium sensitivity test for the presence of epithelial dysfunction in men with diagnosed prostatitis.

We administered the potassium sensitivity test in men who presented with the signs and symptoms of prostatitis (urgency/frequency and/or pelvic pain) after being diagnosed with prostatitis and receiving at least 1 course of antibiotic treatment administered by a urologist other than one of us. We also surveyed the patients for urinary symptoms and pain locations using 2 self-evaluation questionnaires.

A total of 44 patients with prostatitis completed the questionnaires and underwent the potassium sensitivity test. Of the 44 men 37 (84%) had positive potassium sensitivity test results, 89% reported urinary urgency/frequency and 82% reported pain. Pain locations included the perineum, lower abdomen, lower back, penis, testes, scrotum and rectum as well as dysuria and post-void pain. Pain with sexual intercourse was reported by 75% of the patients with prostatitis.

The rate of positive potassium sensitivity test results in patients with prostatitis is almost identical to that reported in those with interstitial cystitis (84% and 79%, respectively), suggesting that prostatitis and interstitial cystitis may be a continuum of lower urinary epithelial dysfunction. Similar to patients with interstitial cystitis, most patients with prostatitis experience pain during sexual intercourse and perceive pain at locations throughout the pelvis. We suggest reclassifying the prostatitis-interstitial cystitis disease process as lower urinary dysfunctional epithelium.