[Current approach to diagnosis of chronic prostatitis]

Area of Science:

• Urology
• Infectious Diseases
• Microbiology

Background:

• Chronic prostatitis remains a significant unresolved medical problem.
• Distinguishing between chronic bacterial prostatitis (CBP), chronic abacterial prostatitis (CAP), and prostate tuberculosis (PTB) is clinically challenging.
• Accurate diagnosis is essential for effective patient management.

Purpose of the Study:

• To compare the frequency of key symptoms (pain, dysuria, sexual dysfunction) in patients with CBP, CAP, and PTB.
• To determine the prevalence of latent infectious prostatitis in patients diagnosed with CAP.
• To evaluate the diagnostic utility of longidaza suppositories in CAP patients.

Main Methods:

• Study included 73 men with chronic prostatitis and a history of frequent exacerbations.
• Expressed prostate secretions (EPS) were analyzed using routine and molecular genetic methods.
• Longidaza rectal suppositories were administered to CAP patients to aid diagnosis.

Main Results:

• Chronic bacterial prostatitis (CBP) was diagnosed in 37% of patients, with significant antibiotic resistance.
• Latent CBP and PTB were frequently misdiagnosed as CAP, with 50% of CAP patients showing pathogens after longidaza treatment.
• Sexual dysfunction was more prevalent in CAP and PTB; hemospermia was indicative of PTB.

Conclusions:

• Chronic abacterial prostatitis (CAP) can mask latent chronic bacterial prostatitis (CBP) and prostate tuberculosis (PTB).
• Diagnostic approaches should incorporate longidaza suppositories and molecular genetic methods for improved pathogen detection.
• Prostate tuberculosis (PTB) requires careful consideration in chronic prostatitis cases, necessitating thorough patient history and targeted investigations.