Clinical Significance of Prostatitis in Patients with Benign Prostatic Hyperplasia

Kang, Taek Won; Oh, Bong Ryoul; Kim, Kang Won; Min, Kyung Dae; Kwon, Dong Deuk; Ryu, Soo Bang

Abstract

PURPOSE: The clinical significance of prostatitis associated with benign prostatic hyperplasia (BPH) remains to be determined. We determined the differences in the prevalence, pattern, clinical symptoms and outcome in BPH patients both with, and without prostatitis.
MATERIALS AND METHODS
This prospective study included 134 consecutive patients with lower urinary tract symptoms related to BPH. The patients were divided into 2 groups relating to the expressed prostatic secretion caused by prostate massage (group 1: more than 10 leukocytes per high power field, group 2: less than 10 leukocytes per high power field). Tamsulosin, a selective alpha1-blocker, and finasteride were administered at doses of 0.2 and 5mg, respectively, once a day for one year. The primary efficacy criteria included, symptomatic improvement (International Prostate Symptom Score: I-PSS), maximum flow rate (Qmax) and residual urine volume.
RESULTS
Prostatitis was identified in 67 of 119 patients (56.3%); the other 15 patients failed the prostatic massage. Of the patients with associated prostatitis, 8 (11.9%) showed bacterial growth. The serum PSA level was higher in group 1 than in group 2, but there were no significant differences in the other clinical parameters. There was no significantly difference in the improvement of the total I-PSS after treatment between the two groups. However, in group 1, the rritative symptom was significantly less improved (p<0.05).
CONCLUSIONS
Prostatic inflammation is a common finding in patients with symptoms of BPH. In such cases, the response to medical treatment for irritative symptoms was inferior in the BPH only cases. There is a need for more studies to distinguish chronic prostatitis and BPH, and to ascertain any additional treatment requirements.