Korean J Urol.  2007 Feb;48(2):189-194. 10.4111/kju.2007.48.2.189.

Diagnostic Value of Polymerase Chain Reaction in Patients with Chronic Pelvic Pain Syndrome: using Semen as a Specimen

• Heo C
• Hong SJ
• Gil MC

• KMID: 2139759
• DOI: http://doi.org/10.4111/kju.2007.48.2.189

Abstract

PURPOSE: Specific microorganisms, such as Chlamydia and Mycoplasma, are rarely detected in chronic pelvic pain syndrome, but fastidious and non-culturable microorganisms may be important in its etiology. The objective of this study was to evaluate the usefulness and significance of polymerase chain reaction (PCR) in the diagnosis of the etiologies of chronic pelvic pain syndrome, especially using semen as a specimen.
MATERIALS AND METHODS
Between August 2005 and July 2006, 237 patients, with a mean age of 39 years (range 25-67 years), were evaluated for chronic pelvic pain syndrome. PCR testing of the semen was performed in all cases to establish the persistence of C. trachomatis, T. vaginalis, M. hominis, M. genitalium and U. urealyticum.
RESULTS
Of the 237 patients, 79 (33.3%) and 158 (66.7%) were categories IIIa and IIIb, respectively. On PCR, using semen, 18 (22.8%) of the 79 category IIIa and 26 (16.5%) of the 158 category IIIb cases were found to have positive PCRs for the causative microorganisms of CPPS. In a total of 53 isolates presenting positive PCR, the common causative microorganisms were U. urealyticum, C. trachomatis, M. genitalium, T. vaginalis and M. hominis in 23 (43.4%), 16 (30.1%), 11 (20.8%), 2 (3.8%) and 1 case (1.9%), respectively. CONCLISIONS: PCR is revolutionizing the diagnosis of many infectious diseases, particularly those caused by microorganisms that are difficult to cultivate. Moreover, PCR shows nearly 100% accuracy in terms of sensitivity and specificity. PCR using semen, which can detect various microorganisms suggestive of the etiologies of chronic pelvic pain syndrome, is expected to play an important role in the diagnosis, treatment and follow up of chronic pelvic pain syndrome in urology.

Keyword

Polymerase chain reaction; Prostatitis; Semen

MeSH Terms

Chlamydia
Communicable Diseases
Diagnosis
Humans
Mycoplasma
Pelvic Pain*
Polymerase Chain Reaction*
Prostatitis
Semen*
Sensitivity and Specificity
Urology

Figure

• 

  Fig. 1 Polymerase chain reaction (PCR) results for Ureaplasma urealyticum (429bp), Chlamydia trachomatis (200bp), Mycoplasma genitalium (347bp), Trichomonas vaginalis (260bp) and Mycoplasma hominis (170bp). Lane 1: 100bp DNA ladder marker, lane 2: negative control, lane 3: positive control, lane 4: patient's sample.

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