Detection of Cryptic Microorganisms by Polymerase Chain Reaction Assay in Chronic Pelvic Pain Syndrome

Ha, Jae Sung; Kim, Sae Woong; Cho, Yong Hyun

Abstract

PURPOSE
This study was undertaken to evaluate the usefulness, and significance, of polymerase chain reaction (PCR) in the diagnosis of chronic pelvic pain syndrome (CPPS), analyzing Chlamydia trachomatis, Trichomonas vaginalis, Mycoplasma hominis, Mycoplasma genitalium and Ureaplasma urealyticum as the main causative organisms of CPPS. MATERIAL AND METHODS: We used a PCR assay designed to detect C. trachomatis, T. vaginalis, M. hominis, M. genitalium and U. urealyticum in expressed prostatic secretions (EPS), or third voided urine specimens (VB3), of 359 patients diagnosed with CPPS.
RESULTS
Among 359 patients, 125 patients (34.8%) were category IIIa and 234 patients (65.2%) were category IIIb. With the use of PCR, Ttwenty-one (16.8%) of the 125 category IIIa, and nineteen (8.1%) of the 234 category IIIb, patients were found to have positive PCRs for the causative organisms of CPPS. In total 43 isolates, of presenting positive PCR, the common causative microorganisms were C. trachomatis in 15 cases (34.9%), U. urealyticum in 14 cases (32.6%), M. genitalium in 13 cases (30.2%) and M. hominis in 1 case (2.3%).
CONCLUSIONS
With the invention of PCR, the inconvenience to patients in the process of extracting causative microorganisms is reduced, and it has become possible to get a result within 2-4 hours in a technically less difficult way. Moreover, PCR shows nearly 100% accuracy in terms of sensitivity and specificity. PCR is expected to play an important role in way of diagnosis, and treatment, for chronic pelvic pain syndrome in urology.