Korean J Urol.  2009 Nov;50(11):1120-1124.

Results of Microorganism Detection by Multiplex Polymerase Chain Reaction in Patients with Chronic Pelvic Pain Syndrome

• Seo KI
• Hwang JC
• Kim TW
• Lee SH
• Park SY
• Roh SH

Abstract

PURPOSE
The aim of this study was to evaluate the results of multiplex polymerase chain reaction (PCR) in patients with chronic pelvic pain syndrome (CPPS) and the significance of microorganisms as the causative factor of CPPS.
MATERIALS AND METHODS
We evaluated the frequency of 19 possible causative microorganisms of prostatitis in 849 patients who had prostatitis symptoms from April 2007 to March 2009 by using multiplex PCR. All of the enrolled patients were category III by the definition of the NIH Chronic Prostatitis Workshop.
RESULTS
Of the 849 patients, 414 (49%) and 435 (51%) were categories IIIa (inflammatory CPPS) and IIIb (noninflammatory CPPS). On multiplex PCR, using the third voided urine specimen (VB3), 369 (89%) of the 414 category IIIa and 367 (84%) of the 435 category IIIb cases were found to have positive PCR results for causative microorganisms. The common microorganisms were Enterococcus, Ureaplasma urealyticum, Lactobacillus, Streptococcus agalactiae, and Chlamydia trachomatis in 173 (18%), 144 (15%), 129 (13%), 78 (8%), and 69 cases (7%), respectively.
CONCLUSIONS
There were too many positive PCR results for causative microorganisms in the CPPS patients despite negative urine culture examination. Therefore, it is necessary to rule out contamination of the specimen to achieve reliable results with multiplex PCR. However, multiplex PCR can detect various unknown microorganisms suggestive of the etiology of CPPS, particularly those that are difficult to cultivate. PCR is expected to play an important role in the diagnosis of CPPS, but further studies will be required to define the usefulness of molecular tests.

Keyword

Prostatitis; Polymerase chain reaction

MeSH Terms

Chlamydia trachomatis
Enterococcus
Humans
Lactobacillus
Multiplex Polymerase Chain Reaction
Pelvic Pain
Polymerase Chain Reaction
Prostatitis
Streptococcus agalactiae
Ureaplasma urealyticum

Figure

• 

  Fig. 1 Graph showing the frequency of species according to polymerase chain reaction findings for each of the chronic pelvic pain syndrome categories. Category IIIa: inflammatory chronic pelvic pain syndrome, Category IIIb: non-inflammatory chronic pelvic pain syndrome, EN: Enterococcus, UU: Ureaplasma urealyticum, LA: Lactobacillus, SA: Streptococcus agalactiae, CT: Chlamydia trachomatis, PR: Prevotella, VE: Veillonella, MG: Mycoplasma genitalium, EC: Escherichia coli, KL: Klebsiella, MH: Mycoplasma hominis, CO: Corynebacterium, CA: Candida, TV: Trichomonas vaginalis, PS: Pseudomonas, ST: Staphylococcus, a: p<0.05.

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