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Bacterial Infection May Be Responsible For Chronic Pelvic Pain in Men.

BETHESDA, MD. -- Chronic pelvic pain syndrome may have an infectious cause, at least in some patients, Dr. Jay C. Lee said at a meeting of the International Prostatitis Collaborative Network.

In his study of 84 men with chronic pelvic pain and 49 healthy controls, Dr. Lee found that bacteria grew nearly twice as often from prostate biopsy samples from the pain patients as from the controls.

The tissue was cultured for aerobes, anaerobes, Trichomonas, chlamydia, and herpes simplex virus. Bacteria grew from prostate biopsies from 39 (46%) of the men with pelvic pain and 14(29%) of the healthy men.

An expressed prostatic secretion sample from each man was used to distinguish category IIIa patients (high levels of white blood cells in the expressed prostatic secretion) from category IIIb patients (identical symptoms, but normal levels of white blood cells in the expressed prostatic secretion).

Bacteria were cultured more often from biopsies from category IIIa pelvic pain syndrome patients than from category IIIb syndrome patients, Dr. Lee reported at the meeting, which was sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases and by the Prostatitis Foundation.

Among men with pelvic pain, 65% of those whose expressed prostatic secretion samples showed more than 500 white blood cells/[mm.sup.3] had positive bacterial cultures, while only 25% of those with fewer than 500 white blood cells/[mm.sup.3] had positive cultures.

High levels of white blood cells in expressed prostatic secretions were only associated with a positive biopsy in the men with pelvic pain, not in the controls, noted Dr. Lee, a urologist at the University of Washington in Seattle.

Also in this group, high levels of white blood cells were associated with coagulase-negative staphylococcus and positive anaerobic cultures.

These associations were not found in healthy men, even though the two groups did not differ significantly in the total levels of white blood cells in their expressed prostatic secretions.

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Author:Lindsay, Heather
Publication:Family Practice News
Geographic Code:1USA
Date:Apr 15, 2000
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