Influence of infection on the distribution patterns of NIH‑Chronic Prostatitis Symptom Index scores in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)

Magri,V.; Wagenlehner,F. M.E.; Marras,E.; Van Till,J. W.O.; Houbiers,J.; Panagopoulos,P.; Petrikkos,G. L.; Perletti,G.

doi:10.3892/etm.2013.1174

August 2013 Volume 6 Issue 2

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August 2013 Volume 6 Issue 2

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Article

Influence of infection on the distribution patterns of NIH‑Chronic Prostatitis Symptom Index scores in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)

Authors:
- V. Magri
- F. M.E. Wagenlehner
- E. Marras
- J. W.O. Van Till
- J. Houbiers
- P. Panagopoulos
- G. L. Petrikkos
- G. Perletti
View Affiliations / Copyright

Affiliations: Urology and Sonography Outpatient Clinic, Azienda Ospedaliera Istituti Clinici di Perfezionamento, Milan, Italy, Department of Urology, Pediatric Urology and Andrology, Justus‑Liebig‑University, Giessen, Germany, Biomedical Research Division, Department of Theoretical and Applied Sciences, Università degli Studi dell'Insubria, Busto Arsizio/Varese, Italy, Global Medical Science, Astellas Pharma Europe, Leiderdorp, The Netherlands, Second Department of Internal Medicine, General University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece, Fourth Department of Internal Medicine, Attikon University General Hospital, National Kapodistrian University of Athens, Athens, Greece
Pages: 503-508
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Published online on: June 21, 2013

https://doi.org/10.3892/etm.2013.1174
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Abstract

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a complex condition for which the etiological determinants are still poorly defined. To better characterize the diagnostic and therapeutic profile of patients, an algorithm known as UPOINT was created, addressing six major phenotypic domains of CP/CPPS, specifically the urinary (U), psycho‑social (P), organ‑specific (O), infection (I), neurological/systemic (N) and muscular tenderness (T) domains. An additional sexual dysfunction domain may be included in the UPOINT(S) system. The impact of the infection domain on the severity of CP/CPPS symptoms is a controversial issue, due to the contradictory results of different trials. The aim of the present retrospective study was to further analyze the extent to which a positive infection domain of UPOINTS may modify the pattern of CP/CPPS symptom scores, assessed with the National Institutes of Health‑Chronic Prostatitis Symptom Index (NIH‑CPSI). In a cohort of 935 patients that was divided on the basis of the presence or absence of prostatic infection, more severe clinical symptoms were shown by the patients with infection (median NIH total score: 24 versus 20 points in uninfected patients; P<0.001). Moreover, NIH‑CPSI score distribution curves were shifted towards more severe symptoms in patients with a positive infection domain. Division of the patients into the six most prominent phenotypic clusters of UPOINTS revealed that the ‘prostate infection‑related sexual dysfunction’ cluster, including the highest proportion of patients with evidence of infection (80%), scored the highest number of NIH‑CPSI points among all the clusters. To assess the influence of the infection domain on the severity of patients' symptoms, all subjects with evidence of infection were withdrawn from the ‘prostate infection‑related sexual dysfunction’ cluster. This modified cluster showed symptom scores significantly less severe than the original cluster, and the CPSI values became comparable to the scores of the five other clusters, which were virtually devoid of patients with evidence of infection. These results suggest that the presence of pathogens in the prostate gland may significantly affect the clinical presentation of patients affected by CP/CPPS, and that the infection domain may be a determinant of the severity of CP/CPPS symptoms in clusters of patients phenotyped with the UPOINTS system. This evidence may convey considerable therapeutic implications.

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1.	Bartoletti R, Cai T, Mondaini N, et al: Prevalence, incidence estimation, risk factors and characterization of chronic prostatitis/chronic pelvic pain syndrome in urological hospital outpatients in Italy: results of a multicenter case-control observational study. J Epidemiology and evaluation of chronic pelvic pain syndrome in men Urol. 178:2411–2415. 2007.
2.	Schaeffer AJ: Epidemiology and evaluation of chronic pelvic pain syndrome in men. Int J Antimicrob Agents. 31(Suppl 1): S108–S111. 2008. View Article : Google Scholar : PubMed/NCBI
3.	Habermacher GM, Chason JT and Schaeffer AJ: Prostatitis/chronic pelvic pain syndrome. Annu Rev Med. 57:195–206. 2006. View Article : Google Scholar : PubMed/NCBI
4.	Shoskes DA, Nickel JC, Dolinga R and Prots D: Clinical phenotyping of patients with chronic prostatitis/chronic pelvic pain syndrome and correlation with symptom severity. Urology. 73:538–542. 2009. View Article : Google Scholar : PubMed/NCBI
5.	Magri V, Wagenlehner F, Perletti G, Schneider S, Marras E, Naber KG and Weidner W: Use of the UPOINT chronic prostatitis/chronic pelvic pain syndrome classification in European patient cohorts: sexual function domain improves correlations. J Urol. 184:2339–2345. 2010. View Article : Google Scholar
6.	Wagenlehner FM, van Till JW, Magri V, Perletti G, Houbiers JG, Weidner W and Nickel JC: National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) symptom evaluation in multinational cohorts of patients with chronic prostatitis/chronic pelvic pain syndrome. Eur Urol. 63:953–959. 2013. View Article : Google Scholar
7.	Krieger JN, Nyberg L Jr and Nickel JC: NIH consensus definition and classification of prostatitis. JAMA. 282:236–237. 1999. View Article : Google Scholar : PubMed/NCBI
8.	Stamey TA: Prostatitis. J R Soc Med. 74:22–40. 1981.
9.	Litwin MS, McNaughton-Collins M, Fowler FJ, et al: The National Institutes of Health chronic prostatitis symptom index: development and validation of a new outcome measure. Chronic Prostatitis Collaborative Research Network. J Urol. 162:369–75. 1999. View Article : Google Scholar
10.	Davis SN, Binik YM, Amsel R and Carrier S: Is a sexual dysfunction domain important for quality of life in men with urological chronic pelvic pain syndrome? Signs “UPOINT” to yes. J Urol. 189:146–151. 2013.PubMed/NCBI
11.	Nickel JC, Downey J, Johnston B and Clark J; Canadian Prostatitis Research Group: Predictors of patient response to antibiotic therapy for the chronic prostatitis/chronic pelvic pain syndrome: a prospective multicenter clinical trial. J Urol. 165:1539–1544. 2001. View Article : Google Scholar : PubMed/NCBI
12.	Nickel JC, Alexander RB, Schaeffer AJ, Landis JR, Knauss JS and Propert KJ; Chronic Prostatitis Collaborative Research Network Study Group: Leukocytes and bacteria in men with chronic prostatitis/chronic pelvic pain syndrome compared to asymptomatic controls. J Urol. 170:818–822. 2003. View Article : Google Scholar : PubMed/NCBI
13.	Magri V and Perletti G: Re: How does the pre-massage and post-massage 2-glass test compare to the Meares-Stamey 4-glass test in men with chronic prostatitis/chronic pelvic pain syndrome? J Urol. 180:1571–1572. 2008. View Article : Google Scholar
14.	Magri V, Trinchieri A, Ceriani I, Marras E and Perletti G: Eradication of unusual pathogens by combination pharmacological therapy is paralleled by improvement of signs and symptoms of chronic prostatitis syndrome. Arch Ital Urol Androl. 79:93–98. 2007.PubMed/NCBI
15.	Magri V, Montanari E, Škerk V, Markotić A, Marras E, Restelli A, Naber KG and Perletti G: Fluoroquinolone-macrolide combination therapy for chronic bacterial prostatitis: retrospective analysis of pathogen eradication rates, inflammatory findings and sexual dysfunction. Asian J Androl. 13:819–827. 2011. View Article : Google Scholar
16.	Zhao Z, Zhang J, He J and Zeng G: Clinical utility of the UPOINT phenotype system in Chinese males with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS): a prospective study. PLoS One. 8:e520442013. View Article : Google Scholar : PubMed/NCBI
17.	Nickel JC, Krieger JN, McNaughton-Collins M, et al: Alfuzosin and symptoms of chronic prostatitis-chronic pelvic pain syndrome. N Engl J Med. 359:2663–2673. 2008. View Article : Google Scholar
18.	Samplaski MK, Li J and Shoskes DA: Clustering of UPOINT domains and subdomains in men with chronic prostatitis/chronic pelvic pain syndrome and contribution to symptom severity. J Urol. 188:1788–1793. 2012. View Article : Google Scholar : PubMed/NCBI

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Influence of infection on the distribution patterns of NIH‑Chronic Prostatitis Symptom Index scores in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS)

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