Bacteria - 2003

[J Dimitrakov]

The Journal of Urology 2003; 169(2):584-588

Prostate Biopsy Culture Findings of Men With Chronic Pelvic Pain Syndrome do Not Differ From Those of Healthy Controls

JAY C. LEE*; CHARLES H. MULLER; IVAN ROTHMAN" ; KATHY J. AGNEW; DAVID ESCHENBACH"¡; MARCIA A. CIOL; JUDITH A. TURNER; RICHARD E. BERGER

ABSTRACT
Purpose:
Previous reports have identified bacteria in the prostate of men with chronic pelvic pain syndrome. To examine whether prostatic bacteria are more prevalent among patients with chronic pelvic pain syndrome than among those without pelvic pain, we compared 4-glass urine test and prostate biopsy results.

Materials and Methods:
A total of 120 patients with types IIIa and IIIb chronic pelvic pain syndrome and 60 asymptomatic controls underwent a standard 4-glass urine test, examination of expressed prostatic secretion leukocytes by hemocytometer and transperineal, digitally guided prostate biopsies. Tissue was cultured for aerobes, anaerobes, Trichomonas vaginalis, Chlamydia trachomatis and herpes simplex virus. Skin cultures were performed on a subset of patients and controls.

Results:
Positive prostate biopsy cultures were obtained from patients and controls. Bacteria were found in 45 of 118 pain patients (38%) and in 21 of 59 controls (36%) (p = 0.74). Older men were more likely to have positive cultures. Men with type IIIa chronic pelvic pain syndrome were more likely than those with type IIIb to have positive prostate biopsy cultures.

Conclusions:
Bacteria cultured from transperineal prostatic biopsies do not differ between men with and without chronic pelvic pain syndrome. Prostatic bacteria obtained by biopsy are probably not etiologically related to the symptoms in the majority of men with chronic pelvic pain syndrome.

Key Words: prostatitis; case-control studies; biopsy; pelvic pain; bacteria

[webslave]

Shazam!

[dshoskes]

Shazam!

It is an excellent article. I wrote an editorial to accompany the article (no guarantee they published it) and the science was very tight.

[tedk]

Its nice to finally get some concrete evidence as to whether or not bacteria play a role in this disease. I would think that studies like this would have been done a long time ago. Also in light of this new info I can't help but wonder about the success claimed by the "Manila Protocol". If the foundation of their treatment relys on the use of antibiotics on bacteria. What can their success be attributed to if these studies are correct.

[webslave]

What can their success be attributed to if these studies are correct.

Leading question Use your imagination.

Also, don't forget that almost all treatments result in a placebo effect in 30-40% of pts. That's why you cannot make pronouncements about treatments without double-blinded, randomized, placebo controlled trials. I suggest that the clinics to which you refer have no idea how to conduct such trials.

Next point: how do you define "cure"? Some of these clinics will tell you that you are "cured" when their labs decide you are clear of the "microbes" that are causing your pain (in their minds).

[Desperato]

Of course, one has to bear in mind that some of the techniques for identifying the microbes are not very precise and bacteria still can be present, in spite of the results. There has been an excellent study in the December Issue of the Journal of Urology about that. The antibiotics, besides killing the bugs, act anti-inflammatory and that explains the relief in the patients.

The real damage most often is some IC similar ulcers, which appear in the bladder and the urethra, causing the prostate to inflame and harming the nerves. The latter explains the perrineal pain /as well as that on the tip of the penis/, as well as the fatigue. This is longterm cured by Elmiron /filling the ulcers/ and nerve-healing medications, such as Milgamma N. The ulcers are most probably caused by an autoimmune reaction.

The presence of ulcers is identified by the so called APF, HB-EGF and EGF markers, which show great reliability in women for identifying IC. They should be studied in men as well.