Dr. Mazzoli (Italy) — In Italy, Prostatitis = Chlamydia

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MARCO3772
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Dr. Mazzoli (Italy) — In Italy, Prostatitis = Chlamydia

Post by MARCO3772 »

Hello my name is Marco, 40 y.o., live in Italy.

History :
06/Dec. I had a unprotected sex with my new partner.
07/Jan. developed white discharge (above all in the morning); itching, burning ejacul/urination; pain on tip of my penis.
07/Febr urethral swab + urine exam : I positive chlamydia (by PCR). Partner all negative.
07/Mar both antibiotic doxycycline for 15 days (100mg + 100mg every day) + 7 days zithromax.
07/May all symptoms go away but remains a hypersensitivity on tip of my penis above all underwear contact.
07/Sept for reassured myself I gone to urologist and dermatologist for visiting but they found nothing.
07/Oct I done again urethral swab + urine + sperm exams : all negative.
08/Jan sex with my partner always protected. My hypersensitivity on tip of my penis is still present. So I gone to specialised clinic in Florence - doctor Sandra Mazzoli who studies Chlamydia about from 20 years and from her point of view (from personal research) she tells that if you are positive IGa in sperm/urine + Interleukin-8 you have still Chlamydia even if PCR is negative ! This means that is necessary again antibiotic for months and months....
In two words : I done again all exams urine/sperm (PCR) + IGM/IGC blood + IGA in sperm and urine + interleukin. Result : positive only IGA and Interleukin. Other exam all negative.

My urologist and one important microbiology expert told me : you don't have more Chlamydia don't worry. The unique important exam is PCR.. you are negative.. ! all exam that you have done + correlation IGa and interleukin doesn't mean nothing.. which is your opinion about this ?
I thinks that at this point it should be really CPPS....
Marco
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Re: In Italy .. Prostatitis = You have/had Chlamydia

Post by webslave »

Beware of Sandra Mazzoli. She is famous for finding chlamydia in almost everyone.

:mad(1):

Image
SANDRA MAZZOLI

Immunoglobulin A (IgA) Chlamydia trachomatis antibody levels etc only show that you have antibodies to chlamydia, in other words that your body knows about this bug, not that you have an infection. And IL-8 has nothing to do with chlamydia.

Systemic serological tests are generally not useful in the diagnosis of genital tract infections caused by C. trachomatis, because antibodies elicited by C. trachomatis are long-Lived and a positive antibody test will not distinguish a previous from a current infection.
In conclusion, the correlation of serology (IgA, IgG testing) with active C. trachomatis infection of the lower genital tract is very low. According to our results, serologic testing for Chlamydia can exclude active infection of the lower genital tract with a high reliability (> or = 95%). However, detection of C. trachomatis can only be reliably achieved by nucleic acid amplification assays. PMID 10782395
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MARCO3772
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Re: In Italy .. Prostatitis = You have/had Chlamydia

Post by MARCO3772 »

Thank you very much ... I think the same ... in fact I gone to Mazzoli only for curiosity.. but when I was in his hospital I saw that it was only business... and search in every thing and in every body the CHLAMYDIA... unfortunately there are too many people who gone to Mazzoli who gave them .. antibiotic.. antibiotic.. only because there are IgA and interleukin positive.. and PCR negative.. thank you again.. fortunately that exist internet and speak and understand some English...
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Re: In Italy .. Prostatitis = You have/had Chlamydia

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"In conclusion, the correlation of serology (IgA, IgG testing) with active C. trachomatis infection of the lower genital tract is very low. According to our results, serologic testing for Chlamydia can exclude active infection of the lower genital tract with a high reliability (> or = 95%). However, detection of C. trachomatis can only be reliably achieved by nucleic acid amplification assays. PMID 10782395 "
Excuse me, I would like to understand better "according to our results.....high reliability " in other words IGA positive test means that my body was in contact with Chlamydia (igm + igc negative) but the unique test for find the active infection is PCR....?
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Re: In Italy .. Prostatitis = You have/had Chlamydia

Post by webslave »

Yes. You can find a positive serology test without infection, for sure. The only sure way is PCR, and even that, if positive, is not a definite sign of infection because fragments of DNA may remain after an infection, and also PCR is very susceptible to contamination.
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Re: In Italy .. Prostatitis = You have/had Chlamydia

Post by MARCO3772 »

Thank you for your reassurance; but my question myself is why in Italy exist this person like Mazzoli, who works also for a public-hospital and search obstinately this Chlamydia and wants .. always... demonstrate that this organisms is responsible of all pathology like chronic prostatitis / chronic pelvic pain syndrome and in general all dysfunctions about genital apparatus...

I thinks ... perhaps.. is a business ??

I tell more.. how is possible to give tons of antibiotics only once person is positive to IGA+IL-8 and negative to PCR, above all when there are researches (for example Stanford.. and others) which go in another direction ..and when in several Italian medicine forums you can read that antibiotic are useless ..???

I was in December 2007 to Mazzoli.. and after two visit (I spend 160 euro = 240 usd for 2 visits and about 200 euro for particular exams)... she told me that "For me you have still Chlamydia.. and it's necessary antibiotics for one months.. and follow up.. ".. in two words... at this point I think myself.. " one moment !".. I have already done therapy for Chlamydia.. and PCR is negative for three times... !!

I like very much to understand and know what do urology-community think about Mazzoli and her research...
thank you
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Re: In Italy .. Prostatitis = You have/had Chlamydia

Post by webslave »

I don't know what the researching urologists think about Mazzoli, but I bet it isn't much :wink:

Remember that "Determination of chlamydial antibodies in serum or semen does not conclusively indicate a current infection with C. trachomatis." (PMID 12950404).

IL-8 levels denote inflammation (not necessarily infection) and do correlate with symptoms (PMID 16643489).

Most of the studies trying to link Chlamydia to chronic prostatitis / chronic pelvic pain syndrome come from a Croatian STD hospital, Mazzoli, and some Chinese studies — not noteworthy or mainstream centers.

But Mazzoli's chlamydia findings are so controversial. In her one published study in this area (PMID 17107749), she found chlamydia trachomatis IgA positivity on about half the chronic prostatitis / chronic pelvic pain syndrome patients she saw — 35/78. Then she uses this to suggest infection in the men and causation of pelvic pain.

Another major study found that localization of uropathogenic bacteria in EPS, VB3 urine and/or semen was similar in men with CP/CPPS (8.0%) and asymptomatic men (8.3%). (PMID 12913707).

Here is a study from a major center, German.
Andrologia. 2003 Oct;35(5):258-62.

The 2001 Giessen Cohort Study on patients with prostatitis syndrome--an evaluation of inflammatory status and search for microorganisms 10 years after a first analysis

Schneider H, Ludwig M, Hossain HM, Diemer T, Weidner W.
Klinik und Poliklinik für Urologie und Kinderurologie, Klinikum der Justus Liebig-Universität Giessen, Giessen, Germany.


During the last years tremendous changes have occurred in the epidemiologic knowledge and the diagnostic process of the prostatitis syndrome. A new worldwide-accepted classification system has become the gold standard in contemporary literature. The aim of this study was to compare the inflammatory and infectious status of men with prostatitis syndrome with results from our study cohort from 1992. A total of 168 symptomatic men (mean age 43.2 years; range 18-79) attending the Giessen prostatitis outpatient department were included. All men underwent a standard four-glass-test including leucocyte analysis in all specimens. A routine search for Ureaplasma urealyticum and Chlamydia trachomatis was performed. Ejaculate analysis following World Health Organization (WHO) criteria has been performed including the evaluation of increased number of peroxidase-positive leucocytes (PPL). Men were classified according to the National Institutes of Health (NIH) prostatitis classification. The distribution of patients according to NIH criteria is as follows: NIH II (4.2%), NIH IIIA (31.5%), NIH IIIB (50.0%) and urethroprostatitis (14.3%). Chlamydial infection was present in one man (0.6%). Only two men with increased leucocytes in prostatic secretions demonstrated > or =106 million ml-1 PPL in semen. As compared with our cohort study 10 years ago, the proportion of the different subtypes of the prostatitis syndrome have remained stable. The aetiological spectrum of chronic bacterial prostatitis has not changed whereas, in contrast, the prevalence of C. trachomatis now is found to be strikingly reduced. Using the WHO cutpoints for leucocytospermia the inclusion of seminal leucocytes to the diagnostic process has not influenced the distribution between inflammatory (type NIH IIIA) and noninflammatory (type NIH IIIB) chronic pelvic pain syndrome.

PMID: 14535851 [PubMed - indexed for MEDLINE]

also this, again from a reputable source:
J Urol. 2003 Feb;169(2):584-7; discussion 587-8.

Prostate biopsy culture findings of men with chronic pelvic pain syndrome do not differ from those of healthy controls.
Lee JC, Muller CH, Rothman I, Agnew KJ, Eschenbach D, Ciol MA, Turner JA, Berger RE.
Department of Urology, University of Washington, Seattle, Washington, USA.


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.

PMID: 12544312 [PubMed - indexed for MEDLINE]
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Re: In Italy .. Prostatitis = You have/had Chlamydia

Post by MARCO3772 »

Thank you very much... I read with attention your answer... I agree with you..
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Re: In Italy .. Prostatitis = You have/had Chlamydia

Post by MARCO3772 »

Thank very much again…
Now I think that it’s better that stop to search my problem in Chlamydia infection which doesn’t exist more…
Now I think now that my hypersensitivity on tip of my penis (presents from 18 months after antibiotic therapy against Chlamydia urethritis) is in my mind… and perhaps this my ultra focus on genital area doesn’t help me to exit this situation….
About your experience it’s possible ?
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Re: In Italy .. Prostatitis = You have/had Chlamydia

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Combination of mind (anxiety), pelvic tension, and neuronal windup.
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Re: In Italy .. Prostatitis = You have/had Chlamydia

Post by MARCO3772 »

a curiosity...
In the forum I read about some Guercini.... in italy this man about 5 years ago told that the causes of the prostatic problems were Chlamydia and company ... done intraprostatic infiltration with antibiotic... I don't want comment about the results of this practise... (if you read italy forum ... there are to much people with permanent serius damages consequence this practise...)
Now... this doctor... fortunately... has changed idea..(i hope) ...
do you know this doctor ?
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Re: In Italy .. Prostatitis = You have/had Chlamydia

Post by webslave »

Dr Guercini is a member of this forum. I do not agree with most of his theories and treatment protocols, but he is a urologist and I am not.
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Re: In Italy .. Prostatitis = You have/had Chlamydia

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I think that the positive line of this urologist is that now ... he believes in "Protocol Stanford" and offers this practise in his office in Rome....
I think about my urologist.. he was of old urologist school .. but i remember last year that when He visited me he told "Marco... you have nothing to urologist operate .. and you must search causes your symptoms and other places..."..and never gave me the antibiotic .. (only in occasion urethritis)...
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Re: In Italy .. Prostatitis = You have/had Chlamydia

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Yes, things are slowly changing, Marco, even in Italy :wink:
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Re: In Italy .. Prostatitis = You have/had Chlamydia

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But in the USA how is the situation...? In other words, this new thought about chronic prostatitis / chronic pelvic pain syndrome is a new frontier or there are also Urologists which don't accept all this and continue search microbiology causes (Chlamydia and company... ); Antibiotic therapy... ?
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