Department of Urology, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou 310016, China.
Asian J Androl. 2012 Sep;14(5):715-9. doi: 10.1038/aja.2012.40. Epub 2012 Jul 16.
We studied the efficacy of culture-specific antibiotic therapy for chronic bacterial prostatitis (CBP) patients with or without prostatic calculi. This study included 101 patients (21-62 years old) who met the consensus criteria for CBP (National Institutes of Health category II). According to the results of transrectal ultrasonography (TRUS), all patients were divided into two groups: Group 1, CBP with prostatic calculi, n=39; Group 2, CBP without prostatic calculi, n=62. All patients received optimal antimicrobial therapy for 4 weeks and followed up for a minimum of 3 months (range: 3-8 months). In addition to expressed prostatic secretions (EPS) and urine culture, all patients were asked to complete the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and the subjective global assessment (SGA). The microbiological eradication rate at the end of treatment were 32/39 (82.1%) and 54/62 (87.1%), while the rates for continued eradication at the end of study were 17/39 (43.6%) and 45/62 (72.6%) in Group 1 and Group 2 (P<0.01), respectively. We observed a decrease in the total NIH-CPSI score median values from 24 to 19 in Group 1 and from 24 to 11 in Group 2. The pain subscore (P<0.01), urinary sunscore (P<0.05) and quality of life (QoL; P<0.05) as well as the total NIH-CPSI score (P<0.01) were significantly improved after antimicrobial treatment in Group 2 compared to Group 1. Response, defined as a decrease of the NIH-CPSI total score by at least 50%, was seen in Group 1 versus Group 2 in 38.5% and 58.1% (P<0.01), respectively. Our results showed that prostatic calculi influence the antimicrobial efficacy in men with CBP. There was a noticeable decrease in the cure rate of CBP patients with prostatic calculi due to relapse after antimicrobial therapy.
我们研究了针对伴有或不伴有前列腺结石的慢性细菌性前列腺炎（CBP）患者的特定抗生素治疗的疗效。这项研究包括 101 名患者（21-62 岁），他们符合 CBP 的共识标准（美国国立卫生研究院分类 II）。根据经直肠超声（TRUS）的结果，所有患者分为两组：组 1，伴有前列腺结石的 CBP，n=39；组 2，不伴有前列腺结石的 CBP，n=62。所有患者接受 4 周的最佳抗菌治疗，并至少随访 3 个月（范围：3-8 个月）。除了前列腺液（EPS）和尿液培养外，所有患者还完成了美国国立卫生研究院慢性前列腺炎症状指数（NIH-CPSI）和主观整体评估（SGA）。治疗结束时的微生物学清除率分别为 39 例中的 32 例（82.1%）和 62 例中的 54 例（87.1%），而研究结束时持续清除率分别为组 1 中的 17 例（43.6%）和组 2 中的 45 例（72.6%）（P<0.01）。我们观察到组 1 的 NIH-CPSI 总分中位数从 24 降至 19，组 2 从 24 降至 11。与组 1 相比，组 2 的疼痛亚评分（P<0.01）、尿评分（P<0.05）和生活质量（QoL；P<0.05）以及 NIH-CPSI 总分（P<0.01）均显著改善。与组 1 相比，组 2 中有 38.5%和 58.1%（P<0.01）的患者对 NIH-CPSI 总分的反应至少下降了 50%。我们的结果表明，前列腺结石会影响 CBP 男性的抗菌疗效。由于抗菌治疗后复发，伴有前列腺结石的 CBP 患者的治愈率明显下降。
