解脲脲原体在慢性前列腺炎中的成石潜能。

Lithogenic Potential of Ureaplasma in Chronic Prostatitis.

机构信息

Urology Secondary Care Clinic, ASST-Nord, Milan, Italy.

Department of Biotechnology and Life Sciences, Section of Medical and Surgical Sciences, University of Insubria, Varese, Italy.

出版信息

Urol Int. 2021;105(3-4):328-333. doi: 10.1159/000511653. Epub 2020 Dec 2.

DOI:10.1159/000511653

PMID:33264795

Abstract

INTRODUCTION

The role of Ureaplasma spp. (UPs) in the pathogenesis of chronic prostatitis is debated. The lithogenic potential of UPs could be a risk factor for the development of chronic prostatitis.

METHODS

A total of 143 patients with identification of UPs were retrospectively selected from a database including patients with prostatitis-like symptoms who were studied according to the same protocol including clinical, microbiological and microscopic evaluation, and transrectal prostate ultrasound. A control group of patients with negative UPs was considered including 393 with chronic bacterial prostatitis (CBP), 42 patients with Chlamydia trachomatis (CT), and 781 patients with chronic pelvic pain syndrome. UPs and Mycoplasma hominis (MH) were identified using a semiquantitative assay.

RESULTS

Calcifications were observed more frequently in patients with UPs (64%) than in patients with CBP without UPs (39%), CT infection (37%), and chronic pelvic pain syndrome (29%) (p < 0.0001). UPs were isolated in VB1 alone in 35 patients (urethral UPs), in expressed prostatic secretion (EPS) or post-massage urine (VB3) or sperm in 77 patients (prostatic UPs) and associated with other pathogens in 31 patients (associated UPs). Calcifications were more frequent in prostatic UPs (71%) and associated UPs (73%) than in urethral UPs (34%). Mean NIH-CPSI scores were not significantly different between groups, although mean WBC counts of sperm of patients with urethral UPs were significantly lower than in patients with prostatic UPs (p = 0.000) and associated UPs (p = 0.002).

CONCLUSIONS

UPs identification in the urogenital fluids is related to higher rates of prostate calcifications. The ability of UPs to promote the formation of calcifications could be related to the chronicization of prostate infection. In particular, the presence of UPs in VB3/EPS/sperm is associated with higher rates of calcifications and high WBC sperm counts, suggesting a partial or full causative role of UPs in the pathogenesis of this disease.

摘要

简介

解脲脲原体（UPs）在慢性前列腺炎发病机制中的作用存在争议。UPs 的成石潜能可能是慢性前列腺炎发展的一个危险因素。

方法

从一个数据库中回顾性选择了 143 例 UPs 鉴定阳性的患者，这些患者根据相同的方案进行了研究，包括前列腺炎样症状患者的临床、微生物学和显微镜评估以及经直肠前列腺超声检查。将 UPs 阴性的患者作为对照组，包括 393 例慢性细菌性前列腺炎（CBP）患者、42 例沙眼衣原体（CT）感染患者和 781 例慢性骨盆疼痛综合征患者。采用半定量法检测 UPs 和人型支原体（MH）。

结果

在 UPs 阳性患者（64%）中观察到钙化的频率高于 UPs 阴性的 CBP 患者（39%）、CT 感染患者（37%）和慢性骨盆疼痛综合征患者（29%）（p<0.0001）。35 例患者（尿道 UPs）仅在 VB1 中分离出 UPs，77 例患者（前列腺 UPs）在前列腺分泌物（EPS）或按摩后尿液（VB3）或精子中分离出 UPs，31 例患者（相关 UPs）与其他病原体相关。在前列腺 UPs（71%）和相关 UPs（73%）中，钙化的频率高于尿道 UPs（34%）。各组之间 NIH-CPSI 评分无显著差异，尽管尿道 UPs 患者的精子中白细胞计数明显低于前列腺 UPs（p=0.000）和相关 UPs（p=0.002）。