Sibert L, Grise P, Boillot B, Loulidi S, Guerin J G
Service d'Urologie, Hôpital Charles Nicolle, Rouen.
Prog Urol. 1996 Feb;6(1):107-11.
Analysis and technical details of Staomey's fractionated urine cultures, the reference method for the evaluation and bacteriological diagnosis of chronic bacterial prostatitis, but the application of which has been rarely described in the literature.
Stamey's test is based on comparative analysis of urine samples representative of the urethra, bladder and prostatic secretions obtained by prostatic massage. This method allows the demonstration of bacteria in the urine or prostatic secretions in the presence of bacterial prostatitis, in contra with non-bacterial prostatitis and prostatodynia. The sampling conditions require a sufficiently full bladder and the samples must be collected according to rigorously sterile procedure. The first step of the examination must not be preceded by urethral swabbing and the urine samples must have a well defined volume. Prostatic secretions are obtained by a prolonged massage of each lobe of the prostate gland.
Bacterial prostatitis is confirmed by the presence of bacteria in the prostatic secretions and U3 in numbers largely exceeding the bacterial counts of the other samples. In the case of lower urinary tract infection, the test must be repeated after disinfection of the bladder urine. The pathogenic role of Gram positive bacteria is confirmed by isolation of a high bacterial count on several occasions. The pathogenic role of Ureaplasma urealyticum and Chlamydiae trachomatis is more controversial, while the role of Trichomonas vaginalis is unlikely and fungal prostatitis is very rare. Semen culture is less reliable than Stamey's test in the diagnosis of prostatitis.
The diagnosis of chronic prostatitis is difficult due to the absence of typical clinical symptoms, specific ultrasonographic signs and the sometimes difficult interpretation of the culture results. Stamey's test is a reference diagnostic examination provided it is performed according to a rigorous methodology.
分析斯塔米分段尿培养法的技术细节，该方法是评估和细菌学诊断慢性细菌性前列腺炎的参考方法，但在文献中对其应用的描述很少。
斯塔米试验基于对经前列腺按摩获得的代表尿道、膀胱和前列腺分泌物的尿液样本进行比较分析。该方法可在细菌性前列腺炎存在时证明尿液或前列腺分泌物中有细菌，与非细菌性前列腺炎和前列腺痛相反。采样条件要求膀胱充分充盈，样本必须按照严格的无菌程序收集。检查的第一步之前不得进行尿道拭子检查，尿液样本必须有明确的体积。通过对前列腺各叶进行长时间按摩获取前列腺分泌物。
前列腺分泌物中存在细菌且U3中的细菌数量大大超过其他样本的细菌计数可确诊细菌性前列腺炎。在下尿路感染的情况下，必须在膀胱尿液消毒后重复该试验。多次分离出高细菌计数可证实革兰氏阳性菌的致病作用。解脲脲原体和沙眼衣原体的致病作用更具争议性，而阴道毛滴虫的作用不太可能，真菌性前列腺炎非常罕见。在前列腺炎诊断中，精液培养不如斯塔米试验可靠。
由于缺乏典型的临床症状、特异性超声体征以及培养结果有时难以解释，慢性前列腺炎的诊断较为困难。斯塔米试验是一种参考诊断检查，前提是按照严格的方法进行操作。
