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Chlamydia trachomatis versus common uropathogens as a cause of chronic bacterial prostatitis: Is there any difference? Results of a prospective parallel-cohort study

Investig Clin Urol. 2017 Nov;58(6):460-467. English.
Published online October 31, 2017. https://doi.org/10.4111/icu.2017.58.6.460
© The Korean Urological Association, 2017

Tommaso Cai,1 Francesca Pisano,2 Gabriella Nesi,3 Vittorio Magri,4 Paolo Verze,5 Gianpaolo Perletti,6 Paolo Gontero,2 Vincenzo Mirone,5 and Riccardo Bartoletti7
1Department of Urology, Santa Chiara Regional Hospital, Trento, Italy.
2Department of Urology, University of Turin, Turin, Italy.
3Division of Pathological Anatomy, University of Florence, Florence, Italy.
4Urology and Sonography Secondary Care Clinic, Azienda Ospedaliera Istituti Clinici di Perfezionamento, Milano, Italy.
5Department of Urology, University of Naples Federico II, Naples, Italy.
6Biomedical Research Division, Department of Theoretical and Applied Sciences, Universita degli Studi dell’Insubria, Busto Arsizio, Italy.
7Department of Translational Research and New Technologies, University of Pisa, Pisa, Italy.

Received June 07, 2017; Accepted July 15, 2017.


Purpose
The role of Chlamydia trachomatis (CT) infection in chronic bacterial prostatitis (CBP) is well known. What is unclear is whether there are any differences in the course or clinical outcome of the disease when the cause is CT or other uropathogens.

Materials and Methods
A series of 311 patients affected by CBP due to CT (cohort A) was compared with a group of 524 patients affected by CBP caused by common uropathogen bacteria (cohort B). All participants completed the following questionnaires: National Institutes of Health Chronic Prostatitis Symptom Index, International Prostate Symptom Score, International Index of Erectile Function-15 erectile function domain (IIEF-15-EFD), Premature Ejaculation Diagnostic Tool (PEDT), and the Short Form 36 (SF-36) Health Survey. All patients were followed with clinical and microbiological evaluations.

Results
After a mean follow-up time of 42.3 months, the number of symptomatic episodes was significantly higher in patients in cohort A than in cohort B (4.1±1.1 vs. 2.8±0.8, p<0.001), and the mean time to first symptomatic recurrence was shorter in cohort A than in cohort B (3.3±2.3 months vs. 5.7±1.9 months, p<0.001). Moreover, scores on the SF-36 tool were significantly lower in cohort A (96.5±1.0 vs. 99.7±1.9, p<0.001) at the first symptomatic recurrence. Cohort A also showed significantly lower scores on the IIEF-15-EFD and PEDT questionnaires at the end of the follow-up period (26.8±2.9 vs. 27.3±3.3, p=0.02 and 11.5±2.3 vs. 4.5±2.8, p<0.001, respectively).

Conclusions
Patients affected by CBP due to CT infection have a higher number of symptomatic recurrences with a more severe impact on quality of life.

Keywords: Chlamydia trachomatis; Prostatitis

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