Article Text
Abstract
Introduction Chronic prostatitis is a distressing condition with significant impact of quality of life. Chronic prostatitis (CP) symptoms include pain, urinary symptoms and sexual dysfunction. The prevalence of prostatitis is approximately 5- 9% in the general population. This retrospective case study evaluated the management of this condition using the NIH –Prostatitis symptoms index (NIH-CPSI) and UPOINT involving 6 domains (urinary, psychological, organic-specific, infection, neurological/systemic, tenderness) to stratify patient into specific symptoms-led phenotypes.
Method The symptoms of patients were captured using the NIH- CPSI scores and the UPOINT diagnostic algorithm addressing CP phenotypic domains according to the likely aetiology mechanism (3). NIH-CPSI is used to measure the severity of CP symptoms, encompassing 13 items grouped into three domains: pain, urinary symptoms and quality of life (QOL). The highest score is 43; a high score indicates a worse outcome. A reduction of 6 points after treatment is considered a good response.
Results 28 patients were seen over 6 months. 57% (16) were new diagnoses and 43% (12) were recurrent. All patients were treated with ciprofloxacin except when gram positive bacteria were detected and Co-Amoxiclav was prescribed. The average reduction in NIH-CPSI score after treatment was 11.5.
Conclusion In our cohort a significant proportion of men responded to antibiotic because of positive bacterial culture in the semen. A quarter of patients had a combination of antibiotics and anti-inflammatories. Patient with voiding difficulties were referred to the urology team, those with psychological problems, were referred to the psychology team.