BJU Int. 2003 Dec;92(9):955-9.
Prevalence, diagnosis and treatment of prostatitis in Italy: a
prospective urology outpatient practice study.

Rizzo M, Marchetti F, Travaglini F, Trinchieri A, Nickel JC.

Department of Urology, University of Florence, Florence, Medical
Department, GlaxoSmithKline S.p.a, Verona, Clinics of Urology,
University of Milan, Milan, Italy, and Queen's University, Kingston,
Canada.

OBJECTIVE: To report a prospective, multicentre descriptive study
designed to determine the prevalence of the diagnosis of prostatitis
in male outpatients examined by urologists in Italy, and to further
examine the diagnostic evaluation and treatment of patients identified
with a clinical diagnosis of prostatitis. PATIENTS AND METHODS:
Between July 2001 and October 2001, 70 urologists, representing a
cross-section of urological centres in Italy, counted and recorded the
overall total of men reported in the clinic and that of patients
diagnosed with prostatitis over a 5-week period. Data on demographics,
previous diagnoses, symptoms, physical examination, laboratory data
and therapy instituted were collected. Patients with a diagnosis of
prostatitis completed questionnaires on symptom frequency and
severity, and quality of life. RESULTS: In all, 8503 patients were
included in the primary outcome analysis; 1148 were identified with
prostatitis (12.8%; mean age 47.1 years, range 16-83) with all age
ranges equally represented, and 68% had had their first symptom within
the last year. The most common presenting symptoms were severe,
bothersome urinary frequency, obstructive voiding symptoms, perineal,
suprapubic and penile pain or discomfort. The self-administered
questionnaire confirmed that the most frequently reported and most
severe symptoms at the time of evaluation were irritative voiding
symptoms, perineal and suprapubic pain and discomfort. Over
three-quarters of the patients were dissatisfied with their quality of
life. While 98% of the patients had a digital rectal examination and
expressed prostatic secretion was successfully recovered in 44%, < 3%
of the patients had the traditional Meares-Stamey four-glass test. The
most common treatment prescribed was drug therapy (not antibiotic).
CONCLUSION: The prevalence of a clinical diagnosis of prostatitis in
urology outpatient practice in Italy was 12.8%. The prevalence,
diagnosis, evaluation and treatment of prostatitis reported in this
prospective study was very similar to that reported in other
retrospective series from other countries.

Int J Urol. 2003 Dec;10(12):636-642.


Questionnaire survey of Japanese urologists concerning the diagnosis
and treatment of chronic prostatitis and chronic pelvic pain syndrome.

Kiyota H, Onodera S, Ohishi Y, Tsukamoto T, Matsumoto T.

Department of Urology, Jikei University, Tokyo, Sapporo Medical
University, Sapporo and University of Occupational and Environmental
Health, Kitakyushu, Japan.

OBJECTIVES: We performed a questionnaire survey to investigate various
issues in the diagnosis and treatment of chronic prostatitis/chronic
pelvic pain syndrome by Japanese urologists and to clarify the
circumstances surrounding prostatitis in Japan. METHODS: Japanese
urologists (n = 1869) were surveyed by mail using a 17-item
questionnaire to determine current diagnostic and treatment practices
for prostatitis/chronic pelvic pain syndrome. RESULTS: Only 1.5%
(11/739) of urologists diagnosed chronic prostatitis/chronic pelvic
pain syndrome using the 4-glass test, while most did so using the
2-glass test (voided bladder [VB]2 and VB3, or VB2 and expressed
prostatic secretion [EPS]). Approximately half (55.2%; 412/746) did
not perform urine cultures to differentiate chronic bacterial
prostatitis from chronic abacterial prostatitis/chronic pelvic pain
syndrome. Approximately half (46%; 343/746) did not count the number
of leukocytes in VB2 or VB3/EPS to differentiate chronic abacterial
prostatitis from chronic pelvic pain syndrome. Although many
urologists (63.8%; 459/720) thought that chronic abacterial
prostatitis/chronic pelvic pain syndrome was not an infectious
disease, many chose antimicrobial agents as the primary treatment.
More than half (52.2%; 384/735) of all urologists felt pessimistic
about dealing with chronic prostatitis/chronic pelvic pain syndrome
compared to treating benign prostatic hypertrophy or prostate cancer,
because of the high number of complaints by patients and their own
lack of confidence in diagnosing and treating the condition.
CONCLUSION: There is much confusion and frustration among Japanese
urologists about chronic prostatitis/chronic pelvic pain syndrome.
Further studies are needed to elucidate its etiology and pathogenesis,
and to establish guidelines for its diagnosis and treatment.