The Clinical and Pathologic Relevance of a Prostate MRI Diagnosis of "Prostatitis".

To investigate the relationship between MRI evidence of prostatitis with clinical symptomatology. Non-malignant abnormalities in peripheral zone are common in prostate mpMRI. These findings are sometimes reported as "prostatitis" or "inflammation" and lead to patient anxiety and urologic referral.

Retrospective review of patients undergoing prostate mpMRI (2016-2017) was performed. Two cohort groups based on the presence of "prostatitis" or "inflammation" in the radiology report were identified. Clinical characteristics included age, PSA, biopsy/intervention history, LUTS, pain, use of urologic medications, prostate volume, and PIRADS score. Pathologic finding of inflammation was recorded. Groups were compared using chi-square for dichotomous variables and t-tests for continuous variables.

104 patients were identified with "prostatitis/inflammation" and 273 without. Report of LUTS was high in both groups (58% and 62% for prostatitis and no prostatitis respectively, p = 0.49), though report of moderate/severe LUTS (physician description or IPSS of 8-19 and 20+) was more common in the no prostatitis group (7% vs 18%, p=0.008). Use of urologic medication was similar between the two groups (31% and 37% for prostatitis and no prostatitis respectively, p = 0.23). Biopsy finding of inflammation was more common in the prostatitis group (57% vs 43% p =0.027). Reports of pelvic pain, dysuria, or urinary findings of inflammation were uncommon in both groups.

While mpMRI findings of prostatitis may indicate NIH Category IV prostatitis, there is no evidence of correlation with categories I, II or III prostatitis nor with symptomatic LUTS, and patients should be reassured that further investigation is not warranted.

Urology. 2021 Feb 01 [Epub ahead of print]

Sij Hemal, Lewis Thomas, Daniel Shoskes

Department of Urology, Glickman Urologic and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH. Electronic address: ., Department of Urology, Glickman Urologic and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH. Electronic address: ., Department of Urology, Glickman Urologic and Kidney Institute, Cleveland Clinic Foundation, Cleveland, OH. Electronic address: .

Go Beyond the Abstract and Read a Commentary by the Author

email news signup