New method for differentiating chronic prostatitis/chronic pelvic pain syndrome IIIA from IIIB involving seminal macrophages and monocytes - Abstract

OBJECTIVES: To evaluate a new method for differentiating inflammatory from noninflammatory prostatitis using the simple and rapid quantification of seminal macrophages and monocytes.

METHODS: Patients affected with chronic pelvic pain syndrome (CPPS) were classified as having the IIIA (n = 11) and IIIB (n = 30) subtypes according to the peroxidase positive leukocyte concentration in semen; 18 healthy individuals served as controls. Seminal inflammatory markers, including polymorphonuclear elastase, interleukin (IL)-6 and IL-8, and numbers of macrophages/monocytes (MMs) per 50 fields of 1000 × magnification (high-power field [hpf]), were determined for all patients.

RESULTS: The numbers of MMs/50 hpf correlated significantly with the peroxidase positive leukocyte counts and IL-8, IL-6, and polymorphonuclear elastase levels (all P < .001). Data from the analysis of receiver operating characteristic curves (area under the curve 0.912 ± 0.073; P < .001) showed a sensitivity of 90.9% and specificity of 86.7% at a cutoff value of 5 MMs/50 hpf. The positive and negative predictive value was 71.4% and 96.3%, respectively. The median concentrations of IL-6, IL-8, and elastase in the patients with CPPS with ≥ 5 MMs/50 hpf differed significantly (P ≤ .002) from those in the patients with <5 MMs/50 hpf.

CONCLUSIONS: The results of our study have shown that the quantification of seminal macrophages and monocytes is a simple, rapid, and reproducible technique by which to differentiate chronic prostatitis/CPPS IIIA from IIIB.

Written by:
Aghazarian A, Plas E, Stancik I, Pflüger H, Lackner J   Are you the author?
Department of Urology, Ludwig-Boltzmann Institute for Urology and Andrology, Vienna, Austria.

Reference: Urology. 2011 Oct;78(4):918-23
doi: 10.1016/j.urology.2011.06.028

PubMed Abstract
PMID: 21840582