OBJECTIVES: To determine the prevalence of chronic prostatitis/chronic pelvic pain syndrome (National Institutes of Health Category III prostatitis) in Penang, Malaysia and estimate the proportion of cases ascertained by population survey that met consensus clinical criteria for "chronic prostatitis."
METHODS: One percent of 20 to 50-year-old men in Penang, Malaysia were surveyed using the National Institutes of Health Chronic Prostatitis Symptom Index. A clinical evaluation that included lower urinary tract localization studies was recommended for symptomatic subjects who met the survey definition to identify bacterial prostatitis and other diagnoses that would exclude them from the consensus clinical definition for chronic prostatitis (Category III).
RESULTS: Of 3147 subjects surveyed, 275 (8.7%) met the survey criteria for chronic prostatitis. The prevalence of chronic prostatitis was 8.0% among Malays, 8.9% among non-Malays, and 16% among noncitizens (P = 0.025). The prevalence increased with age: 6.3% in 20 to 30-year-old men, 8.9% in 31 to 40-year-old men, and 12.6% in 41 to 50-year-old men (P <0.001). Of 87 subjects evaluated clinically, 65 (75%) met the consensus clinical criteria for chronic prostatitis.
CONCLUSIONS: Chronic prostatitis represents an important, international healthcare problem. A thorough clinical evaluation is necessary to verify that chronic prostatitis is indeed responsible for a patient's pelvic pain and lower urinary tract symptoms.
OBJECTIVES: To examine the prevalence, characteristics, and impact of sexual dysfunction in our primary care referral population.
METHODS: Participants seeking treatment for chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) were recruited from general urology clinics. The subjects completed the National Institutes of Health-Chronic Prostatitis Symptom Index, International Index of Erectile Function-5, and selected questions from the University of Washington Symptom Score. Additional information on demographics and medical and treatment history were also obtained. Sexual dysfunction was defined as self-reported erectile dysfunction (ED) or ejaculatory difficulty, or both.
RESULTS: Of 296 participants with CP/CPPS, 214 (72.3%) reported sexual dysfunction. The National Institutes of Health-Chronic Prostatitis Symptom Index total score averaged 22.5 +/- 6.9 for participants with sexual dysfunction compared with 20.4 +/- 7.8 for participants who did not report sexual dysfunction (P = 0.03). Of the 214 participants with sexual dysfunction, 54 (25.0%) complained of ED only, 71 (33.4%) complained of ejaculatory difficulties only, and 89 (41.6%) complained of both ED and ejaculatory difficulties. Men reporting both ED and ejaculatory difficulty reported worse CP/CPPS symptoms (analysis of variance, P = 0.042) and worse quality of life (analysis of variance, P = 0.006) than men without sexual dysfunction.
CONCLUSIONS: Sexual dysfunction was reported by almost three quarters of patients with CP/CPPS. Patients with CP/CPPS and sexual dysfunction experienced substantially worse symptoms, particularly worse quality of life, than other patients with CP/CPPS. Sexual dysfunction merits consideration as an important aspect of CP/CPPS and a potential outcome measure.