Comparison of Bacterial Cultures in Urine and Semen after Prostate Massage in Patients with Chronic Prostatitis/Chronic Pelvic Pain Syndrome
Tsung-Han Cheng1、I-Hung Cheng2、Hau-Chern Jan1、Yu-Sheng Cheng1、Tsung-Yen Lin2
1Department of Urology, National Cheng Kung University Hospital, Tainan, Taiwan, and 2Division of Urology, Department of Surgery, National Cheng Kung University Hospital, Dou-Liou Branch, College of Medicine, National Cheng Kung University, Yunlin
Purpose: To our knowledge, antimicrobial therapy is the most commonly prescribed treatment for the CP/CPPS syndromes, though bacteria are cultured in only 5%-10% of patients suffering prostatitis. Our research aimed to clarify the microbiome from CP/CPPS patients to supply more specific antimicrobial treatment through post prostatic massage semen culture rather than urine culture from the traditional two-glass test.
Materials and Methods: We enrolled 30 patients diagnosed with CP/CPPS between August 2020 and August 2021. Urine cultures before and after prostatic massage were collected according to a two-glass test. Semen analysis was also collected after prostate massage. The positive rate of each culture was compared to see if semen analysis is more reliable than urine culture for diagnosing CP/CPPS. We also analyze urine culture before and after prostate massage and semen culture to offer more specific antimicrobial treatment. National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) was recorded as outcome parameters before and after the treatment.
Results: Among the 30 patients, two patients showed positive pre-massage urine culture, 2 showed positive post-massage urine culture, and they all had positive semen culture results. Of all the 30 patients, 28 yielded positive semen culture after prostate massage. The most commonly seen culture result was Gram-positive coccus, followed by Gram-negative bacilli. The NIH-CPSI after medication treatment at OPD was significantly lower than before.
Conclusions: The urine culture from the traditional two-glass test for choosing the adequate antibiotics for CP/CPPS patients may not be as specific as semen culture after prostatic massage. We believe post-prostatic massage semen culture could be used more commonly at OPD for CP/CPPS patients due to its convenience and specificity.