陰道滴蟲感染在慢性攝護腺炎及骨盆疼痛症候群
張博誌 陳煜 謝明里 黃世聰 黃信介 許毓昭 李威昌
林口長庚紀念醫院 外科部 男性學及婦女泌尿科
Trichomonas vaginalis infection in patients with chronic prostatitis/chronic pelvic pain syndrome
Po-Chih Chang, Yu Chen, Ming-Li Hsieh, Shih-Tsung Huang, Hsin-Chieh Huang, Yu-Chao Hsu, Wei-Chang Li
Andrology and Female Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou medical center, Taiwan
Purpose : We use immunochromatographic rapid tests to diagnose Trichomonas vaginalis infection in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) to determine the prevalence of T.vaginalis and associated clinical characteristics in them.
Materials and methods : From 2013 to 2015, patients with characteristic pelvic pains, urinary complaints and sexual dysfunction compatible with CP/CPPS as defined by the NIH diagnostic criteria were enrolled prospectively for study. Post-prostate massage urine Trichomonas rapid tests (Jei Daniel Biotech, Jinan, China) were performed on all patients. Demographic characteristics and urogenital symptoms of CP/CPPS were recorded. Routine urinalysis of post-prostate message urine was also performed. Laboratory examination results of expressed prostate secretion (EPS), if available, were recorded. For patients tested positive for T.vaginalis, treatment course were recorded. Follow-up tests were also provided to document cure of trichomoniasis.
Results : Among the 138 patients with CP/CPPS, 28 (20.3%) tested positive for T.vaginalis. Symptoms including peri-genital pain, lower urinary tract symptoms, depression and sexual dysfunction did not differ between patient with and without T.vaginalis infection. Patients with hematospermia were more likely to have T.vaginalis infection (5/28 vs 3/110, p=0.009). Patients with leukocytes in EPS were also more like to be positive for T.vaginalis (5/28 vs 2/110, p=0.004). Treatment for T.vaginalis was given to all positive patients and was well-tolerated. Patient reported symptom improvement after treatment.
Conclusion : Testing and treatment for T.vaginalis should be considered in all patients with CP/CPPS,
especially those with hematospermia and leukocytes in EPS