使用台灣健保資料庫去探討慢性攝護腺發炎/慢性骨盆腔疼痛跟其他攝護腺疾病之間的關聯性

林宗彥¹、陳奕宏¹、蘇建州²、張育菁²、歐建慧³、鄭裕生³

¹國立成功大學附設醫院斗六分院泌尿部、²國立成功大學醫學院藥理所、³國立成功大學附設醫院泌尿部

Correlation between Chronic prostatitis/Chronic pelvic pain syndrome and other prostatic disease in population-base study using Taiwan National Health Insurance Research Database

Tsung-Yen Lin¹, I-Hung Cheng¹, Chien-Chou Su², Yu-Ching Chang²,Ou Chien-Hui³ Yu-Sheng Cheng³

¹Division of Urology, Department of Surgery, National Cheng Kung University Hospital, Dou-Liou Branch, College of Medicine, National Cheng Kung University, Yunlin, and ²Institue of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, and ³Department of Urology, Medical College and Hospital, National Cheng-Kung University, Tainan, Taiwan

Abstract

Purpose:

Chronic prostatitis/Chronic pelvic pain syndrome (CP/CPPS), contributing to 90~95% disorders of prostate inflammation, is the most common disease of prostate in young male. Other prostate diseases included prostate cancer and benign prostatic hyperplasia were proved to be associated with prostate inflammation in molecular research. But there was no clinical literature exploring the correlation between CP/CPPS and these prostate diseases. Therefore, we aimed to evaluate the correlation between CP/CPPS and other prostatic disorders using long-period Taiwan’s National Health Insurance Research Database (NHIRD). 

Materials and Methods:

From 2002 to 2016, ≧20 year-old patients with CP/CPPS diagnosis at least two outpatient clinics were enrolled from Taiwan’s NHIRD. Exclusion criteria was diagnosis with benign prostatic hyperplasia, prostate cancer, inguinal hernia, interstitial cystitis, or urethritis within 6 months before and after the first CP/CPPS diagnosis. The same number of age-matched controls without CP/CPPS diagnosis were selected. We used conditional logistic regressions to study association of CP/CPPS with subsequent BPH and prostate cancer.   

Results:

Total of 70882 CP/CPPS patients and 70882 non-CP/CPPS controls were enrolled. Regarding different groups according to the age of CP/CPPS diagnosis, the incidence of prostate cancer was 0.6, 6.9, 34.9, 40.8, 40.7 cases in 1000 people in age 20-39, 40-59, 60-69, 70-79, ≧80, and the incidence of BPH was 22.6, 98.7, 213.3. 298.2, 364.8 cases in 1000 people in age 20-39, 40-59, 60-69, 70-79, ≧80. The hazard ratio (HR) of subsequent prostate cancer in CP/CPPS group compared to non-CP/CPPS group was 40.9, 23.6, 12.5, 7.6,3.2 in age 20-39, 40-59, 60-69, 70-79, ≧80, and HR of subsequent BPH was 6.8, 3.8, 2.4, 2.1, 2.1 in age 20-39, 40-59, 60-69, 70-79, ≧80.   

Conclusions:

In our 15-year database study, the patients diagnosed with CP/CPPS have a higher chance of getting subsequent prostate cancer or BPH.