焦慮是慢性攝護腺炎與類攝護腺炎症候群症狀嚴重度的主要決定因子

李彥良¹、劉佳旻²、陳奕宏³、黃元麒³、陳幸儀¹、侯琇瓊¹、鄭裕生¹、林宗彥^1.3

¹國立成功大學附設醫院泌尿部、²衛生福利部台南醫院泌尿科、³國立成功大學附設醫院斗六分院泌尿部

Anxiety Drives Symptom Severity in Chronic Prostatitis and Prostatitis-like Syndrome

Yen-Liang Li¹, Chia-Min Liu², I-Hung Chen³, Yuan-Chi Huang³, Hsing-Yi Chen¹, Hsiu-Chiung Hou¹, Yu-Sheng Cheng¹, Tsung-Yen Lin^1,3

¹Department of Urology, Medical College and Hospital, National Cheng-Kung University, Tainan, Taiwan, ²Department of Urology, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan, ³Division of Urology, Department of Surgery, National Cheng Kung University Hospital Dou-Liou Branch, Yunlin, Taiwan,  

Abstract

Purpose:

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a heterogeneous condition in which psychological factors may play a key role, but their impact across different symptom durations remains unclear.

Materials and Methods:

We retrospectively analyzed 109 men with prostatitis-like symptoms, stratified by symptom duration (<3 vs ≥3 months). Clinical, psychological [Hospital Anxiety and Depression Scale (HADS)], sexual function [International Index of Erectile Function-5 (IIEF-5), Male Sexual Health Questionnaire–Ejaculatory Dysfunction (MSHQ-EjD), Premature Ejaculation Diagnostic Tool (PEDT)], and microbiological data were collected. Symptom severity was assessed using the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI). Regression analyses were performed to identify associated factors.

Results:

Baseline characteristics were similar between groups. Anxiety (HADS-A) was significantly associated with higher NIH-CPSI scores and all symptom domains (r ≈ 0.40–0.50, p < 0.01). In multivariable analysis, anxiety remained the strongest independent predictor of symptom severity (β ≈ 0.72, p < 0.001), whereas microbiological findings and most clinical variables were not significant. Sexual function showed only a modest association. 

Conclusions:

Anxiety is the key determinant of symptom severity in CP/CPPS, regardless of symptom duration. Early prostatitis-like symptoms (<3 months) share similar characteristics and should not be overlooked. These findings support the integration of psychological assessment into routine management.