PROSTATIC FLUID INFLAMMATION IN PROSTATITIS

We studied expressed prostatic secretions from 106 patients with prost atitis to determine the longitudinal course of prostatic fluid inflamm ation. Prostatic fluid specimens were collected from 14 patients with acute bacterial, 13 with chronic bacterial and 79 with abacterial pros tatitis. White blood cells per high power microscopic field of the exp ressed prostatic secretion were counted under a cover slip. Inflammati on in the expressed prostatic secretion was considered to be consisten t with prostatitis if there were 10 or more white blood cells per high power field. The 14 patients with acute bacterial prostatitis had a m ean of 10 visits with a mean followup of 59 months. Inflammation resol ved within 1 month in 9 patients with acute bacterial prostatitis but; it recurred in 5 other patients in association with urinary tract inf ection. The 13 patients with chronic bacterial prostatitis had a mean of 10 visits with a mean followup of 58 months. Episodic inflammation in the expressed prostatic secretion associated with urinary tract inf ection was seen in all patients during followup. The 79 patients with abacterial prostatitis had a mean of 7 visits with a mean followup of 40 months. Resolution of inflammation in the expressed prostatic secre tion occurred in 9 patients (11%). Inflammation in the expressed prost atic secretion at followup was seen in 70 patients (89%), and 27 of th e 79 patients (34%) had 10 or more white blood cells per high power fi eld of expressed prostatic secretion in all subsequent specimens. In c ases of abacterial prostatitis, neither the initial expressed prostati c secretion white blood count nor the presence of symptoms reliably pr edicted subsequent inflammation. The data suggest that prostatic infla mmation resolves in most patients with acute bacterial prostatitis and is episodic in patients with chronic bacterial or abacterial prostati tis.