THE POSSIBLE ROLE OF ANAEROBIC-BACTERIA IN CHRONIC PROSTATITIS

Prostatitis, the most common urological disease in men, afflicts betwe en 25 and 50% of all adult men. Four clinical categories are recognize d: acute and chronic bacterial prostatitis, non-bacterial prostatitis and prostatodynia. The role of Gram-positive aerobic bacteria and the different anaerobes in chronic bacterial prostatitis is still a matter of debate. During this study, the urethral discharge and the prostati c fluid obtained after prostatic massage of 50 patients with chronic p rostatitis, confirmed by clinical examination and resistant to empiric al quinolone therapy, were cultured under aerobic and anaerobic condit ions. The parallel specimens from 24 patients exhibited high colony co unts of Gram-positive and Gram-negative anaerobic bacteria, either alo ne (18 cases) or in combination with aerobic bacteria (6 cases). The s pecimens obtained after prostatic massage of the remaining 26 patients were completely negative for both aerobic and anaerobic bacteria. No Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum or T richomonas vaginalis were isolated from these patients. Patients with chronic prostatitis who gave positive culture results for anaerobes we re treated with amoxicillin/clavulanic acid or clindamycin for 3-6 wee ks. After treatment, samples were again taken and cultured for all pat hogens known to cause prostatitis. These post-therapeutic samples reve aled a decrease or total eliminatian of the symptoms, and no anaerobic bacteria could be detected.