title: Changes in white blood cell counts in men undergoing thrice-weekly prostatic massage, microbial diagnosis and antimicrobial therapy for genitourinary complaints.
abstract: OBJECTIVE
  To report changes in the white blood cell (WBC) counts in expressed prostatic secretions (EPS) in men with pelvic symptoms undergoing thrice-weekly prostatic massage combined with antimicrobial therapy.
  
  
  METHODS
  The study comprised a retrospective analysis of the records of 35 patients (mean age 45.3 years, range 28-70, SD, 12.03) with pelvic pain, pain in the lower back, obstructive urinary symptoms, irritative urinary symptoms, or sexual dysfunction, who had undergone the same diagnosis and treatment protocol in a genitourinary clinic in Manila, Philippines, from September 1992 to September 1995.
  
  
  RESULTS
  EPS were obtained 347 times in 35 patients (median 9 times per patient, range 6-16). In 26 of the 35 (74%) patients the WBC count in the EPS was < 10 per oil-immersion field (OIF, x1000) at the first prostatic massage. In 34 of 35 (97%) patients the WBC count rose to > or = 10 as prostatic massage continued on a thrice-weekly schedule. The mean (range, SD) initial WBC count in the EPS was 8.4 (1-48, 8.43) and the maximum was 40.9 (6-60, 19.05); the difference between these values was 32.5 (3-57, 18.78; 95% confidence interval 26.1-40.1) and the difference was statistically significant (paired t-test, P < 0.001).
  
  
  CONCLUSIONS
  The classification of patients into those with prostatodynia or prostatitis based on one EPS examination is misleading and thrice-weekly massage of the prostate is better than a single collection of EPS to obtain the most purulent sample for Gram staining and culture.
authors.affiliation: The Prostatitis Foundation, Smithshire, Illinois 61473, USA.
authors.forename: B R
authors.initials: BR
authors.lastname: Hennenfent
authors.forename: A E
authors.initials: AE
authors.lastname: Feliciano
mesh_terms: D000328:Adult; D000368:Aged; D000892:Anti-Infective Agents, Urinary / Q000627:therapeutic use; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use; D001424:Bacterial Infections / Q000097:blood* / Q000188:drug therapy; D004359:Drug Therapy, Combination; D006801:Humans; D007958:Leukocyte Count; D017116:Low Back Pain / Q000209:etiology; D008297:Male; D008405:Massage; D008875:Middle Aged; D008911:Minocycline / Q000627:therapeutic use; D015242:Ofloxacin / Q000627:therapeutic use; D010146:Pain / Q000209:etiology; D017699:Pelvic Pain / Q000209:etiology; D011472:Prostatitis / Q000097:blood* / Q000628:therapy; D012189:Retrospective Studies; D012735:Sexual Dysfunction, Physiological / Q000209:etiology; D016055:Urinary Retention / Q000209:etiology
chemical_list: D000892:Anti-Infective Agents, Urinary; D000903:Antibiotics, Antineoplastic; D015242:Ofloxacin; D008911:Minocycline