title: The chronic prostatitis-chronic pelvic pain syndrome can be characterized by prostatic tissue pressure measurements.
abstract: OBJECTIVE
  We performed a prospective study to confirm early results implying that intraprostatic tissue pressure is elevated in men with the chronic prostatitis-chronic pelvic pain syndrome. We planned to determine further whether this technique would detect a significant difference in inflammatory and noninflammatory categories IIIA and IIIB.
  
  
  METHODS
  A total of 48 patients with the chronic prostatitis-chronic pelvic pain syndrome, including 18 with inflammatory category IIIA and 30 with noninflammatory category IIIB disease, and 12 asymptomatic controls completed a Finnish version of the National Institutes of Health-Chronic Prostatitis Symptom Index. In addition, culture and microscopy of lower urinary tract segmented specimens, serum prostate specific antigen determination, transrectal ultrasound, uroflowmetry and ultrasound post-void residual urine measurement were done. All patients and controls also underwent independent intraprostatic right and left lobe tissue pressure measurement using a standard intracompartmental tissue pressure monitor system. Pressure was measured via an intraprostatic needle placed percutaneously in the perineum at baseline, and 10, 60 and 120 seconds after standard saline injection.
  
  
  RESULTS
  All patients with the chronic prostatitis-chronic pelvic pain syndrome had significantly higher pressure at all measurement points compared with controls (p <0.001). Mean intraprostatic tissue pressure was significantly higher (p <0.01) in category IIIA with greater than 10 leukocytes per high power field in prostate specific specimens compared with category IIIB with less than 10.
  
  
  CONCLUSIONS
  Our study supports the suggestion that patients with the chronic prostatitis-chronic pelvic pain syndrome have significantly higher prostate tissue pressure than controls. Findings also validated the previous clinical assumption that there is a rationale for differentiating chronic prostatitis-chronic pelvic pain syndrome cases into inflammatory and noninflammatory categories.
authors.affiliation: Division of Urology, Department of Surgery, Oulu University Hospital, Oulu, Finland.
authors.forename: Aare
authors.initials: A
authors.lastname: Mehik
authors.forename: Pekka
authors.initials: P
authors.lastname: Hellström
authors.forename: J Curtis
authors.initials: JC
authors.lastname: Nickel
authors.forename: Ansa
authors.initials: A
authors.lastname: Kilponen
authors.forename: Markku
authors.initials: M
authors.lastname: Leskinen
authors.forename: Ari
authors.initials: A
authors.lastname: Sarpola
authors.forename: Olavi
authors.initials: O
authors.lastname: Lukkarinen
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D006801:Humans; D008297:Male; D008365:Manometry / Q000379:methods; D008875:Middle Aged; D017699:Pelvic Pain / Q000175:diagnosis*; D011312:Pressure; D011446:Prospective Studies; D011472:Prostatitis / Q000175:diagnosis*; D013577:Syndrome