title: Redundant prepuce increases the odds of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS).
abstract: Some published evidence has revealed that the dendritic cells can interact with pathogens that exist in the inner foreskin. This information provides a new vision that pathogens could play a role through the redundant prepuce; numerous studies have failed to find pathogens in prostates of patients who had chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). However, no studies have reported an association between foreskin length and CP/CPPS. Hence, we conducted a retrospective case-control study of clinical data from 322 CP/CPPS patients (case group) and 341 nonCP/CPPS patients (control group). Demographic characteristics, lifestyle factors, and foreskin lengths were collected and analyzed. Multivariate logistic regression was adopted to calculate the odds of foreskin length for CP/CPPS. According to the multivariate logistic regression results, when the foreskin length covered up more than half of the glans penis, the odds for CP/CPPS were higher with an increased foreskin (odds ratio (OR): 1.66, 95% confidence interval (CI): 1.04-2.66). In comparison, when the glans penis was completely covered by the foreskin, the OR value increased to 1.86 (95% CI, 1.2-2.88). The study results showed an association between foreskin length and the odds of CP/CPPS. When the foreskin length covered up more than half of the glans penis, there were greater odds for CP/CPPS. This possible mechanism might result from interaction between pathogens and DCs in the inner foreskin, consequently activating T-cells to mediate allergic inflammation in the prostate and producing the autoimmunizations causing CP/CPPS.
authors.forename: Yu-Yang
authors.initials: YY
authors.lastname: Zhao
authors.forename: Dong-Liang
authors.initials: DL
authors.lastname: Xu
authors.forename: Fu-Jun
authors.initials: FJ
authors.lastname: Zhao
authors.forename: Bang-Min
authors.initials: BM
authors.lastname: Han
authors.forename: Yi
authors.initials: Y
authors.lastname: Shao
authors.affiliation: Department of Urology, Shanghai First People's Hospital, Institute of Urology, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhao
authors.affiliation: Department of Urology, Shanghai First People's Hospital, Institute of Urology, Shanghai Jiao Tong University, Shanghai, China.
authors.forename: Shu-Jie
authors.initials: SJ
authors.lastname: Xia
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D052816:Foreskin / Q000033:anatomy & histology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D009929:Organ Size; D010413:Penis / Q000033:anatomy & histology; D011472:Prostatitis; D012189:Retrospective Studies; D055815:Young Adult