The presence of Chlamydia is associated with increased leukocyte counts and pain severity in men with chronic pelvic pain syndrome.
OBJECTIVE
To examine the role of urinary chlamydial infection in patients with chronic prostatitis and/or chronic pelvic pain syndrome (CP-CPPS).


METHODS
We recruited men aged 18-55 years over 4 years. We excluded patients with acute urethritis and any acute genitourinary infections. The participants evaluated their CP-CPPS-like symptoms with the Korean version National Institutes of Health-Chronic Prostatitis Symptom Index questionnaires. We measured white blood cell (WBC) counts in expressed prostatic secretion (EPS). In-house nucleic acid amplification test for Chlamydia trachomatis and Neisseria gonorrhoeae detection and WBC counts were performed from the patient's first-voided urine.


RESULTS
A total of 765 eligible men were classified into 3 groups: 196 in non-CP-CPPS, 410 in noninflammatory CP-CPPS, and 159 in inflammatory CP-CPPS groups. The chlamydia-infected men showed higher pain, poor quality of life (QOL), and total scores in National Institutes of Health-Chronic Prostatitis Symptom Index questionnaires than the negative men (P = .041 for pain; P = .043 for QOL, and P = .027 for total). Multivariate analysis found that urinary chlamydial infection increased the risk of WBC count ≥16 in EPS (adjusted odds ratio [OR], 2.189; 95% confidence interval [CI], 1.021-4.690; P = .044) and WBC count between 2 and 4 in urine (OR, 5.227; 95% CI, 2.503-10.918; P = .001). In addition, chlamydial infection also increased the risk of inflammatory CP-CPPS than the non-CP-CPPS group (OR, 2.448; 95% CI, 1.010-5.932; P = .044), whereas the patients with noninflammatory CP-CPPS were not affected (OR, 1.6557; 95% CI, 0.738-3.717; P = .221).


CONCLUSIONS
Urinary chlamydial infection increased the pain scores and WBC counts in EPS and worsens the QOL in the patients with CP-CPPS.
Department of Urology, Dankook University College of Medicine, Cheonan, Korea.
Heeyoon
H
Park
Department of Molecular Diagnostics, SolGent, Daejeon, Korea.
Seon-mi
SM
Sim
Department of Urology, Dankook University College of Medicine, Cheonan, Korea. Electronic address: multiorigins@yahoo.com.
Gilho
G
Lee
D000293:Adolescent; D000328:Adult; D002692:Chlamydia trachomatis / Q000302:isolation & purification*; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011472:Prostatitis / Q000097:blood* / Q000382:microbiology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult