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• W2110364065 abstract "No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Nov 2000PROSPECTIVE IDENTIFICATION OF NATIONAL INSTITUTES OF HEALTH CATEGORY IV PROSTATITIS IN MEN WITH ELEVATED PROSTATE SPECIFIC ANTIGEN JEANNETTE M. POTTS JEANNETTE M. POTTSJEANNETTE M. POTTS More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)67026-7AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Although prostatitis may cause elevated prostate specific antigen (PSA), asymptomatic patients are not routinely screened for this diagnosis before transrectal biopsy is performed to rule out cancer. Many negative biopsies reveal evidence of prostatitis classified as National Institutes of Health (NIH) category IV prostatitis or asymptomatic inflammation. To our knowledge this report represents the initial study of the incidence of NIH category IV prostatitis in men before biopsy and its clinical significance. Materials and Methods: From 1996 to 1998 asymptomatic men with elevated PSA levels were evaluated for laboratory signs of prostatitis. Patients with expressed prostatic secretions or post-prostate massage urine (voiding bottle 3 [VB3]) positive for greater than 20 and greater than 10 white blood cells per high power field, respectively, received antibiotics for 4 weeks and were reevaluated after 6 to 8 weeks. Men without these clinical signs promptly underwent biopsy. Those with acute urinary tract infection and PSA greater than 30 ng./ml., without a rectum or who refused biopsy were excluded from study. Results: Of the 187 study patients 122 were evaluable with a mean PSA of 9.35 ng./ml., including 51 (42%) with laboratory signs of prostatitis. After treatment PSA was normal in 22 cases and remained elevated in 29, including 9 in which biopsy revealed cancer. The change or improvement in PSA was significantly greater in men with benign results than in those with prostate cancer (−21.32 versus −1.33%, p = 0.001). In the cohort with negative expressed prostatic secretion and VB3 results transrectal ultrasound guided biopsy was done promptly. Screening decreased the number of biopsies by 18% (22 of 122 cases). The positive predictive value of PSA for detecting biopsy proved cancer improved with screening for prostatitis (45 of 122 cases or 37% versus 36 of 71 or 51%). Long-term followup revealed continued normal or stable PSA in the prostatitis cohort. Conclusions: Screening for NIH category IV prostatitis should be considered in men with elevated PSA. Although patients may be asymptomatic, anxiety caused by prostate cancer and diagnostic procedures contributes to the clinical significance of this disorder. 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Google Scholar From the Urological Institute, Cleveland Clinic Foundation, Cleveland, Ohio© 2000 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byTaneja S (2018) Re: The Effect of a Pure Anti-Inflammatory Therapy on Reducing Prostate-Specific Antigen Levels in Patients Diagnosed with a Histologic ProstatitisJournal of Urology, VOL. 196, NO. 5, (1446-1446), Online publication date: 1-Nov-2016.Stopiglia R, Ferreira U, Silva M, Matheus W, Denardi F and Reis L (2018) Prostate Specific Antigen Decrease and Prostate Cancer Diagnosis: Antibiotic Versus Placebo Prospective Randomized Clinical TrialJournal of Urology, VOL. 183, NO. 3, (940-945), Online publication date: 1-Mar-2010.Tekin A, Yuksel A, Tekin S, Gumrukcu G, Aslan A and Sengor F (2018) Post-Prostatic Massage Examination for Prediction of Asymptomatic Prostatitis in Needle Biopsies: A Prospective StudyJournal of Urology, VOL. 182, NO. 2, (564-569), Online publication date: 1-Aug-2009.SCHAEFFER A, WU S, TENNENBERG A and KAHN J (2018) TREATMENT OF CHRONIC BACTERIAL PROSTATITIS WITH LEVOFLOXACIN AND CIPROFLOXACIN LOWERS SERUM PROSTATE SPECIFIC ANTIGENJournal of Urology, VOL. 174, NO. 1, (161-164), Online publication date: 1-Jul-2005.CARVER B, BOZEMAN C, WILLIAMS B and VENABLE D (2018) The Prevalence of Men With National Institutes of Health Category IV Prostatitis and Association With Serum Prostate Specific AntigenJournal of Urology, VOL. 169, NO. 2, (589-591), Online publication date: 1-Feb-2003.LEE S, KU J, PARK H, JEONG C and KIM S (2018) Prostatic Calculi Do Not Influence The Level of Serum Prostate Specific Antigen in Men Without Clinically Detectable Prostate Cancer or ProstatitisJournal of Urology, VOL. 170, NO. 3, (745-748), Online publication date: 1-Sep-2003.Bozeman C, Carver B, Eastham J and Venable D (2018) Treatment Of Chronic Prostatitis Lowers Serum Prostate Specific AntigenJournal of Urology, VOL. 167, NO. 4, (1723-1726), Online publication date: 1-Apr-2002. Volume 164Issue 5November 2000Page: 1550-1553 Advertisement Copyright & Permissions© 2000 by American Urological Association, Inc.Keywordsbiopsyprostate-specific antigenprostateprostatitisMetricsAuthor Information JEANNETTE M. POTTS More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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