Prevalence of Premature Ejaculation in Chronic Pelvic Pain Syndrome / 대한남성과학회지

PURPOSE: Premature ejaculation is a common male sexual dysfunction and has an adverse effect on QoL(quality of life). Chronic pelvic pain syndrome(CPPS) is also a common and serious health problem affecting QoL. Although both disorders are common their etiopathogeneses are not well understood. We investigated the prevalence and effect of premature ejaculation on erectile function in CPPS patients and compared these patients with healthy control subjects. MATERIALS AND METHODS: 638 CPPS patients and 102 healthy controls were enrolled in this study. Each patient was given a questionnaire consisting of 3 parts: a demographic data questionnaire, the Korean version of the NIH-CPSI(National Institutes of Health-Chronic Prostatitis Symptom Index), and IIEF(International Index of Erectile Function). Premature ejaculation was defined as intravaginal ejaculation latency of less than 3 minutes with the same partner for at least 6 months. RESULTS: 303 patients with CPPS and 83 healthy controls were eligible for the analysis. The rate of premature ejaculation was much higher in patients with CPPS(71.62%) than healthy controls(22.89%), and this difference was statistically significant(p < 0.01). In the patients with CPPS, the frequency of sexual intercourse per month during the last 3 months was 4.79+/-3.43. In the patients with CPPS, the mean scores for IIEF-EF(erectile function), IIEF-IS(intercourse satisfaction), IIEF-OF(orgasmic function), IIEF-SD(sexual desire) and IIEF-OS(overall satisfaction) were 21.7+/-6.4, 8.5+/-2.9, 7.4+/-2.5, 5.3+/-2.0 and 5.2+/-2.1, respectively. Each mean IIEF domain score was lower than healthy controls, and these differences were statistically significant. But in the patients with CPPS categorized in IIIa and IIIb, the frequency of sexual intercourse and each IIEF domain score showed no difference. CONCLUSIONS: The rate of premature ejaculation was higher in the patients with CPPS than healthy controls.

Elevation of Serum Prostate Specific Antigen in Subclinical Prostatitis: The Role of Pathology of Inflammation / 대한비뇨기과학회지

PURPOSE: We evaluated the correlation of the pathologic diagnosis, including the grade or location of the inflammation on a prostate biopsy specimen, to the serum prostate-specific antigen(PSA) level. MATERIALS AND METHODS: 172 patients(the patients' PSA was> or=4ng/ml) who received prostate biopsy at our department from January 2000 to August 2003 were retrospectively studied. The pre-biopsy PSA and pathology, including the diagnoses and inflammatory patterns, were analyzed. The pathologic patterns of inflammation were divided as acute or chronic by the predominant inflammatory cell type; especially, the chronic inflammation was divided by grade or location, and then this was reviewed by 1 pathologist. Chronic Inflammation was graded as I, II or III according to the severity of inflammation. The PSA levels were compared among the grades. The presence or absence of chronic inflammation was checked in the periglandular, stromal and perivascular areas, respectively. The PSA levels were compared between the presence and absence of inflammation at each location. RESULTS: Among 172 patients, the number of patients with prostate cancer was 37(21.5%), and 68 patients had only BPH(39.5%), 27 had only prostatitis(15.7%) and 40 patients had benign prostatic hyperplasia(BPH) with prostatitis(23.3%). The number of patients with any prostatitis was 67(39.0%). The age of the patients was 68.4+/-8.7 years(45-91), the serum PSA was 13.30+/-14.38ng/ml(4.30-102.48), and the prostate size was 49.5+/-21.1ml(20-126). One case of BPH with prostatitis had a PSA level above 100ng/ml. Among the 67 specimens that showed prostatitis, 16 patients had histologically acute inflammation(23.9%) and 51 patients had chronic inflammation(76.1%). The PSA levels of the acute or chronic inflammation patients were 24.04+/-25.95ng/ml(4.46-102.48) and 9.93+/-4.73ng/ml(4.3-21.12, p=0.047), respectively. The PSA levels were not different among the 3 grades of chronic inflammation. In periglandular, stromal and perivascular locations, the PSA levels were not different between the presence and absence of chronic inflammation. CONCLUSIONS: About 39% of the prostate biopsy specimens showed prostatitis. The PSA level was higher for the acute inflammation than for the chronic inflammation. However, there was no difference in PSA levels among the each of the grades or locations of chronic prostatic inflammation.