Results of Microorganism Detection by Multiplex Polymerase Chain Reaction in Patients with Chronic Pelvic Pain Syndrome

ABSTRACT

PURPOSE: The aim of this study was to evaluate the results of multiplex polymerase chain reaction (PCR) in patients with chronic pelvic pain syndrome (CPPS) and the significance of microorganisms as the causative factor of CPPS. MATERIALS AND METHODS: We evaluated the frequency of 19 possible causative microorganisms of prostatitis in 849 patients who had prostatitis symptoms from April 2007 to March 2009 by using multiplex PCR. All of the enrolled patients were category III by the definition of the NIH Chronic Prostatitis Workshop. RESULTS: Of the 849 patients, 414 (49%) and 435 (51%) were categories IIIa (inflammatory CPPS) and IIIb (noninflammatory CPPS). On multiplex PCR, using the third voided urine specimen (VB3), 369 (89%) of the 414 category IIIa and 367 (84%) of the 435 category IIIb cases were found to have positive PCR results for causative microorganisms. The common microorganisms were Enterococcus, Ureaplasma urealyticum, Lactobacillus, Streptococcus agalactiae, and Chlamydia trachomatis in 173 (18%), 144 (15%), 129 (13%), 78 (8%), and 69 cases (7%), respectively. CONCLUSIONS: There were too many positive PCR results for causative microorganisms in the CPPS patients despite negative urine culture examination. Therefore, it is necessary to rule out contamination of the specimen to achieve reliable results with multiplex PCR. However, multiplex PCR can detect various unknown microorganisms suggestive of the etiology of CPPS, particularly those that are difficult to cultivate. PCR is expected to play an important role in the diagnosis of CPPS, but further studies will be required to define the usefulness of molecular tests.