Chronic prostatitis/pelvic pain syndrome: MRI findings and clinical correlations

Associated Factors for Prostate Enlargement in Chinese Adult Men Aged <40 Receiving Checkups

PURPOSE

Prostate enlargement (PE) is an increase in prostate volume in morphology. PE was also observed in some patients aged <40 with chronic prostatitis. This study aimed to explore the associated factors for PE in Chinese adult men aged <40.

METHODS

The medical records of 1851 consecutive Chinese adult men aged <40 in a single center were retrospectively analyzed. The checkup indicator characteristics between the PE and non-PE groups were compared by univariate analysis, and the associated factors were analyzed by multivariate analysis.

RESULTS

The overall prevalence of PE (defined as prostate volume ≥ 20 ml) in adult men aged < 40 was 10.4%. Age and the proportions of subjects with prostate calcification or hypertension were different between the PE and non-PE groups (P < 0.05). Multivariate logistic analysis showed that prostate calcification (odds ratio [OR], 1.831; 95% confidence interval [CI], 1.281-2.619; P=0.001), hypertension (OR, 1.528; 95% CI, 1.125-2.076; P=0.007), and age (OR, 1.117; 95% CI, 1.078-1.159; P < 0.001) were associated factors for PE in adult men aged <40.

CONCLUSIONS

The prevalence of PE in Chinese adult check-up men aged <40 was not rare. In addition to age, prostate calcification and hypertension were associated factors for PE in Chinese adult men aged <40.

The Clinical and Pathologic Relevance of a Prostate MRI Diagnosis of "Prostatitis"

OBJECTIVE

To investigate the relationship between magnetic resonance imaging evidence of prostatitis with clinical symptomatology. Non-malignant abnormalities in peripheral zone are common in prostate multiparametric prostate magnetic resonance imaging (mpMRI). These findings are sometimes reported as "prostatitis" or "inflammation" and lead to patient anxiety and urologic referral.

METHODS

Retrospective review of patients undergoing prostate mpMRI (2016-2017) was performed. Two cohort groups based on the presence of "prostatitis" or "inflammation" in the radiology report were identified. Clinical characteristics included age, prostate specific antigen, biopsy/intervention history, true lower urinary tract symptoms (LUTS), pain, use of urologic medications, prostate volume, and PIRADS score. Pathologic finding of inflammation was recorded. Groups were compared using chi-square for dichotomous variables and t-tests for continuous variables.

RESULTS

One hundred and four patients were identified with "prostatitis/inflammation" and 273 without. Report of LUTS was high in both groups (58% and 62% for prostatitis and no prostatitis respectively, P= .49), though report of moderate/severe LUTS (physician description or IPSS of 8-19 and 20+) was more common in the no prostatitis group (7% vs 18%, P= .008). Use of urologic medication was similar between the 2 groups (31% and 37% for prostatitis and no prostatitis respectively, P = .23). Biopsy finding of inflammation was more common in the prostatitis group (57% vs 43% P = .027). Reports of pelvic pain, dysuria, or urinary findings of inflammation were uncommon in both groups.

CONCLUSION

While mpMRI findings of prostatitis may indicate NIH Category IV prostatitis, there is no evidence of correlation with categories I, II or III prostatitis nor with symptomatic LUTS, and patients should be reassured that further investigation is not warranted.