Pathogenic mechanisms of pain in chronic bacterial prostatitis

Shormanov I.S., Solov'ev A.S.

Summary. Purpose of the study. To study the nature and frequency of the manifestations of endothelial dysfunction and to clarify their relationship with pain syndrome in patients with exacerbation of chronic bacterial prostatitis (CBP).

Material and methods. The study included 120 men aged 22-48 years with clinical and laboratory exacerbation of CKD and 30 clinically healthy men of the same age (control group) who were evaluated pain index (NIH-CPSI-QL), the severity of erectile dysfunction (ICEF 5), determined plasma levels of free L-arginine (precursor of nitric oxide NO) and perform ultrasonic dopplerography of vessels of the prostate.

Results. Decreased libido, and disorders of erectile function was noted in at 51.7% and 49.2 percent of patients, respectively (p<0.05). We found a significant negative relationship between pain index and severity of erectile dysfunction (n=120; r=0,385; p=0.001). At 31,7% patients had erectile dysfunction that was diagnosed with an absolute deficiency of plasma free L-arginine (p<0.05). In patients with CBP was reduced by 28.9% velocity of blood flow in the prostate arteries, increased indices of resistance to blood flow in all major blood reservoirs of the prostate and decreased by 27.4% from the linear velocity of the blood through the veins of the prostate compared with the control group (p<0.05). We found a significant positive correlation between the pain index (IB) and the resistance index of blood flow in the capsular arteries of the prostate (n=120; r=0,231; p=0.001).

Conclusion. The study demonstrated pathogenetically important, but clinically underappreciated role of endothelial dysfunction in the multifactorial mechanisms of the pain syndrome in the exacerbation of CBP.

Authors declare lack of the possible conflicts of interests.

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chronic bacterial prostatitis, endothelial dysfunction, erectile dysfunction, L-arginine, prostatic hemodynamics, pathogenetic connection