The Significance of Histological Chronic Prostatitis in Transrectal Prostate Biopsy

Purpose: The histological finding of chronic prostatitis (CP) has been linked to higher levels of prostatic specific antigen (PSA), prostate cancer (PCa) and lower urinary tract symptoms. However, its clinical meaning is still uncertain. We performed a retrospective analysis to determine the role of CP and its relationship to the diagnosis of PCa. Methods: Patients undergoing prostate biopsy from January 2008 to June 2013 were selected from our database. Those with the histological finding of CP were the focus of this analysis. They were categorized depending on the presence or absence of this feature. We determined the association between CP and PCa diagnosis using univariate and multivariate analyses. Statistical significance was stated as p<0.05. Results: 540 patients were selected. The mean age was 65 ± 7.51 years and median PSA of 7.49 ng/ml. Two groups were defined: 1) 331 patients with chronic prostatitis and 2) 209 without chronic prostatitis. No statistical differences were found between groups regarding age, PSA, IPSS score, prophylactic antibiotic use, comorbidities, alpha-blocker or 5-α-reductase inhibitor therapy, transurethral catheter at biopsy or infectious complications. Significant differences were found for previous hospitalizations, number of previous biopsies, suspicious digital prostate exam, number of cores taken, prostate volume, cancer diagnosis, percentage of positive cores and Gleason score >=7. A multivariate analysis model showed “protective” effect between CP and diagnosis of PCa (HR 0.17, p= <0.01). Conclusion: Our results suggest that the histological finding of CP is inversely related to PCa diagnosis.