Chronic prostatitis: symptomatology and the impact on the quality of life in a Sri Lankan population

Abstract

Chronic prostatitis (CP) or Chronic Pelvic Pain Syndrome (CPPS) affects men in all ethnic origins where they experience considerable morbidity and may remain symptomatic for years as there is limited understanding of the pathophysiology and the optimal treatment.The data regarding Sri Lankan patients remain sparse. The objective of this study was study the symptomatology associated with CP/CPPS in a Sri Lankan population and to evaluate its impact on their quality of life (QOL). A descriptive cross sectional study was conducted in the surgical unit and Genito-Urology clinic in Teaching Hospital Peradeniya from March 2010 to August 2011. The study group included all patients who were clinically diagnosed with CP/CPPS according to the National Institutes of Health (NIH) definition. Symptomatology and QOL were evaluated with NIH Chronic Prostatitis Symptom Index (NIH-CPSI), a nine-item tool with 4 subscores and a total score ranging from 0-43 points, and with higher scores indicating more severe symptoms. The study group included 43 subjects with a mean age of 36.3 (SD=12.21) years with an age range of 18-65 years. The duration of symptoms at presentation ranged from 3 months to 7 years. The commonest presentations were pelvic pain (n=43) involving suprapubic area, urethra or testicles and urinary symptoms (n=38) includ.ing dysuria, frequency and poor emptying. Of the total study group 44.18% (n=19) experienced post ejaculatory pain. NIH-CPSI indicated that except 4. others had experienced pelvic pain commonly in suprapubic area (n=34) during the week prior to assessment while n=35 had dysuria and n=15 had post ejaculatory pain. The average pain was 8.95 measured on visual analogues scale. Most had poor emptying (n=30) and frequency (n=33) as urinary symptoms. Symptoms of 88.37% of patients (n=38) had interfered their usual activities. QOL was affected in all except one. Among affected. most '(n=20) were unhappy to spend the rest of life with their symptoms and n=18 had mixed feeling about it. The Pain score ranged from 0-17 while the urinary symptom score, QOL Impact, Symptom Scale Score and Total score displayed a range of 0-10,0-12,0-27 and 0-37 respectively. Of the study population 55.81% (n=24) had symptoms of moderate severity while 27.9% (n= 12) had severe symptoms. Pelvic pain, urinary symptoms and post ejaculatory pain are the commonest symptoms among local patients with CP who show a broad age range. The symptoms display a wide range of degree of severity and it affects the QOL in 97.67%. Further extensive research are required regarding Sri Lankan patients.