Clinical Outcome of Acute Prostatitis, a Multicenter Study

초록

Introduction : There is few available study about acute prostatitis in Korea. Methods: We reviewed the clinical records of 225 patients who were diagnosed as acute prostatitis in 11 hospitals from 1994 Jan. to 2004 May. In these patients, we analyzed urine culture, change in the PSA value and the prostate volume, the incidence of prostate abscess, antibiotics used in Tx, time to the complete remission and the rate of progression to chronic prostatitis. Results: The chief complaints of patients were high fever, dysuria, frequency and the accompanying diseases were hypertension(17%), diabetes(13%), neurogenic bladder, BPH. In routine U/A, abnormal numbers of WBC was found in 83%, and RBC in 72% of patients. The organisms were cultured in 45% of patients - E.coli(64%), P. aeruginosa, et al. Mean PSA at initial Dx was 20.9±30.4ng/ml. 78% showed PSA elevation and 5 patients over 100ng/ml. U/S was performed in 84 patients. Mean prostate volume was 41.9cc and prostate abscess was found in 4 patients(4.8%). IV antibiotics used in Tx was cephalosporine family (66%), aminoglycosides (68%), and quinolone family (47%). Alpha blocker was added in 54%. Oral quinolone (63%), cephalosporine(36%), and alpha blocker(54%) were prescribed for mean 4.9 wks after discharge. Of 18 patients who received prostate massage after 8 weeks of Tx, 9(50%) showed chronic prostatitis findings and the percentage would be 5% if counted in terms of 176 patients. In the 41 patients in whom PSA was elevated (mean 26.5ng/ml), the value was declined below 4ng/ml in 54% after 10 wks of Tx. Conclusions: The most common chief complaint of acute prostatitis was high fever and the most common causative organism was E.coli. Admission period was not longer than 3 weeks and PSA elevation was observed in 78% of patients. Although acute prostatitis was treated with proper antibiotics, the progression to chronic prostatitis was observed in 5-8% of patients.