Acute bacterial prostatitis: How to prevent and manage chronic infection?

We conducted a retrospective analysis of acute bacterial prostatitis (ABP) to evaluate the factors of progressing tochronic infection and chronic pelvic pain syndrome IIIa (CPPS IIIa) from ABP. The clinical records of 480 cases compatiblewith a confirmed diagnosis of ABP from five urological centers between 2001 and 2010 were reviewed. We defined chronicinfection (CI) as a progression to chronic bacterial prostatitis (II), epididymo-orchitis, and showing persistent pyuria andbacteriuria after treatment of ABP in admission periods when followed up at 3 months or more. Results were analyzed accordingto two categories: category I, developed to CI (group A, n = 49) versus recovered without CI or CPPS IIIa (group C, n = 385);and category II, developed to CPPS IIIa (group B, n = 46) versus recovered without CI or CPPS IIIa (group C, n = 385). Of the480 ABP patients, 10.2% (49/480) progressed to CI and 9.6% (46/480) progressed to CPPS IIIa. The frequency of CI was 11.3%(49/434) and that of CPPS IIIa was 10.7% (46/431). The factors that affected progression to CI were diabetes, priormanipulation, not doing cystostomy, and urethral catheterization (P < 0.05). The factors that affected progression to CPPSIIIa were the same as CI, but prostate volume was included in the CPPS IIIa group (P < 0.05). The identification andcharacterization of these factors may accelerate the development of preventive, diagnostic, and therapeutic strategies forthe treatment of CI and CPPS IIIa from ABP.