Incidence and clinical characteristics of National Institutes of Health type III prostatitis in the community
Incidence and clinical characteristics of National Institutes of Health type III prostatitis in the community
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DOI：
10.1097/01.ju.0000182152.28519.e7
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发表时间：
2005-12-01
影响因子：
6.6
通讯作者：
Calhoun, EA
中科院分区：
文献类型：
--
作者：
Clemens, JQ;Meenan, RT;Calhoun, EA
目的：目前对前列腺炎的人群流行病学研究很少。我们使用编码的医生诊断和随后的图表审查来估计医生诊断的美国国立卫生研究院（NIH）III型前列腺炎的发生率和临床特征。材料和方法：计算机搜索凯撒永久西北（波特兰，俄勒冈州）数据库进行了为期2年的时间间隔2002年5月至2004年5月，以确定新的诊断慢性前列腺炎（国际疾病分类，第9次修订代码601.1）和前列腺炎未另行说明（国际疾病分类，第9次修订代码601.9）。在1,223名被确定为这些编码诊断的男性中，对413名（33.8%）的随机子集进行了病历审查。根据NIH前列腺炎定义对患者进行分类，I/II型-尿液分析或培养显示脓尿和/或菌尿，III型-NIH慢性前列腺炎症状指数中至少有1种疼痛或泌尿系统症状（会阴、睾丸、阴茎尖端、耻骨或膀胱区域疼痛、排尿困难、射精痛、排空不全、尿频），IV型炎症前列腺活检和前列腺症状以外的其他listed.Results：在413例患者中，57例以前被诊断为前列腺炎（流行病例），46例在病历中没有前列腺炎诊断的证据，7例由Kaiser Permanente Northwest计划以外的医生治疗。在其余303例中，分布为58例I/II型、189例III型、33例IV型和23例其他。医生诊断的III型前列腺炎的发病率为3.3/1000人-年。如果从分析中排除孤立的泌尿系统症状，则发病率降至2.8/1000人-年。III型前列腺炎患者的平均年龄为52.9岁（范围为29至82岁）。最常见的临床症状是排尿困难、尿频和会阴疼痛。44%的患者就诊时症状持续时间小于3个月，31%为3个月或更长，25%未指明。大多数（78%）的新的前列腺炎诊断是由初级保健physics.Conclusions：这些数据表明，前列腺炎是常见的诊断在社区设置，和III型前列腺炎占大多数这些诊断。症状的持续时间和复杂性低于已建立的前列腺炎研究队列中报告的症状。社区中大多数前列腺炎的诊断都是由非泌尿科医生做出的。
Purpose: Few population based epidemiological studies of prostatitis have been performed. We used coded physician diagnoses and subsequent chart reviews to estimate the incidence and clinical characteristics of physician diagnosed National Institutes of Health (NIH) type III prostatitis.Materials and Methods: Computer searches of the Kaiser Permanente Northwest (Portland, Oregon) database were performed on the 2-year interval May 2002 to May 2004 to identify new diagnoses of chronic prostatitis (International Classification of Diseases, 9th Revision code 601.1) and prostatitis not otherwise specified (International Classification of Diseases, 9th Revision code 601.9). Of the 1,223 men identified with these coded diagnoses, chart reviews were performed on a random subset of 413 (33.8%). Patients were categorized based on NIH prostatitis definitions of type I/II-evidence of pyuria and/or bacteriuria on urinalysis or culture, type III-presence of at least 1 of the pain or urinary symptoms in the NIH Chronic Prostatitis Symptom Index (pain in the perineum, testicles, tip of penis, pubic or bladder area, dysuria, ejaculatory pain, incomplete emptying, urinary frequency), type IV-inflammation on prostate biopsy and Other-symptoms other than those listed.Results: Of the 413 patients 57 were previously diagnosed with prostatitis (prevalent cases), 46 had no evidence of a prostatitis diagnosis in the medical record and 7 were treated by physicians outside of the Kaiser Permanente Northwest plan. Of the remaining 303 the distribution was 58 type I/II, 189 type III, 33 type IV and 23 Other. The incidence of physician diagnosed type III prostatitis was 3.3 per 1,000 person-years. If those with isolated urinary symptoms were excluded from analysis, the incidence decreased to 2.8 per 1,000 person-years. The mean age of those with type III prostatitis was 52.9 years (range 29 to 82). The most common presenting symptoms were dysuria, urinary frequency and perineal pain. Symptom duration at presentation was less than 3 months in 44%, 3 months or greater in 31% and unspecified in 25%. The majority (78%) of new prostatitis diagnoses was made by primary care physicians.Conclusions: These data indicate that prostatitis is commonly diagnosed in the community setting, and that type III prostatitis accounts for the majority of these diagnoses. The duration and complexity of symptoms are less than those reported in established prostatitis research cohorts. Most prostatitis diagnoses in the community are made by nonurologists.