World J Mens Health.  2019 Sep;37(3):355-363. 10.5534/wjmh.180081.

Roles of Ureaplasma Species in Idiopathic Chronic Prostatitis: A Case-Control Study

• Park H
• Lee G

• KMID: 2455412
• DOI: http://doi.org/10.5534/wjmh.180081

Abstract

PURPOSE
Because of the inconsistent symptoms associated with Ureaplasma infections, their clinical significances in genitourinary tracts are under debate. Therefore, we evaluated the presence of Ureaplasma urealyticum (UU) and Ureaplasma parvum (UP) in urine samples and examined their associations with chronic prostatitis (CP) through a case and control study.
MATERIALS AND METHODS
We included 696 nonchlamydial nongonococcal (NCNG) urine samples from men; 350 were categorized into non-inflammatory CP, 88 in inflammatory CP, and 258 in non-CP group. We amplified a region in the Ureaplasma urease areas from these samples and determined their biovars using the Sanger method.
RESULTS
Among the NCNG population, the rates of UU, UP, and non-UU/UP were 3.88%, 6.46%, and 89.66%, respectively. The overall infection rates of non-CP, inflammatory CP, and non-inflammatory CP groups were 4.15%, 6.10%, and 3.65% in UU (p=0.612) and 6.85%, 7.22%, and 6.50% in UP (p=0.968), respectively. UU infection increased the risk of white blood cell (WBC) counts (≥5) in urine (p=0.005). In contrast, UP infections did not increase the risks of urethritis. Re-analysis from the 633 men who were excluded from urethritis effects did not reveal the associations between UU infection and the clinical characteristics of CP. Furthermore, the profiles from the National Institutes of Health-Chronic Prostatitis Symptom Index questionnaire and WBC counts in expressed prostatic secretion were similar among the non-CP and the two CP groups in each Ureaplasma infection.
CONCLUSIONS
We found that UU may induce male urethritis. However, Ureapalsma species in urine were not definitively associated with the occurrence of CP.

Keyword

Chronic prostatitis; Infection; Prostate; Ureaplasma parvum; Ureaplasma urealyticum

MeSH Terms

Academies and Institutes
Case-Control Studies*
Humans
Leukocytes
Male
Methods
Prostate
Prostatitis*
Ureaplasma Infections
Ureaplasma urealyticum
Ureaplasma*
Urease
Urethritis
Urease

Figure

• 

  Fig. 1 Schematic drawing of the study design. A total of 810 men underwent basic chronic prostatitis (CP) evaluation tests including a lower urinary localization test and an in house multiplex polymerase chain reaction (PCR) test for Neisseria gonorrhoeae and Chlamydia trachomatis. Among this population, 49 were diagnosed with chronic bacterial prostatitis and 63 were diagnosed with urinary chlamydial infection; these 112 men were excluded from the study. Two men with mixed Ureaplasma infections in their urine were also excluded from this study. The remaining 696 men were classified into either the control group (258 cases) or CP positive group (438 cases). The compatible CP patients were further classified into inflammatory CP (88 cases) or non-inflammatory CP (350 cases) based on the white blood cell (WBC) counts in expressed prostatic secretion (EPS). Dotted box: excluded cases. Solid box: included cases. HPF: high-power field, NIH-CPSI: National Institutes of Health-Chronic Prostatitis Symptom Index, STI: sexually transmitted infection.

• 

  Fig. 2 (A, B) We amplified partial segments of UreA and UreB regions of Ureaplasma species, and found genotypes of U. urealyticum and U. parvum. (C) Because of the clear dissimilarity in DNA sequences between U. urealyticum and U. parvum in the amplified region, the two genotypes could be distinguished clearly. The solid box of each organism contains the amplified DNA in the partial UreA gene, while the dotted box of each organism represents the partial UreB gene. The numbers in boxes represent DNA sequence loci based on AF085733 for U. parvum and AF085721 for U. urealyticum. Primers for polymerase chain reactions are indicated by the arrows.

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