The role of microscopic examination in the diagnosis of chronic bacterial prostatitis
Ibishev, KS1; Krakhotkin, DV1; Krainiy, PA1; Zagirov, ZM1; Magomedov, RG1
1: Rostov State Medical University,Department of urology, Rostov-on-Don, Russia
Objective: To perform a comparative analysis of the results of microscopic examination of the prostatic secretion in patients with testosterone deficiency and normal level testosterone.
Materials and methods: The analysis of the results of the study of 124 patients with chronic bacterial prostatitis, which were divided into three groups, depending on the level of testosterone. Group I (46 patients) with level testosterone below 8 nmol / L, group II (27 patients) whose serum testosterone level corresponded to the gray zone from 8 to 12 nmol / L and Group III (51 patients) with a normal testosterone - higher than 12.1 nmol / l. Patients were of equal age and duration of the disease.
The age of the patients was from 20 to 45 years. Electron microscopy was performed using a new Nikon Neoscope Benchtop scanning electron microscope, with high resolution. Microscopic examination is performed on samples prostatic secretion and urine obtained during the test Meares-Stamey. The study of the bio-samples for studying the hormonal status was performed by radioimmunoassay, using the Immunotech (Czech Republic) IM-1119, A-21854, IM-1381, IM-2125, EIA-2330
Results: With microscopy of prostatic secretion, the presence of leukocytes> 10 in the field of vision in the prostatic secretion was detected in patients of all three groups. In patients of group I, p = 0.6137; In group II p = 0.9717; And in group III p = 0.9844. In the prostatic secretion, all three groups showed an increase in both the leukocyte count and the number of epithelial cells. When analyzing the level lecithin grains, their significant decrease (p <0.05) were noted in group I patients 39 (79.5%) and in group II patients 19 (70%), when the patients of group III showed only in 16 (31.3%). Electron microscopy and further evaluation of the cytological component of prostatic secretion demonstrated a prevalence of neutrophils in patients with a normal level of total testosterone, when a high level of lymphocytic cells was observed in patients with testosterone deficiency. In the analysis of the prostatic secretion, in all patients of the I group with a total testosterone level greater than 12 nmol / L, actively phagocytotizing macrophages are observed.
Conclusions:. In patients with a total testosterone level in the blood serum below the reference values, there is a disturbance of protective mechanisms in the prostatic secretion, which contributes to decrease of effectiveness antibiotic therapy and maintenance of the infectious inflammatory process in prostate.
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