Impact Of Chronic Prostatitis On Sexual Dysfunction And Its Mechanism

Objective: To study the mechanism of action and effect of the chronic prostatitis on patients' sexual dysfunction; To analyze the relationship between chronic prostatitis and sexual dysfunction, premature ejaculation (PE) and erectile dysfunction (ED), especially. Methods: 236patients with chronic prostatitis at our hospital from September 2008 to March 2010 were selected,at the age of 18-60.All people are screening through the history, physical examination , prostate routine and bacteria check for chronic prostatitis. Ask and fill with basic situation, including age, duration and treatment. All patients were investigated the prevalence of PE and ED by the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI), Chinese index of sexual function for premature ejaculation-5 (CIPE-5) and the International Index of Erectile Function-5 (IIEF-5). The relativity between sexual dysfunction and patient age, duration of disease and occupation were analyzed. Results: The incidence of CP in patients with PE had no obvious correlation between age group (P > 0.05).There was no statistically significant difference between the difference was found between the prevalence of ED according to subgroups by patient age; A higher incidence of ED occurred with the increased age. Prevalence of PE and ED were positive correlated with duration of disease. There was no statistically significant correlation between the NIH-CPSI and CIPE-5, IIEF-5.And ROC (operationg preferred auxiliary characteristic) curve are applied in order to showing the accuracy of experimental results. Conclusions: Prostatitis is common in adult males. Although it is not direct threat to life, it seriously affects the quality of life. The prostatitis is divided into four types: typeâ… prostatitis is sudden onset, It's major clinical manifestations include systemic symptom, such as chills,fever,exhaustion, accompanied by the pain of perineum on the pubis, urinary irritation symptoms (emiction, emiction aching, etc) and urination difficulties, even the acute urinary retention.Typeâ…¡prostatitis's major clinical manifestations is infection of lower urinary tract. Type III prostatitis's major clinical manifestations is pain symptoms in pelvic region. Because chronic pain can not be eliminated, the quality of life is lower and sexual dysfunction, anxiety, depression, insomnia, memory decline starte to appear. Typeâ…£prostatitis is without obvious clinical symptoms. Becausethe objective index of diagnosis of CP is in relative lack,NIH-CPSI is recommended. CPSI mainly includes the following three parts, The first part is evaluation of the site, frequency and the pain, this part is from the 1st to 4th question (0 ~ 21 points). The second part is used to assess the symptom score, from the 5th to 6th question (0 ~ 10points). The third part is used to assess chronic prostatitis's influence on the quality of life, from the 7th to 9th question (0 ~ 12points). Currently NIH-CPSI has been translated into many languages, used to assess in symptoms and efficacy on hronic prostatitis. Grading method is applied according to CPSI score on the NIH-CPSI : mild 9 ~ 18 points, moderate 19 ~ 28 points, severe 29-38 points. 1. The prevalence of PE and ED in236 patients were 37.29% (88/236) and 12.29% (29/236), respectively. This is similar with domestic and international data. So CP is an important factor of on sexual dysfunction.2. There was no statistically significant difference between the prevalence of PE according to subgroups by patient age. A higher incidence of ED occurred with the increased age. It is analyzed that PE is bound up with mental factors. 3. Prevalence of PE and ED were positive correlated with duration of disease. This is because duration of disease is long and the psychological pressure causes sexual dysfunction of self-doubt. And the inflammatory stimulate the nerves around prostate and have a bigger impact with the extension of time. 4. We observe that the incidence of PE and ED was improved slightly with the increase of CP symptom scores. But there is not obvious statistical significance. In summary:Chronic prostatitis was one of factors to prevalence of PE and ED. There was no relationship between prevalence of PE and patient age; A higher incidence of ED occurred with the increased age. The prevalence of PE and ED were positive correlated with duration of disease. There was no relationship between severity of symptom and that of PE and ED.