JC Nickel, D Hunter, J Downey, J Clark
Queen's University, Kingston, Canada
Introduction and Objective The NIH Chronic Prostatitis Symptom Index
(CPSI) was employed to determine the prevalence of prostatitis-like symptoms among men at risk (20-74) in a community-based study. L&A County has a large rural area, one major town, and a suburban area with a stable
population of men ages 20-70, representative of the Canadian demographic profile.
Methods The study was a cross-sectional postal survey of men ages 20-74 years in L&A County. The questionnaire collected
information on two domains of chronic prostatitis identified in the NIH-CPSI, namely, pain (location, severity, frequency) and voiding function (irritative, obstructive) as well as demographic, quality of life, general
health, and health-seeking behavior. The self-reported pain score was used to identify prostatitis-like symptoms (most discriminating domain). Based on analysis of the NIH-CPSI final validation study comparing
prostatitis patients to normal controls and BPH patients, the two questions most specific for prostatitis (perineal pain/discomfort and/ or pain/ discomfort on ejaculation) and a total pain score (0-21) of > 4 was
employed to identify men with significant prostatitis-like symptoms. Demographic questions (age, education) were adapted from the 1996 Census of Canada. Questions on length of symptoms and advice-seeking behavior were
taken from published questions used in BPH popuiation-based studies.
Results The study is ongoing. At time of interim analysis (September 15, 1999), 803 men had completed the survey. Seventy-five (9.3%) of the
men were identified as having chronic prostatitis-like symptoms. As well as perineal or ejaculatory pain/discomfort, 60 % of the prostatitis group also had pain/discomfort in the pubic or bladder area. The average
NIH-CPSI pain score for prostatitis group was 8.6 0.3. The average age (years) of the prostatitis population was 51 compared to 52 for men without prostatitis-like symptoms. The prevalence was 10.3% in men < 50 years
old and 8.7% in men 2 50 years. The voiding score (0-10) was 3.8 0.5 (compared to 1.3 0.1 for normals) in men < 50 years and 4.3 0.4 (compared to 1.9 0.1 for normals) in men 2 50 years. Demographics, frequency
distributions, sampling bias, and non-response bias will be analysed in more detail.
Conclusion This epidemiological community-based study employing the new prostatitis symptom index provides valuable
information on the prevalence of chronic prostatitis-like symptoms in men at risk.