Influence of the lifestyle of a patient with chronic prostatitis on its quality

Introduction

Although a true rate of chronic prostatitis is unknown, its share in the structure of  urologic applications for medical help to commercial medical centres reaches 17.7% (42.3% among patients with urogenital infections) [1]. The main symptoms of chronic prostatitis (pain, sexual dysfunction, dysuria) exhaust a patient decreasing his/her quality of life. All the inventories used for the evaluation of the symptoms in patients with chronic prostatitis have a section "Quality of Life". The standard inventories International Prostate Symptom Score (IPSS) and National Institutes of Health chronic Prostatitis Symptom Index (NIH-CPSI) have sections for self-evaluation of the quality of life in general ranking from "perfect" to "unbearable". The inventories include such questions as "How often have symptoms prevented you from doing your routine activities this week (work, leisure activities, etc)?", "How often have you thought about the symptoms you have this week?". However, the authors believe that these questions do not provide sufficient information on the quality of life.

In clinical medicine, there are special inventories for the evaluation of the quality of life but they are complicated and not suitable for patients with chronic prostatitis.

The present study aimed to evaluate the quality of life depending on the quality of life of young active men with chronic abacterial category IIIa prostatitis by the adapted inventory for the evaluation of the quality of life MOS SF-36.

Materials and methods

The study included 105 patients that were divided into two groups: Group I included mobile patients that had 15 and more air trips per year (49 patients) and Group II included non-mobile patients (56 patients). Patients from Group II were men whose activity did not involve such additional loads as jet lags, ionizing radiation, and other negative factors associated with air trips, i.e. office workers, low and mid-level managers, sales managers, etc.

Study inclusion criteria:

1. chronic category IIIa prostatitis in the acute phase confirmed by 15 and more points by the NIH-CPSI scale and the presence of 15 and more leucocytes in the prostate fluid during light microscopy of a direct smear.
2. Socially successful men.
3. Age: 35 - 45 years old.
4. Signed informed consent.

Study exclusion criteria:

1. Social maladjustment (no permanent job, no accommodation).
2. Drug addiction.
3. Alcohol abuse.
4. chronic somatic diseases with often relapses (chronic obstructive lung disease, chronic hepatitis, hypertonic disease).
5. Endocrinal diseases.
6. Organ failure.
7. Oncologic diseases.
8. Depression and any psychic diseases.
9. Syndrome of chronic pain of other than prostatic localization.
10. Sexually-transmitted diseases and any other infections.
11. Pathogenic microflora (10² and more in the titer) revealed in the prostatic fluid.

Patients were asked to use a visual-digital scale for the self-evaluation of their general perception of health, interpersonal relationships, physical activity, social activity, and sexual function. The perfect quality of life by all the parameters was scored 5 points and unbearably bad — 25 points. Besides, the authors retrospectively accounted for the number of episodes of chronic prostatitis acute relapse within a year.

The statistical processing of the results was performed using a pc and the statistical software programs Microsoft Excel 2007 and Statistica for Windows 6.0. The authors estimated the arithmetic mean (x), mean arithmetic deviation (x-x), mean square deviation (σ), and relative error of the mean (m). To solve the issue of accidental discrepancies of the mean values (relative), the authors calculated the mean error of the mean difference. The obtained results were presented as the mean ± error the mean (M±m). Further, the authors compared the mean values of the selections (Ml and M2), calculated Student's t-test, and evaluated the significance of p. The differences were statistically significant at p <0.05.

Results

The intensity of symptoms and quality of life of patients evaluated by the NIH-CpSI inventory depending on the lifestyle is presented in Table 1.

Patients, whose work was associated with often business trips had more intensive pain and lower quality of life. The total score by the scale of symptoms of chronic prostatitis in mobile patients was also 1.5 times higher than in non-mobile. The authors revealed a statistically significant difference in the rate of relapses. patients with often air trips had chronic prostatitis relapses 1.5 times more often than non-mobile patients.

A more detailed analysis of the quality of life did not reveal significant differences in the score between the groups (Table 2).

Discussion

Currently, the quality of life of a patient is regarded as a primary criterion and is certainly assessed as an important parameter of the overall effectiveness of treatment. A.Z. Vinarov and R.V. Rozhivanov showed that the application of testosterone containing gel (Androgel^®) in patients with chronic prostatitis with androgen deficiency significantly improved their quality of life [2]. R. Mandar Mandar et al. [3] highlighted the negative influence of chronic prostatitis on the quality of life of patients and their families.

Experts in prostate treatment [4] also draw attention to the quality of life of patients with chronic prostatitis. The modern approach to the evaluation of the symptoms is based on the system UpOINTS (U - urological, P - psycho-social, O - organ-specific, I — infection, N — neurological, T — muscle tension and tenderness, and recently added domain S — sexuality). The impact of the domain "p" is quite significant. A patient with chronic prostatitis can have depression because of the disease, which sharply decreases the quality of life.

Dybowski et assoc, analyzed the results of a 12-month prospective study on the evaluation of predictors of the quality of life worsening in patients with chronic pelvic pain and concluded that the baseline depressive and anxious condition of a patient-led to a more expressed decrease in the quality of life after the development of chronic prostatitis [5].

The revealed differences in the intensity of symptoms of chronic prostatitis and the quality of life of patients depending on their lifestyle demonstrated a new area of interest for a doctor in making a treatment plan for such patients.

Conclusion

Frequent flights and jet lag negatively affect the symptoms of chronic prostatitis. Additional research is needed to develop methods for correcting this aggravating factor.