Confusion on studies

[prostateproblem]

Hi Mark,

I was reading articles on Medline, well studies, and I came across the one below. If I understand this, it contradicts what has been proven in later studies today...why is that?

Also the second study below shows AJ Shaeffer saying there is no bacteria in the prostate in 1 study and saying there is in another ??? Using similar techniques???

Negative bacterial polymerase chain reaction (PCR) findings in prostate tissue from patients with symptoms of chronic pelvic pain syndrome (CPPS) and localized prostate cancer.

Leskinen MJ, Rantakokko-Jalava K, Manninen R, Leppilahti M, Marttila T, Kylmala T, Tammela TL.

Department of Urology, Seinajoki Central Hospital, Seinajoki, Finland. [email protected]

BACKGROUND: The etiology of chronic pelvic pain syndrome (CPPS) remains obscure. Although, bacterial etiology has frequently been suggested, evidence of both bacterial involvement in chronic prostatitis / chronic pelvic pain syndrome and the presence of normal bacterial flora in the prostate remain uncertain. MATERIALS AND METHODS: We investigated the presence of bacterial DNA using polymerase chain reaction (PCR) techniques on prostatic tissue samples obtained in radical prostatectomy from 10 patients with moderate to severe symptoms of chronic prostatitis / chronic pelvic pain syndrome and 10 nonsymptomatic patients with localized prostate cancer. For symptom evaluation we used the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI). RESULTS: All but one sample were negative for bacterial DNA. The PCR from a symptomatic patient was reproducibly positive in 16S rDNA PCR but negative in 23S rDNA PCR. Bacterial DNA was found in only one out of two sample aliquots and cloning yielded different sequences in two PCR products. CONCLUSIONS: A bacterial etiology for chronic prostatitis / chronic pelvic pain syndrome symptoms could not be demonstrated in patients with prostate cancer. The results also suggest that the prostate is unlikely to harbor bacterial normal flora. Copyright 2003 Wiley-Liss, Inc.

PMID: 12661035 [PubMed - indexed for MEDLINE]



Evaluation of the bacterial flora of the prostate using a 16S rRNA gene based polymerase chain reaction.

Hochreiter WW, Duncan JL, Schaeffer AJ.

Department of Urology, Northwestern University Medical School, Chicago, Illinois, USA.

PURPOSE: The role of bacteria in the chronic pelvic pain syndrome (nonbacterial prostatitis and prostatodynia) is controversial and difficult to assess because the bacterial flora of the prostate is not well defined. Polymerase chain reaction (PCR) is a highly sensitive molecular method of bacterial detection. It confirms the sterility of tissue with a high level of confidence and detects small numbers of microbial agents that may represent pathogens. We performed PCR to determine bacterial colonization of the prostate in presumably healthy men and in those undergoing simple or radical prostatectomy. MATERIALS AND METHODS: We analyzed 28 prostate samples from 18 organ donors from whom prostate tissue was obtained under sterile surgical conditions at organ withdrawal, 14 sterile surgical prostate specimens from 7 patients undergoing radical prostatectomy for prostate cancer who previously underwent transrectal biopsy and 6 sterile surgical specimens from 2 men who underwent simple prostatectomy for benign prostatic hyperplasia (BPH), including 1 with an indwelling catheter for several weeks. For PCR we used 2 sets of primers to detect bacterial 16S rRNA gene sequences. Normal prostate tissue seeded in vitro with known numbers of Escherichia coli was used to assess the sensitivity of PCR. RESULTS: Only 3 of the 28 organ donor samples had histological signs of minimal inflammation and all other samples appeared to be normal without evidence of inflammatory reaction. All of these samples were PCR negative. Of several PCR control reactions the mixture of prostate tissue seeded with known numbers of E. coli demonstrated the high sensitivity of the assay, allowing the detection of as few as 6 bacteria in the presence of 25 mg. of prostate tissue. A focal and heterogeneous distribution of inflammation and infection was noted in the 14 radical prostatectomy specimens. In the prostate cancer and BPH groups there was a strong association of inflammation with positive PCR findings. Of 11 samples 3 without but all 9 with inflammation were PCR positive. CONCLUSIONS: PCR is a highly sensitive method for detecting bacteria in the prostate. In our study negative PCR reactions in the prostate tissue of apparently healthy men made the presence of normal bacterial flora in the prostate extremely unlikely. The presence of bacteria and/or inflammation in radical prostatectomy specimens was found to be a localized process. Concordance between inflammation and positive PCR results in simple and radical prostatectomy specimens suggests that bacteria may frequently have a role in histologically inflammatory prostatitis.

[webslave]

Please include dates for each study, and journal name.

[prostateproblem]

1: Prostate. 2003 May 1;55(2):105-10. Related Articles, Links

Wiley, Interscience ??? I think its a book publisher.

Negative bacterial polymerase chain reaction (PCR) findings in prostate tissue from patients with symptoms of chronic pelvic pain syndrome (CPPS) and localized prostate cancer.

Leskinen MJ, Rantakokko-Jalava K, Manninen R, Leppilahti M, Marttila T, Kylmala T, Tammela TL.

Here is a direct link: http://www.ncbi.nlm.nih.gov/entrez/quer ... =iconabstr


2: J Urol. 2000 Jan;163(1):127-30. Related Articles, Links

LWWonline ???

Evaluation of the bacterial flora of the prostate using a 16S rRNA gene based polymerase chain reaction.

Hochreiter WW, Duncan JL, Schaeffer AJ.

Direct link: http://www.ncbi.nlm.nih.gov/entrez/quer ... =iconabstr

[webslave]

The most recent studies, done with fastidious care by the best experts in the most trusted centers in the USA (not some tiny Finnish hospital), have shown that there is no real difference in terms of pathogenic bacteria in controls and CP/CPPS patients. That's all you need to know.

I suggest that if you are not prepared to read a lot of studies and look carefully at the evidence presented at https://ucpps.men , or if you do not know how to assess the relevance of scientific abstracts, or you find yourself struggling to understand the medical jargon and statitistical data, you should not do your own research but rather trust what we are telling you.

[prostateproblem]

Yea, your probably right. I just end up confusing myself.

Thanks for your insight.

[Ralph]

The only thing more contradictory than medical studies is politics. There are at least half a dozen published papers in good peer review journals that support any medical theory about anything.

[webslave]

That's true, which is why one needs to be quite knowledgeable in an area before making judgments as to the relative worth of these studies. In the end, you go with the broadest consensus from the best studies (properly designed! Let's stick to evidence--based medicine) from the biggest and most trusted centers. That's why we discount bacteria as a cause of the continuing pain of pelvic myoneurpathy aka CPPS.