Seventy-eight men with symptoms of chronic or subacute prostatitis were enrolled. Investigations for the presence of Chlamydia trachomatis in urethral swabs were carried out. The expressed prostatic secretions were additionally examined for Mycoplasma hominis, Ureaplasma urealyticum, Gardnerella vaginalis, other gram-negative and gram-positive bacteria, Trichomonas vaginalis, yeast-like fungi and leucocyte count. Furthermore, all patients were evaluated for the presence of serum anti-chlamydial IgG antibodies. Signs of inflammation on the basis of the count of leucocytes per hpf in the prostatic secretions were detected in 42 patients (group I). Prostatodynia was found in the remaining 36 men (group II). In group I, chlamydial antigen was detected in the urethra and expressed prostatic secretions (EPS) in 6 (14.3%) and 9 (21.4%) patients, respectively. No evidence of current chlamydial infection was found in group II. The presence of serum anti-chlamydial IgG antibodies was demonstrated in 13/42 (30.9%) patients with prostatitis and in 3/36 (8.3%) patients with prostatodynia (P < 0.01). The results suggest that chlamydia may be one of the causative agents of chronic prostatitis.

Abstract.IntroductionThe aim of the study was to evaluate the correlation between the presence of anti-C. trachomatis (C.t.) antibodies in serum and expressed prostatic secretions (EPS) and the concentration of citric acid in patients with chronic prostatitis.Materials and MethodsThe study involved 34 men with chronic prostatitis. The leukocyte count, presence of anti-C.t. antibodies (IgA, IgG), and citric acid concentration were determined in the EPS. The serum was examined for IgM, IgA, and IgG anti-C.t. antibodies. Specific antibodies were determined using the EIA method. The concentration of citric acid was measured using the ultraviolet method.ResultsInflammation of the prostate (≥10 PMN) was found in 61.8% of the patients. A reduction in citric acid concentration in the EPS was detected in 58.8% of the men. Specific serum antibodies were detected in 58.8% of the patients, including 23.5% with IgM, 32.4% with IgA, and 44.1% with IgG. In all patients, serum IgM and IgA antibody titers were low, while those of IgG antibodies were strongly positive in 46.7% of the patients. Anti-C.t. antibodies in the EPS were detected in 44.1% of the patients, including 32.4% with IgA and 35.3% with IgG. In contrast to serum, the titers of IgG antibodies in the EPS were low in all the patients, while those of IgA were strongly positive in 54.5% of cases. In patients with positive serological outcomes, 85% had reduced concentrations of citric acid.ConclusionsThe occurrence of anti-C.t. antibodies is usually accompanied by a decrease in the concentration of citric acid in the prostatic secretion.

Determination of the concentration of citric acid in the prostatic fluid is a good indicator of prostatitis. C.t. infection of the prostate gland is accompanied by a decrease in the concentration of citric acid.

Introduction: The aim of the study was to determine the numbers of polymorphonuclear (PMN) leukocytes and PMN elastase and citric acid concentrations in chronic prostatitis patients regardless of etiology and in those with Chlamydia trachomatis infection of the prostate gland. Materials and Methods: The study involved 46 patients with chronic prostatitis. Expressed prostatitc secretions (EPS) were obtained to determine the leukocyte count, PMN elastase (ELISA) and citric acid concentrations (UV method), and the occurrence of C. trachomatis infection (ligase chain reaction). Results: Increased PMN cell counts (≥10 per high-power field) were found in 73.9% of patients and increased PMN elastase concentration (<250 ng/ml) in 78.3%. In 44.4% of the patients the elastase concentration indicated moderate (250-1000 ng/ml) and in 55.6% acute infection (≥1000 ng/ml). Decreased citric acid concentration (<18.12 mg/ml) in the EPS was found in 65.2% of the men. C. trachomatis prostate infection was detected in 17.4% of the patients and all of these men had higher inflammation parameters and lower citric acid concentrations. Conclusions: C. trachomatis prostate inflammation was accompanied by an increase in inflammation markers and a decrease in citric acid concentration.