Overlap Of Diagnosis Of Overactive Bladder And Ⅲ Chronic Prostatitis In Young Men

Background:Overactive Bladder (OAB) and Chronic Prostatitis/Chronic Pelvic Pain Syndrome(CP/CPPS) are very common and quite difficult syndromes in urological clinical. The prevalence is as high as 10% or even more, especially among young men. The occurrence of the mechanism has not been completely expounded, leading to unreasonable treatment or unsatisfied treatment with the quality of life of patients seriously affected, causing a huge waste of health care and human resources. To the clinical manifestations of these two disease or syndrome, there are many common symptoms or similar symptoms, and a lot of overlap. The symptom of OAB is mainly urgency, with or without urge incontinence, usually with frequency and nocturia. It is commonly associated with pain or discomfort in reproductive system of clinical patients. Though the symptom of CP/CPPS is mainly pain or discomfort in reproductive system, most patients are associated with voiding dysfunction and other symptoms, such as urinary frequency, urgency, etc. It is coincided with the major symptoms of OAB of many common and overlapping. The symptoms of these two diseases (syndromes) are so complicated with many common and overlapping that it is difficult to take diagnosis, differential diagnosis and treatment. In addition, the treatments of these two diseases (syndromes) are not the same. If differential diagnosis is unclear, it will lead to unsatisfied treatment. Over time, it will seriously affect the health and quality of life of patients, causing medical burden of person and society. Clemens et al. did studies on patients with urination or storage symptoms or pain in reproductive system. The results indicated that it is as high as 34% or more of the overlap among the three. Considering so many common symptoms between OAB and CP/CPPS, we can infer that there is some overlap between the two in diagnosis. Whether it is similar to foreign research with relatively high rates overlap, there is no report in our country.Objective: To explore symptoms and diagnosis of overlap between OAB and CP/CPPS, providing reference for clinical treatment.Materials and Methods: Diagnose and classify all selected objects according to the current internationally recognized definition and diagnostic criteria of OAB and CP/CPPS. Based on inclusion criteria and exclusion criteria, a total of 151 young male patients were enrolled, mean age 30.9±8.52. Divide them into OAB group,ⅢA CP/CPPS group,ⅢB CP/CPPS group,OAB withⅢA CP/CPPS group, OAB withⅢB CP/CPPS group by initial diagnosis. According to the age, divide them into 18-25 group, 26-35 group, 36-49 group and compare the overlap among each group. Analyse clinical symptoms (frequency, urgency, nocturia, urge incontinence, urinary endless sense, difficulty urinating, pain or discomfort genitourinary) in each group of patients to compare the overlap among each group. Analyse EPS and the results of urinary B-ultrasound of patients in each group and compare the results of calcification and echo of the prostate to find out the overlap among each group. Collect all data and make statistical analysis.Results:1. The study collected data of patients with OAB or CP diagnosed by Guangzhou First Municipal People's Hospital Urology out-patient from March 2010 to March 2011. A total of 151 young male patients were enrolled, between the ages of 18-49 years, mean 30.9±8.52. In these enrolled 151 objects, there were OAB 119 cases(78.8%),ⅢA CP/CPPS 65 cases(43%),ⅢB CP/CPPS 25 cases(16.6%). In addition, there are OAB withⅢA CP/CPPS 41 cases(7.2%), OAB withⅢB CP/CPPS 16 cases(10.6%), so there were 57 cases(37.75%) diagnosed of OAB with CP/CPPS.2. The rates of overlap of diagnosis among each age groups were not significantly difference (P> 0.05).3. Overlap in terms of symptoms, in OAB withⅢA CP/CPPS group, there were urgency 41 cases(100%), frequency 37 cases(90.2%), nocturia 14 cases(34.1%), urge incontinence 1 case(2.4%), urinary endless sense 10 cases(24.4%), difficulty urinating 2 cases(4.9%), pain or discomfort genitourinary 33 cases(80.5%). In OAB withⅢB CP/CPPS group, there were 14 cases(87.5%), 13 cases(81.2%), 7cases(43.8%), 1 case(6.2%), 2 cases(12.5%), 14 cases(87.5%). In all symptoms, the rates of overlap of urgency and frequency are highest.4. Observation of EPS in patients with OAB, in OAB group, there were 19 cases(30.6%) with positive microscopy of white blood cells. While in OAB withⅢA CP/CPPS group, there were 41 cases(71.9% of OAB with CP/CPPS group),and there were 16 cases(28.1% of OAB with CP/CPPS group) in OAB withⅢB CP/CPPS group.5. In OAB withⅢA CP/CPPS group, according to B-ultrasound of prostate, there were uneven echo 2 cases(4.9%), calcification 2 cases(4.9%), uneven echo with calcification 3 cases(6.2%). In OAB withⅢB CP/CPPS group, there were calcification 2 cases(12.5%), uneven echo with calcification 3 cases(6.2%).Conclusion:1. Between OAB and CP / CPPS, these is a very high overlap of the diagnosis, and the rate is 37.75%.2.Between OAB and CP / CPPS, these are high and low overlap of the symptoms, and the rates of urgency, frequency, nocturia, urge incontinence, urinary endless sense , difficulty urinating, pain or discomfort genitourinary are from 2.4% to 100%. In all symptoms, the rates of overlap of urgency and frequency are highest.3. The higher overlap of symptom and diagnosis between OAB and CP / CPPS should be attached great importance, needed further examination to identify and guide a more rational and effective treatment of clinical.