Introduction: The study aimed to explore clinical influence of prostatic stones on lower urinary tract symptoms (LUTS), seminal plasma cytokines, and serum biomarkers. Materials and Methods: A total of 70 men aged ≤50 years with LUTS divided into 2 groups: group with stones (GSt) and group without prostatic stones (GNoSt). All subjects completed the International Prostate Symptom Score (IPSS) questionnaire and National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) scoring questionnaire. Pre- and post-prostate massage test and uroflowmetry were performed. The serum concentration of total prostate specific antigen (PSA), free PSA, and free/total PSA (f/t PSA) ratio, seminal concentration of cytokines interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-12p70, and tumor necrosis factor-alpha were measured. Results: GSt subjects had significantly more severe symptoms based on IPSS answers (p = 0.0289). All domains in NIH-CPSI scores were significantly higher in the GSt group: pain (p = 0.001), urinary symptoms (p = 0.023), quality of life (p = 0.008), and with overall (p = 0.003). GSt subjects also had significantly lower maximum urinary flow (Qmax; p = 0.011), lower f/t PSA ratio (p = 0.048), and higher concentration of IL-1β (p = 0.011) and IL-8 (p = 0.001). Conclusions: Prostatic stones may influence the severity of LUTS and the symptoms of chronic prostatitis. They might reduce Qmax rate and lead to reduction of the f/t PSA ratio and produce more severe inflammation causing increased seminal concentration of IL-1β and IL-8.

Keywords:
Prostate, Inflammation, Lower urinary tract symptoms, Cytokines, Prostate stones
1.
Shoskes DA, Lee CT, Murphy D, Kefer J, Wood HM: Incidence and significance of prostatic stones in men with chronic prostatitis/chronic pelvic pain syndrome. Urology 2007;70:235-238.
2.
Shoskes DA, Thomas KD, Gomez E: Anti-nanobacterial therapy for men with chronic prostatitis/chronic pelvic pain syndrome and prostatic stones: preliminary experience. J Urol 2005;173:474-477.
3.
Park SW, Nam JK, Lee SD, Chung MK: Are prostatic calculi independent predictive factors of lower urinary tract symptoms? Asian J Androl 2010;12:221-226.
4.
Kim WB, Doo SW, Yang WJ, Song YS: Influence of prostatic calculi on lower urinary tract symptoms in middle-aged men. Urology 2011;78:447-449.
5.
König JE, Senge T, Allhoff EP, König W: Analysis of the inflammatory network in benign prostate hyperplasia and prostate cancer. Prostate 2004;58:121-129.
6.
Geramoutsos I, Gyftopoulos K, Perimenis P, Thanou V, Liagka D, Siamblis D, et al: Clinical correlation of prostatic lithiasis with chronic pelvic pain syndromes in young adults. Eur Urol 2004;45:333-337; discussion 337-338.
7.
Bock E, Calugi V, Stolfi V, Rossi P, D'Ascenzo R, Solivetti FM: [Calcifications of the prostate: a transrectal echographic study]. Radiol Med 1989;77:501-503.
8.
Lee SE, Ku JH, Park HK, Jeong CK, Kim SH: Prostatic calculi do not influence the level of serum prostate specific antigen in men without clinically detectable prostate cancer or prostatitis. J Urol 2003;170:745-748.
9.
Pontari MA, Ruggieri MR: Mechanisms in prostatitis/chronic pelvic pain syndrome. J Urol 2004;172:839-845.
10.
Stancik I, Plas E, Juza J, Pfluger H: Effect of antibiotic therapy on interleukin-6 in fresh semen and postmasturbation urine samples of patients with chronic prostatitis/chronic pelvic pain syndrome. Urology 2008;72:336-339.
11.
Khadra A, Fletcher P, Luzzi G, Shattock R, Hay P: Interleukin-8 levels in seminal plasma in chronic prostatitis/chronic pelvic pain syndrome and nonspecific urethritis. BJU Int 2006;97:1043-1046.
12.
Penna G, Mondaini N, Amuchastegui S, Degli Innocenti S, Carini M, Giubilei G, Fibbi B, Colli E, Maggi M, Adorini L: Seminal plasma cytokines and chemokines in prostate inflammation: interleukin 8 as a predictive biomarker in chronic prostatitis/chronic pelvic pain syndrome and benign prostatic hyperplasia. Eur Urol 2007;51:524-533.
13.
Alexander RB, Ponniah S, Hasday J, Hebel JR: Elevated levels of proinflammatory cytokines in the semen of patients with chronic prostatitis/chronic pelvic pain syndrome. Urology 1998;52:744-749.
14.
Nadler RB, Koch AE, Calhoun EA, et al: IL-1beta and TNF-alpha in prostatic secretions are indicators in the evaluation of men with chronic prostatitis. J Urol 2000;164:214-218.
15.
Orhan I, Onur R, Ilhan N, Ardicoglu A: Seminal plasma cytokine levels in the diagnosis of chronic pelvic pain syndrome. Int J Urol 2001;8:495-499.
16.
Hochreiter WW, Nadler RB, Koch AE, Campbell PL, Ludwig M, Weidner W, Schaeffer AJ: Evaluation of the cytokines interleukin 8 and epithelial neutrophil activating peptide 78 as indicators of inflammation in prostatic secretions. Urology 2000;56:1025-1029.
17.
Krieger JN, Nyberg L Jr, Nickel JC: NIH consensus definition and classification of prostatitis. JAMA 1999;282:236-237.
18.
Nickel JC: The pre and post massage test (PPMT): a simple screen for prostatitis. Tech Urol 1997;3:38-43.
19.
Wu KY, Tsai YS, Chen CH, Chen IH, Tzai TS, Tong YC: Association of prostate blood flow with male lower urinary tract symptoms. Urol Int 2016;97:352-357.
20.
Nickel JC, True LD, Krieger JN, Berger RE, Boag AH, Young ID: Consensus development of a histopathological classification system for chronic prostatic inflammation. BJU Int 2001;87:797-805.
21.
Pontari MA: Inflammation and anti-inflammatory therapy in chronic prostatitis. Urology 2002;60(6 suppl):29-33; discussion 33-34.
22.
Schaeffer AJ: Evaluation of the cytokines in genital secretions of patients with chronic prostatitis. J Urol 2005;173:844-845.
23.
Klimas R, Bennett B, Gardner WA Jr: Prostatic calculi: a review. Prostate 1985;7:91-96.
24.
Sondergaard G, Vetner M, Christensen PO: Prostatic calculi. Acta Pathol Microbiol Immunol Scand A 1987;95:141-145.
25.
Sfanos KS, Wilson BA, De Marzo AM, Isaacs WB: Acute inflammatory proteins constitute the organic matrix of prostatic corpora amylacea and calculi in men with prostate cancer. Proc Natl Acad Sci U S A 2009;106:3443-3448.
26.
Yanamandra K, Alexeyev O, Zamotin V, Srivastava V, Shchukarev A, Brorsson AC, et al: Amyloid formation by the pro-inflammatory S100A8/A9 proteins in the ageing prostate. PLoS One 2009;4:e5562.
27.
Nickel JC, McLean RJ: Bacterial biofilms in urology. Infect Urol 1998;11:169-175.
28.
Mazzoli S: Biofilms in chronic bacterial prostatitis (NIH-II) and in prostatic calcifications. FEMS Immunol Med Microbiol 2010;59:337-344.
29.
Dessombz A, Méria P, Bazin D, Daudon M: Prostatic stones: evidence of a specific chemistry related to infection and presence of bacterial imprints. PLoS One 2012;7:e51691.
30.
Zhao WP, Li YT, Chen J, Zhang ZG, Jiang H, Xia D, et al: Prostatic calculi influence the antimicrobial efficacy in men with chronic bacterial prostatitis. Asian J Androl 2012;14:715-719.
31.
Fu Y, Zhou Z, Yang B, Zhang K, He L, Zhang X: The relationship between the clinical progression of benign prostatic hyperplasia and metabolic syndrome: a prospective study. Urol Int 2016;97:330-335.
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2017
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