Comparative analysis of the rate of microorganism detection in the prostatic fluid and ejaculate using real-time polymerase chain reaction in patients with category IV chronic prostatitis

The study objective is to compare the rate of detection of various microorganisms in the prostatic fluid and ejaculate using real-time polymerase chain reaction in patients with category IV chronic prostatitis.Materials and methods. Between December of 2016 and July 2019, a prospective study including 81 patients with category IV chronic prostatitis per the National Institutes of Health Prostatitis Syndrome Classification (1999) was performed. The patients referred to the clinic of the Ivanovo State Medical Academy for preconception preparation, infertility or erectile disfunction. At the examination, all patients lacked symptoms characteristic of category II or III chronic prostatitis. Transrectal ultrasound of the prostate, microscopic examination of the prostatic fluid and (or) ejaculate, quantitative examination of urogenital tract microbiota using real-time polymerase chain reaction were performed.Results. Comparison of microbiota of the prostatic fluid and ejaculate showed significant differences in the total amount of bacterial mass: in the prostatic fluid mean titer was 3.7 ± 1.6, in the ejaculate it was 2.6 ± 1.8 (p <0.001). Prostatic fluid contained significantly more of the following microorganisms: Enterobacteriaceae spp./Enterococcus spp., Staphylococcus spp., Streptococcus spp., Corynebacterium, Eubacterium, Anaerococcus (p <0.05). No significant differences in the amounts of other microorganisms were observed.Conclusion. The study demonstrates significant heterogeneity of qualitative and quantitative microbiota content in the prostatic fluid and ejaculate. Supposedly, it can be explained by anatomical and physiological characteristics of the prostate, seminal vesicles and periurethral glands that secrete fluid for the ejaculate. The ejaculate contains less microorganisms compared to prostatic fluid which should be taken into account in differential diagnosis of infections of the urogenital tract.The authors declare no conflict of interest.All patients gave written informed consent to participate in the study.