中国慢性前列腺炎和性功能障碍的流行病学调查及慢性前列腺炎的诊断与疗效评判标准的初步研究
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摘要
目的：了解我国前列腺炎样症状的发生情况、慢性前列腺炎的相关影响因素治疗情况及其与性功能障碍（勃起功能障碍、早泄）的相关性。方法：对我国15~60岁男性社区人群15000人进行问卷调查。调查表包括美国国立卫生研究院前列腺炎症状评分指数表（NIH-CPSI)、IIEF-5、人口统计学资料等30项内容，利用SPSS10.01软件分析，得出我国前列腺炎样症状的发生率，了解我国慢性前列腺炎治疗状况；得出我国ED及PE发病状况及其与慢性前列腺炎的关系。结果：发放调查表15000份，收到有效问卷12743份（84.95%)。根据美国国立卫生研究院前列腺炎症状评分指数表（NIH-CPSI)及前列腺炎样症状评判标准，1071人具有前列腺炎样症状，我国前列腺炎样症状的发生率为8.4%，其中年龄大于30岁者前列腺炎样症状患病率（11.2%)明显高于年龄小于30岁者（5.3%);前列腺炎样症状发生同年龄、生活习惯（吸烟、饮酒）、文化程度、民族、有无其他性伴侣、情绪等因素有相关性；其中调查者中确诊慢性前列腺炎（CP)为571(4.5%)人，571人中有372(65.1%)人接受了正规长期治疗，年治疗次数约12次；治疗过程中有271(72.8%)人使用抗生素，其中有效及效果较好者占79.3%，患者的年平均治疗费用为8059元。本组已婚且有性活动的调查者共7372人，其中有5028(68.2%)人性功能正常，平均年龄为37.2±10.1岁；有1740(23.6%)人性功能下降，平均年龄为40.1±12.9岁；其中问卷中自评有勃起功能障碍的占12.0%，IIEF-5评分诊断为勃起功能障碍的占17.1%;自评组及评分组均具有随年龄发病升高的趋势，其中年龄51~60岁组中ED自评及评分患病率为17.2%和29.1%;具有前列腺炎症状的已婚患者有771名，其中有39.3%自评为ED患者，通过IIEF-5评分为ED的有30.1%；已确诊为慢性前列腺炎的患者有370例，其中自评ED占40.5%，评分为ED的占35.1%，两组都随年龄升高ED的患病率增加。其中问卷中回答有早泄的有1127(15.3%)人，平均年龄为34.9±10.5岁，非PE组年龄35.3±14.2岁，PE组疼痛评分、排尿评分、QOL评分分别为12.5±5.1、5.9±3.0、9.7±2.1，较非PE组的7.2±4.6、4.0±2.7、6.9±3.0明显升高（p值均<0.05);其中伴有前歹丨」腺炎样症状者771人中PE患病为494(64.1%)人，年龄介于31~40岁组PE患病为189(58.7%)人，年龄介于41~50岁组PE患病为103(56.3%)人，年龄介于51~60岁组PE患病为89(76.7%)人；其中确诊为慢性前列腺炎的有370例(5.0%)，其中有137(36.9%)人患早泄，其PE患病率明显升高。结论我国男性人群前列腺炎样症状的发生率较高，其发病与年龄等多种因素有关。前列腺炎患者中有大部分接受了正规治疗，治疗中抗生素使用率较高，治疗费用较高，总体治疗效果不满意。我国男性人群勃起功能障碍的患病率较高，其发病与年龄呈正相关，人群中ED自评患病率低于评分患病率，在具有前列腺炎症状者和前列腺炎组中ED自评患病率高于评分患病率，推测可能是前列腺炎对患者的心理的影响所致，CP与ED关系密切；同时发现伴有CP的ED患者仅占总患者的1/4~1/3，可见还有多种原因导致ED。我国男性人群早泄的患病率较高，其发病与年龄呈负相关，认为早泄是一种与年龄相关的症状；同时发现在具有前列腺炎症状的患者和前列腺炎患者患病率更高，后者尤为明显，提示我们在诊治早泄病人的同时，应考虑到是否合并有慢性前列腺炎并进行相应的治疗。
目的：根据主要症状与次要症状评估前列腺炎患者的症状，探讨以主要症状诊断前列腺炎的准确性、有效性，并进一步探讨疗效评判标准。
方法：通过多中心对安徽、北京、陕西、广州、四川、上海等多家医院门诊患者1500人及对照组200人填写慢性前列腺炎问卷调查表，内容包括人口统计学资料、前列腺炎有关症状的特点、自我评价、治疗情况、NIH-CPSI、主要症状、次要症状等27个问题，由经治医生协助填写调查表，并对患者/填表人进行评估、诊断、分型、分度。收集、整理资料后采用SPSS16.0软件分析。新前列腺炎诊断标准暂定：符合任何1条主要症状者伴随/或不伴随次要症状，且经一定时间自我调整无缓解者可以诊断。分析我国目前前列腺炎诊治状况，比较现用的临床诊断方法与新诊断方法的一致性。
结果：共收到有效问卷1313份，其中正常人群93份，门诊慢性前列腺炎患者问卷1220份。门诊1220例CP患者中第一次出现的症状是疼痛者有453(34.5%)人，排尿症状者有329(24.6%)人，两者均有者339(25.8%)人。本组CP患者出现有相关部位疼痛症状的有977(80.1%)人，出现有排尿症状的有841(68.9%)人。1220例CP患者中，疼痛症状评分为7.53±4.47，排尿症状评分为3.77±2.91，QOL影响分值为7.83±2.40，CPSI评分为19.13±6.24。对以上患者进行新方法评价，主要症状评分为14.17±6.07，次要症状评分为2.41±2.10，新方法总分为16.58±6.69。对1313份量表进行分析，对传统诊断方法、新方法两种诊断结果做一致性检验，以传统方法作为“金标准”，则新方法诊断CP的灵敏度为95.9%，特异度为90.3%，正确指数为0.862，假阴性率为4.1%，假阳性率为9.7%，阳性预测值为99.2%，阴性预测值为62.7%。按照拟定的新方法诊断，填表的1220名CP患者中有50例为非病例，他们的症状特点如下：疼痛症状评分为0.48±1.84，排尿症状评分为1.14±2.16，但QOL评分及CPSI总分为6.24±2.67、7.86±4.40。其中具有精神心理症状、性功能障碍者、生殖功能障碍及其他症状如滴白者分别有26、28、18、19例。按照不同诊断方法对CP患者次要症状的分析可知有精神、心理症状的有672(55.1%)人，有性功能障碍者564(46.2%)，有生殖功能障碍者188(15.4%)，其他症状如滴白等有351(28.8%)人。在医生的诊断方法中，依据NIH-CPSI的诊断CP患者184人，依据临床经验843人，依据NIH-CPSI的诊断和临床经验39人，依据临床经验和EPS涂片150人。根据主要症状可把前列腺炎分为无症状型、疼痛型、排尿型，两者兼有型，各占4.1%，27.0%,15.8%,53.1%。
结论：目前门诊前列腺炎患者数量多，临床上前列腺炎的诊断、分型大多以经验诊断为主；以主要症状为依据进行前列腺炎诊断灵敏度高，特异度稍低，造成这种现象的原因是部分以性功能障碍及生殖功能障碍为主要就诊原因的患者被诊为慢性前列腺炎引起的假阳性。次要症状在诊断分度中起到一定作用，次要症状多的患者多为中重度CP。经大样本病例对照研究可进一步探讨疗效评判方法及标准。
Background: Chronic prostatitis (CP), one of the most common and puzzlingdiseases seen in the daily practice of urology, is characterized by high prevalence, lowcure rate, frequent recurrence and severe impairment of quality of life.To date therehave been few epidemiological studies on the prevalence of prostatitis-like symptoms inChina. The NIH-CPSI has been accepted by the international prostatitis researchcommunity as an accepted outcome measure. We developed a Chinese version of theNIH-CPSI (CHI-NIH-CPSI) by translating it into Chinese，and conifrmed its validityand applicability to Chinese patients with CP.The aim of this study is to assess theprevalence of prostatitis and identiifed their associated risk factors in a population basedChinese sample and the status of treatment of chronic prostatitis in Chinese men, also,to assess the prevalence of erectile dysfunction (ED) and premature ejaculation (PE) inChinese men with chronic pelvic pain syndrome and studied its correlation to chronicprostatitis.
Methods: A population based cross-sectional survey of the prevalence of prostatitisand sexual dysfunction in men15to60years old (age range chosen to allowcomparison to census data) was performed in Beijing'，Anhui, Xian, Guangzhou andGansu cities or provinces representative of the North, Mideast, Middle，South and Westin China. In each city or province3rural villages and3communities were chosenrandomly. The questionnaire consisted of sociodemographics (weight, height, age, marital status, education level and smoking,drinking), current stress and health raitngs,lifestyle, edical history, EPS evaluation, NIH-CPSI score and International Index ofErectile Function-5. Descriptive statistics were used. The data were processed withSPSS? version10.01for Windows. The t test, Mann-Whitney test, Pearson test andchi-square test were used for power analysis and p less than0.05was consideredsigniifcant in single factor correlation.
Results: Of15,000selected individuals12,743subjects responded to thequestionnaire survey, giving a response rate of84.95%. Information on12,743(84.95%)men was collected. Of these men1,071(8.4%) reported prostatitis-like symptoms. Thepercent of chronic prostatitis was4.5%(571) among the symptoms group according topast urological history and expressed prostatic secretion evaluation. The peak age ofmen with symptoms ranged from31to40years old (12.0%). The percent of symptomswas less than10.0%in groups younger than30years, but it was more than10.0%ingroups older than30years.
The syndrome is closely related to alcohol consumption, cigarette smoking，frequentintercourse, as well as fatigue, pressure and too little sleep. A total of12743men(84.95%) completed the questionnaire, of whom1071(8.4%) were identified as havingprostatitis-like symptoms and517(4.5%) were diagnosed with CP according toNIH-CPSI criteria and prostatitis-like symptomatology. Of the CP patients,372(65.1%)underwent long-term routine treatment12times per year. Additionally,217(72.8%)patients received antibiotic therapy and215(79.3%) men showed therapeutic effects.The treatment cost USD1151(8059yuan) per person per year on average. Among7372eligible men，5028(68.2%，mean age37.2士10.19)，1740(23.6%，mean age40.1土12.94) and602(8.2%, mean age48.6土10.80) individuals were experiencing normalsexual function, decreased sexual functionand decreased libido，respectively.ED prevalence as assessed by self-report and IIEF-5score was12.0%and17.1%，respectively. Among771men with prostatitis-like symptoms, ED prevalence asassessed by self-report and IIEF-5score was39.3%and30.1%，respectively. Among370men suffering from chronic prostatitis, ED prevalence as assessed by self-reportand IIEF-5score was40.5%and35.1%，respectively. The prevalence of self-reportedand IIEF-5score-assessed ED had high correlation with increasing age among alleligible men，men with prostatitis-like symptoms, and men with chronic prostatitis. EDprevalence as assessed by both self-report and IIEF-5score was higher in men withprostatitis-like symptoms and with chronic prostatitis than in the general group. Theprevalence of ED was higher in the prostatitis population than in the general populationwith either self-reported or IIEF-5score assessment. The prevalence was higher withself-reported than with IIEF-5assessment in men with prostatitis. Among the7372eligible men，1127(15.3%) self-reported PE. The mean ages for PE group and non-PEgroup were34.9士10.5and35.3士14.2，respectively. Participants with PE had worseNIH-CPSI total scores (mean37.2士4.6) than men without PE (meanl8.2±5.6). Theparticipants with PE also had higher NIH-CPSI pain sub-scores (mean12.5士5.1) thanthose without PE (mean7.2士4.6)，and the PE group had worse urinary sub-scores(mean5.9士3.0) than the non-PE group (mean4.0士2.7).Eligible men suffering from thePE had higher QOL sub-scores (mean9.7土2.1) than men without PE (mean6.9土3.0).The IIEF-5score was16.7士3.2in the PE group and22.6土2.9in the non-PE group. Theprevalence of PE was64.1%and36.9%in the prostatitis-like symptom and chronicprostatitis group, respectively, which was signiifcantly higher than in the whole eligiblepopulation (15.3%).
Conclusion: Prostatitis-like symptoms are a multifactorial problem affecting men ofall ages (15to60years) and demographics, and the prevalence is high in China. Thesyndrome is closely related to alcohol consumption, cigarette smoking，frequent intercourse, as well as fatigue, pressure and too little sleep. These findings suggest thatrisk factors for this condition are largely modiifable and highlight potential targets forfuture prevention. Most CP patients received routine treatment, in most cases withantibiotics. Treatment was costly and most CP patients were not satisifed with itseffectiveness. Antibacterial treatment might have been effective primarily in patientswith bacterial disease. Also, our ifndings showed a high prevalence of ED in patientswith CP/CPPS that increased with age. These ifndings suggest that more prospectiveresearch is needed to further characterize the pathogenesis of ED and its correlation toprostatitis, and to elucidate the role of inlfammation and infection of the prostate glandin sexual dysfunction in men. More importantly, our study also demonstrates thatself-reported ED prevalence is higher than the prevalence of ED reported by IIEF-5score among men with CP/CPPS. Assessments of ED prevalence among those reliant onself-reporting alone are likely to overestimate the true burden of ED within the greaterpopulation. Further more，these ifndings showed a high prevalence of prematureejaculation in patients with CP/CPPS. Examination of the prostate, physically andmicrobiologically，should be considered during assessment of patients with prematureejaculation. Importantly, these ifndings suggest that more prospective research isneeded to further characterize the etiology of prostatitis and its correlation to PE，and toelucidate the role of inflammation and infection of prostatic gland in sexual dysfunctionin men.
Objective: To evaluate the symptoms of prostatitis patients on the basis of the majorand minor symptoms, and then discuss the accuracy and eiffcacy of prostatitis diagnosisbased on the major symptoms. Furthermore, to identiyf the judging criteria of thetherapeutic efficacy.
Methods: We distributed the questionnaires for chronic prostatitis to1500out-patients and200healthy people in several hospitals at Anhui, Beijing，Shanxi，Guangzhou, Sichuan, Shanghai et al. The contents of the questionnaire includedemographic information, the related symptom characteristics of prostatitis, theself-assessment of the patient, the treatment state, NIH-CPSI， major symptoms,minor symptoms and other20questions. Under the assistance of the medical registrars,we completed the questionnaires and then evaluated, diagnosed, classified andgraduated the patients or subjects. After collecting the questionnaires, we analyzedthe data by using SPSS16.0software. The new judging criteria of prostatitis weredeifned as follows: whose symptom was consistent with one of the major symptoms thatcan not be relieved by self-modulation, regardless of the minor symptoms, can bedeifned as a prostatitis patient.
Results: We have received1313valid questionnaires, which consisted of93healthypeople and1220out-patients. In the1220out-patients with chronic prostatitis, theearliest symptom of453(34.5%) patients was pain, the earliest symptom of329(24.6%) patients was urination, and339(25.8%) patients presented both of the earliestsymptoms of pain and urination. In this group of patients with chronic prostatitis,977(80.1%) of whom suffered pain,841(68.9%) of whom suffered urination. In the1220out-patients with chronic prostatitis, the score of the pain symptom was7.53±4.47，thescore of the urination symptom was3.77±2.91，the score of QOL influence was7.83土2.40， the score of CPSI was19.13±6.24. To introduce the new method to evaluate thepatients with chronic prostatitis above, the score of major symptom was14.17土6.07,the score of major symptom was2.41土2.10，and the total score of the new method was16.58±6.69. We then carried out the concordance test between the traditional andnew diagnostic method in the1313valid questionnaires. To deifne the traditionaldiagnostic method as the authoritative standard, the sensitivity of the new method todiagnose chronic prostatitis was95.9%, the specificity was90.3%, the accuracy-indexwas0.86，the false negative rate was4.1%，the false positive rate was9.7%, thepositive prediction value was99.2%, the negative prediction value was62.7%. Todiagnose by using the new method,50of the1220out-patients with chronic prostatitiswere not patients, the characteristics of the symptoms were as follows: the score of thepain symptom was0.48土1.84，the score of the urination symptom was1.14±2.16，thescore of QOL influence was6.24土2.67， the score of CPSI was7.86土4.40. Amongthem,26people suffered the psychology symptom,28people suffered the sexualdisturbance,18people suffered the dysgenesia,19people suffered the other symptomssuch as urinary white drop. By using different diagnostic methods to analyze theminor symptoms of the chronic prostatitis patients, we found that672(55.1%)of themsuffered the psychology symptom,564(46.2%) of them suffered the sexual disturbance,188(15.4%) of them suffered the dysgenesia,351(28.8%) suffered the othersymptoms such as urinary white drop. In the doctors' diagnostic methods,184of thechronic prostatitis patients were diagnosed via the NIH-CPSI,843of them werediagnosed via the clinical experience,39of them were diagnosed via both of the NIH-CPSI and clinical experience,150of them were diagnosed via both of the EPS andclinical experience. Based on the major symptoms, prostatitis can be classiifed as fourtypes: no symptom, pain symptom, urination symptom and both of the pain andurination symptom, the percent was4.1%，27.0%,15.8%and53.1%, respectively.
Conclusion: At present, there are a great quantity of patients with chronic prostatitis inclinical out-patient service. The methods to diagnose and classiyf prostatitis weremainly in experience, to diagnose prostatitis based on the major symptoms has thecharacteristics of high sensitivity and lower speciifcity, which reason is caused by thefalse positive diagnosis of the patients who suffer the sexual disturbance anddysgenesia. The play a deifnite role in diagnosis and classiifcation, the patients whosuffer various kinds of minor symptoms are probably the midrange and severe chronicprostatitis patients. Suiffcient cases are necessary for evaluating the judging methodsand criteria of the therapeutic eiffcacy.
目的：根据主要症状与次要症状评估前列腺炎患者的症状，探讨以主要症状诊断前列腺炎的准确性、有效性，并进一步探讨疗效评判标准。
方法：通过多中心对安徽、北京、陕西、广州、四川、上海等多家医院门诊患者1500人及对照组200人填写慢性前列腺炎问卷调查表，内容包括人口统计学资料、前列腺炎有关症状的特点、自我评价、治疗情况、NIH-CPSI、主要症状、次要症状等27个问题，由经治医生协助填写调查表，并对患者/填表人进行评估、诊断、分型、分度。收集、整理资料后采用SPSS16.0软件分析。新前列腺炎诊断标准暂定：符合任何1条主要症状者伴随/或不伴随次要症状，且经一定时间自我调整无缓解者可以诊断。分析我国目前前列腺炎诊治状况，比较现用的临床诊断方法与新诊断方法的一致性。
结果：共收到有效问卷1313份，其中正常人群93份，门诊慢性前列腺炎患者问卷1220份。门诊1220例CP患者中第一次出现的症状是疼痛者有453(34.5%)人，排尿症状者有329(24.6%)人，两者均有者339(25.8%)人。本组CP患者出现有相关部位疼痛症状的有977(80.1%)人，出现有排尿症状的有841(68.9%)人。1220例CP患者中，疼痛症状评分为7.53±4.47，排尿症状评分为3.77±2.91，QOL影响分值为7.83±2.40，CPSI评分为19.13±6.24。对以上患者进行新方法评价，主要症状评分为14.17±6.07，次要症状评分为2.41±2.10，新方法总分为16.58±6.69。对1313份量表进行分析，对传统诊断方法、新方法两种诊断结果做一致性检验，以传统方法作为“金标准”，则新方法诊断CP的灵敏度为95.9%，特异度为90.3%，正确指数为0.862，假阴性率为4.1%，假阳性率为9.7%，阳性预测值为99.2%，阴性预测值为62.7%。按照拟定的新方法诊断，填表的1220名CP患者中有50例为非病例，他们的症状特点如下：疼痛症状评分为0.48±1.84，排尿症状评分为1.14±2.16，但QOL评分及CPSI总分为6.24±2.67、7.86±4.40。其中具有精神心理症状、性功能障碍者、生殖功能障碍及其他症状如滴白者分别有26、28、18、19例。按照不同诊断方法对CP患者次要症状的分析可知有精神、心理症状的有672(55.1%)人，有性功能障碍者564(46.2%)，有生殖功能障碍者188(15.4%)，其他症状如滴白等有351(28.8%)人。在医生的诊断方法中，依据NIH-CPSI的诊断CP患者184人，依据临床经验843人，依据NIH-CPSI的诊断和临床经验39人，依据临床经验和EPS涂片150人。根据主要症状可把前列腺炎分为无症状型、疼痛型、排尿型，两者兼有型，各占4.1%，27.0%,15.8%,53.1%。
结论：目前门诊前列腺炎患者数量多，临床上前列腺炎的诊断、分型大多以经验诊断为主；以主要症状为依据进行前列腺炎诊断灵敏度高，特异度稍低，造成这种现象的原因是部分以性功能障碍及生殖功能障碍为主要就诊原因的患者被诊为慢性前列腺炎引起的假阳性。次要症状在诊断分度中起到一定作用，次要症状多的患者多为中重度CP。经大样本病例对照研究可进一步探讨疗效评判方法及标准。
Background: Chronic prostatitis (CP), one of the most common and puzzlingdiseases seen in the daily practice of urology, is characterized by high prevalence, lowcure rate, frequent recurrence and severe impairment of quality of life.To date therehave been few epidemiological studies on the prevalence of prostatitis-like symptoms inChina. The NIH-CPSI has been accepted by the international prostatitis researchcommunity as an accepted outcome measure. We developed a Chinese version of theNIH-CPSI (CHI-NIH-CPSI) by translating it into Chinese，and conifrmed its validityand applicability to Chinese patients with CP.The aim of this study is to assess theprevalence of prostatitis and identiifed their associated risk factors in a population basedChinese sample and the status of treatment of chronic prostatitis in Chinese men, also,to assess the prevalence of erectile dysfunction (ED) and premature ejaculation (PE) inChinese men with chronic pelvic pain syndrome and studied its correlation to chronicprostatitis.
Methods: A population based cross-sectional survey of the prevalence of prostatitisand sexual dysfunction in men15to60years old (age range chosen to allowcomparison to census data) was performed in Beijing'，Anhui, Xian, Guangzhou andGansu cities or provinces representative of the North, Mideast, Middle，South and Westin China. In each city or province3rural villages and3communities were chosenrandomly. The questionnaire consisted of sociodemographics (weight, height, age, marital status, education level and smoking,drinking), current stress and health raitngs,lifestyle, edical history, EPS evaluation, NIH-CPSI score and International Index ofErectile Function-5. Descriptive statistics were used. The data were processed withSPSS? version10.01for Windows. The t test, Mann-Whitney test, Pearson test andchi-square test were used for power analysis and p less than0.05was consideredsigniifcant in single factor correlation.
Results: Of15,000selected individuals12,743subjects responded to thequestionnaire survey, giving a response rate of84.95%. Information on12,743(84.95%)men was collected. Of these men1,071(8.4%) reported prostatitis-like symptoms. Thepercent of chronic prostatitis was4.5%(571) among the symptoms group according topast urological history and expressed prostatic secretion evaluation. The peak age ofmen with symptoms ranged from31to40years old (12.0%). The percent of symptomswas less than10.0%in groups younger than30years, but it was more than10.0%ingroups older than30years.
The syndrome is closely related to alcohol consumption, cigarette smoking，frequentintercourse, as well as fatigue, pressure and too little sleep. A total of12743men(84.95%) completed the questionnaire, of whom1071(8.4%) were identified as havingprostatitis-like symptoms and517(4.5%) were diagnosed with CP according toNIH-CPSI criteria and prostatitis-like symptomatology. Of the CP patients,372(65.1%)underwent long-term routine treatment12times per year. Additionally,217(72.8%)patients received antibiotic therapy and215(79.3%) men showed therapeutic effects.The treatment cost USD1151(8059yuan) per person per year on average. Among7372eligible men，5028(68.2%，mean age37.2士10.19)，1740(23.6%，mean age40.1土12.94) and602(8.2%, mean age48.6土10.80) individuals were experiencing normalsexual function, decreased sexual functionand decreased libido，respectively.ED prevalence as assessed by self-report and IIEF-5score was12.0%and17.1%，respectively. Among771men with prostatitis-like symptoms, ED prevalence asassessed by self-report and IIEF-5score was39.3%and30.1%，respectively. Among370men suffering from chronic prostatitis, ED prevalence as assessed by self-reportand IIEF-5score was40.5%and35.1%，respectively. The prevalence of self-reportedand IIEF-5score-assessed ED had high correlation with increasing age among alleligible men，men with prostatitis-like symptoms, and men with chronic prostatitis. EDprevalence as assessed by both self-report and IIEF-5score was higher in men withprostatitis-like symptoms and with chronic prostatitis than in the general group. Theprevalence of ED was higher in the prostatitis population than in the general populationwith either self-reported or IIEF-5score assessment. The prevalence was higher withself-reported than with IIEF-5assessment in men with prostatitis. Among the7372eligible men，1127(15.3%) self-reported PE. The mean ages for PE group and non-PEgroup were34.9士10.5and35.3士14.2，respectively. Participants with PE had worseNIH-CPSI total scores (mean37.2士4.6) than men without PE (meanl8.2±5.6). Theparticipants with PE also had higher NIH-CPSI pain sub-scores (mean12.5士5.1) thanthose without PE (mean7.2士4.6)，and the PE group had worse urinary sub-scores(mean5.9士3.0) than the non-PE group (mean4.0士2.7).Eligible men suffering from thePE had higher QOL sub-scores (mean9.7土2.1) than men without PE (mean6.9土3.0).The IIEF-5score was16.7士3.2in the PE group and22.6土2.9in the non-PE group. Theprevalence of PE was64.1%and36.9%in the prostatitis-like symptom and chronicprostatitis group, respectively, which was signiifcantly higher than in the whole eligiblepopulation (15.3%).
Conclusion: Prostatitis-like symptoms are a multifactorial problem affecting men ofall ages (15to60years) and demographics, and the prevalence is high in China. Thesyndrome is closely related to alcohol consumption, cigarette smoking，frequent intercourse, as well as fatigue, pressure and too little sleep. These findings suggest thatrisk factors for this condition are largely modiifable and highlight potential targets forfuture prevention. Most CP patients received routine treatment, in most cases withantibiotics. Treatment was costly and most CP patients were not satisifed with itseffectiveness. Antibacterial treatment might have been effective primarily in patientswith bacterial disease. Also, our ifndings showed a high prevalence of ED in patientswith CP/CPPS that increased with age. These ifndings suggest that more prospectiveresearch is needed to further characterize the pathogenesis of ED and its correlation toprostatitis, and to elucidate the role of inlfammation and infection of the prostate glandin sexual dysfunction in men. More importantly, our study also demonstrates thatself-reported ED prevalence is higher than the prevalence of ED reported by IIEF-5score among men with CP/CPPS. Assessments of ED prevalence among those reliant onself-reporting alone are likely to overestimate the true burden of ED within the greaterpopulation. Further more，these ifndings showed a high prevalence of prematureejaculation in patients with CP/CPPS. Examination of the prostate, physically andmicrobiologically，should be considered during assessment of patients with prematureejaculation. Importantly, these ifndings suggest that more prospective research isneeded to further characterize the etiology of prostatitis and its correlation to PE，and toelucidate the role of inflammation and infection of prostatic gland in sexual dysfunctionin men.
Objective: To evaluate the symptoms of prostatitis patients on the basis of the majorand minor symptoms, and then discuss the accuracy and eiffcacy of prostatitis diagnosisbased on the major symptoms. Furthermore, to identiyf the judging criteria of thetherapeutic efficacy.
Methods: We distributed the questionnaires for chronic prostatitis to1500out-patients and200healthy people in several hospitals at Anhui, Beijing，Shanxi，Guangzhou, Sichuan, Shanghai et al. The contents of the questionnaire includedemographic information, the related symptom characteristics of prostatitis, theself-assessment of the patient, the treatment state, NIH-CPSI， major symptoms,minor symptoms and other20questions. Under the assistance of the medical registrars,we completed the questionnaires and then evaluated, diagnosed, classified andgraduated the patients or subjects. After collecting the questionnaires, we analyzedthe data by using SPSS16.0software. The new judging criteria of prostatitis weredeifned as follows: whose symptom was consistent with one of the major symptoms thatcan not be relieved by self-modulation, regardless of the minor symptoms, can bedeifned as a prostatitis patient.
Results: We have received1313valid questionnaires, which consisted of93healthypeople and1220out-patients. In the1220out-patients with chronic prostatitis, theearliest symptom of453(34.5%) patients was pain, the earliest symptom of329(24.6%) patients was urination, and339(25.8%) patients presented both of the earliestsymptoms of pain and urination. In this group of patients with chronic prostatitis,977(80.1%) of whom suffered pain,841(68.9%) of whom suffered urination. In the1220out-patients with chronic prostatitis, the score of the pain symptom was7.53±4.47，thescore of the urination symptom was3.77±2.91，the score of QOL influence was7.83土2.40， the score of CPSI was19.13±6.24. To introduce the new method to evaluate thepatients with chronic prostatitis above, the score of major symptom was14.17土6.07,the score of major symptom was2.41土2.10，and the total score of the new method was16.58±6.69. We then carried out the concordance test between the traditional andnew diagnostic method in the1313valid questionnaires. To deifne the traditionaldiagnostic method as the authoritative standard, the sensitivity of the new method todiagnose chronic prostatitis was95.9%, the specificity was90.3%, the accuracy-indexwas0.86，the false negative rate was4.1%，the false positive rate was9.7%, thepositive prediction value was99.2%, the negative prediction value was62.7%. Todiagnose by using the new method,50of the1220out-patients with chronic prostatitiswere not patients, the characteristics of the symptoms were as follows: the score of thepain symptom was0.48土1.84，the score of the urination symptom was1.14±2.16，thescore of QOL influence was6.24土2.67， the score of CPSI was7.86土4.40. Amongthem,26people suffered the psychology symptom,28people suffered the sexualdisturbance,18people suffered the dysgenesia,19people suffered the other symptomssuch as urinary white drop. By using different diagnostic methods to analyze theminor symptoms of the chronic prostatitis patients, we found that672(55.1%)of themsuffered the psychology symptom,564(46.2%) of them suffered the sexual disturbance,188(15.4%) of them suffered the dysgenesia,351(28.8%) suffered the othersymptoms such as urinary white drop. In the doctors' diagnostic methods,184of thechronic prostatitis patients were diagnosed via the NIH-CPSI,843of them werediagnosed via the clinical experience,39of them were diagnosed via both of the NIH-CPSI and clinical experience,150of them were diagnosed via both of the EPS andclinical experience. Based on the major symptoms, prostatitis can be classiifed as fourtypes: no symptom, pain symptom, urination symptom and both of the pain andurination symptom, the percent was4.1%，27.0%,15.8%and53.1%, respectively.
Conclusion: At present, there are a great quantity of patients with chronic prostatitis inclinical out-patient service. The methods to diagnose and classiyf prostatitis weremainly in experience, to diagnose prostatitis based on the major symptoms has thecharacteristics of high sensitivity and lower speciifcity, which reason is caused by thefalse positive diagnosis of the patients who suffer the sexual disturbance anddysgenesia. The play a deifnite role in diagnosis and classiifcation, the patients whosuffer various kinds of minor symptoms are probably the midrange and severe chronicprostatitis patients. Suiffcient cases are necessary for evaluating the judging methodsand criteria of the therapeutic eiffcacy.
引文
1. Krieger JN, Riley DE，Cheah PY,et al. Epidemiology of prostatitis: newevidence for a world-wide problem. World journal of urology,2003，21(2):70-74.
2. Mehik A，Hellstrom P，Sarpola A，et al. Fears, sexual disturbances andpersonality features in men with prostatitis: a population-based cross-sectionalstudy in Finland. BJU international,2001，88(1):35-38.
3. Nickel JC. Prostatitis: lessons from the20th century. BJU international,2000,85(2):179-185.
4. 梁朝朝.加强我国慢性前列腺炎的流行病学研究.中华泌尿外科杂志，2006，27(8):509-511.
5. Ku JH，Kim ME，Lee NK，et al. The prevalence of chronic prostatitis-likesymptoms in young men: a community-based survey. Urological research,2001，29(2):108-112.
6. Nickel JC, Nyberg LM，Hennenfent M. Research guidelines for chronicprostatitis: consensus report from the ifrst National Institutes of HealthInternational Prostatitis Collaborative Network. Urology,1999，54(2):229-233.
7. Krieger JN, Nyberg L，Jr., Nickel JC. NIH consensus definition andclassiifcation of prostatitis. JAMA: the journal of the American MedicalAssociation,1999，282(3):236-237.
8. 刘骋，梁朝朝，张学军,等.慢性前列腺炎病原学初步研究.中华泌尿外科杂志，2005,26(12):826-828.
9. Nickel JC, Downey J，Hunter D，et al. Prevalence of prostatitis-like symptoms ina population based study using the National Institutes of Health chronicprostatitis symptom index. The Journal of urology,2001，165(3):842-845.
10. NIH Consensus Conference. Impotence. NIH Consensus Development Panel onImpotence. JAMA: the journal of the American Medical Association,1993，270(1):83-90.
11. Rosen RC，Cappelleri JC，Smith MD，et al. Development and evaluation of anabridged,5-item version of the International Index of Erectile Function (IIEF-5)as a diagnostic tool for erectile dysfunction. International journal of impotenceresearch,1999，11(6):319-326.
12. McMahon CG，Althof SE，Waldinger MD，et al. An evidence-based deifnition oflifelong premature ejaculation: report of the International Society for SexualMedicine (ISSM) ad hoc committee for the deifnition of premature ejaculation.The journal of sexual medicine，2008，5(7):1590-1606.
13. Carver BS，Bozeman CB，Williams BJ，et al. The prevalence of men withNational Institutes of Health category IV prostatitis and association with serumprostate specific antigen. The Journal of urology,2003，169(2):589-591.
14. Nickel JC, Downey J，Young I,et al. Asymptomatic inflammation and/orinfection in benign prostatic hyperplasia. BJU international,1999，84(9):976-981.
15. Tan JK，Png DJ, Liew LC,et al. Prevalence of prostatitis-like symptoms inSingapore: a population-based study. Singapore medical journal,2002，43(4):189-193.
16. Lee SW, Liong ML, Yuen KH,et al. Prostatitis-like symptoms: diagnosis andmanagement in a Malaysian primary care population. Urologia internationalis,2009，82(1):32-37.
17. Kunishima Y, Mori M，Kitamura H,et al. Prevalence of prostatitis-like symptomsin Japanese men: Population-based study in a town in Hokkaido. Internationaljournal of urology: oiffcial journal of the Japanese Urological Association,2006，13(10):1286-1289.
18. Mehik A，Hellstrom P, Lukkarinen0,et al. Epidemiology of prostatitis inFinnish men: a population-based cross-sectional study. BJU international,2000，86(4):443-448.
19. Rizzo M，Marchetti F，Travaglini F，et al. Prevalence, diagnosis and treatment ofprostatitis in Italy: a prospective urology outpatient practice study. BJUinternational,2003，92(9):955-959.
20. Collins MM，Stafford RS，O'Leary MP，et al. Distinguishing chronic prostatitisand benign prostatic hyperplasia symptoms: results of a national survey ofphysician visits. Urology,1999，53(5):921-925.
21. Roberts RO，Jacobson DJ，Girman CJ，et al. Prevalence of prostatitis-likesymptoms in a community based cohort of older men. The Journal of urology,2002，168(6):2467-2471.
22. Turner JA，Ciol MA, Von Korff M，et al. Validity and responsiveness of thenational institutes of health chronic prostatitis symptom index. The Journal ofurology,2003，169(2):580-583.
23.Cheah PY，Liong ML, Yuen KH，et al. Chronic prostatitis: symptom survey withfollow-up clinical evaluation. Urology，2003，61(1):60-64.
24.Clemens JQ, Meenan RT'，OKeeffe-Rosetti MC，et al. Prevalence ofprostatitis-like symptoms in a managed care population. The Journal of urology,2006，176(2):593-596; discussion596.
25. Tripp DA, Nickel JC，Ross S，et al. Prevalence, symptom impact and predictorsof chronic prostatitis-like symptoms in Canadian males aged16-19years. BJUinternational,2009，103(8):1080-1084.
26. Tripp DA, Nickel JC, Pikard JL,et al. Chronic prostatitis-like symptoms inAfrican males aged16-19years. The Canadian journal of urology,2012，19(1):6081-6087.
27. Ferris JA，Pitts MK，Richters J,et al. National prevalence of urogenital pain andprostatitis-like symptoms in Australian men using the National Institutes ofHealth Chronic Prostatitis Symptoms Index. BJU international,2010，105(3):373-379.
28. 夏同礼，孔祥田，宓培，等.我国成人前列腺非特异性炎.中华泌尿外科杂志，1995，15(12):711-713.
29. Schatteman PH, Hoekx L，Wyndaele JJ,et al. Inlfammation in prostate biopsiesof men without prostatic malignancy or clinical prostatitis: correlation with totalserum PSA and PSA density. European urology,2000，37(4):404-412.
30. Shimomura T, Kiyota H, Takahashi H,et al.[Prostate histopathology of NIHcategory IV prostatitis detected by sextant prostate needle biopsy from thepatients with high prostatic speciifc antigen], Kansenshogaku zasshi The Journalof the Japanese Association for Infectious Diseases,2003，77(8):611-617.
31. True LD，Berger RE, Rothman I,et al. Prostate histopathology and the chronicprostatitis/chronic pelvic pain syndrome: a prospective biopsy study. The Journalofurology,1999，162(6):2014-2018.
32. Edlin RS，Heyns CF，Van Vuuren SP，et al. Prevalence of histological prostatitisin men with benign prostatic hyperplasia or adenocarcinoma of the prostatepresenting without urinary retention. South African journal of surgerySuid-Afrikaanse tydskrif vir chirurgie，2012，50(4):127-130.
33. Collins MM，Meigs JB，Barry MJ，et al. Prevalence and correlates of prostatitisin the health professionals follow-up study cohort. The Journal of urology,2002，167(3):1363-1366.
34. Liang CZ，Zhang XJ，Hao ZY，et al. An epidemiological study of patients withchronic prostatitis. BJU international,2004，94(4):568-570.
35. Moon TD，Hagen L，Heisey DM. Urinary symptomatology in younger men.Urology，1997，50(5):700-703.
36. Bartoletti R，Cai T, Mondaini N,et al. Prevalence, incidence estimation, riskfactors and characterization of chronic prostatitis/chronic pelvic pain syndromein urological hospital outpatients in Italy: results of a multicenter case-controlobservational study. The Journal of urology,2007，178(6):2411-2415; discussion2415.
37. Milton K. A dietary cure for prostatitis and the urethral syndrome. InfectiousDiseases in Clinical Practice,2002，11(3):107-110.
38. 王祖龙，孙自学，王瑞，等.郑州市高校男生慢性前列腺炎患病调查.中国公共卫生,2009,25(9):1049-1050.
39. _個车，郭永顺，于海易，等.青年人群中列腺炎样症状及其相关因素的调查.中华男科学杂志，2007,13(12):1087-1090.
40. Daniels NA，Ewing SK，Zmuda JM，et al. Correlates and prevalence of prostatitisin a large community-based cohort of older men. Urology,2005，66(5):964-970.
41. Hedelin H, Jonsson K. Chronic abacterial prostatitis and cold exposure: anexplorative study. Scandinavian journal of urology and nephrology,2007，41(5):430-435.
42. Hedelin H，Johannisson H，Welin L. Prevalence of the chronic prostatitis/chronicpelvic pain syndrome among40-69-year-old men residing in a temperate climate.Scandinavian journal of urology,2013.
43. 蓝天，王养民，陈烨，等.慢性前列腺炎相关危险因素的多中心联合调查研究.解放军医学杂志，2010,35(1):79-82.
44. 房蕾，韩家盛.某市出租车司机前列腺炎样症状调查.中国误诊学杂志，2009々（21):5286-5287..
45. 张友宏，马立伟，刘文学，等.煤矿井下工人前列腺炎的调查分析与对策.中国男科学杂志J007J1(2):50-51..
46. Schaeffer A J. Epidemiology and demographics of prostatitis. Andrologia，2003，35(5):252-257.
47. 关晓海，陈晶，高伟兴，等.不同种族慢性前列腺炎245例发病情况比较.中国综合临床，2007,23(8):725-727.
48. Alexander RB, Propert KJ，Schaeffer AJ，et al. Ciprolfoxacin or tamsulosin inmen with chronic prostatitis/chronic pelvic pain syndrome: a randomized,double-blind trial. Annals of internal medicine，2004，141(8):581-589.
49. Nickel JC，Zadeikis N，Spivey M，et al. Clinical signiifcance of antimicrobialtherapy in chronic prostatitis associated with non-traditional uropathogens. JUrol.2005;173:S30.
50. Nickel JC, Downey J，Johnston B，et al. Predictors of patient response toantibiotic therapy for the chronic prostatitis/chronic pelvic pain syndrome: aprospective multicenter clinical trial. The Journal of urology,2001，165(5):1539-1544.
51. Calhoun EA, McNaughton Collins M，Pontari MA,et al. The economic impactof chronic prostatitis. Archives of internal medicine,2004，164(11):1231-1236.
52. Duloy AM, Calhoun EA，Clemens JQ. Economic impact of chronic prostatitis.Current urology reports,2007，8(4):336-339.
53. McKinlay JB. The worldwide prevalence and epidemiology of erectiledysfunction. International journal of impotence research,2000，12Suppl4:S6-S11.
54. Shamloul R， Ghanem H. Erectile dysfunction. The Lancet,2013，381(9861):153-165.
55. Feldman HA, Goldstein I, Hatzichristou DG,et al. Impotence and its medical andpsychosocial correlates: results of the Massachusetts Male Aging Study. TheJournal of urology,1994，151(1):54-61.
56. Blanker MH，Bosch JL，Groeneveld FP,et al. Erectile and ejaculatorydysfunction in a community-based sample of men50to78years old: prevalence,concern，and relation to sexual activity. Urology，2001，57(4):763-768.
57. Mulligan T，Retchin SM，Chinchilli VM，et al. The role of aging and chronicdisease in sexual dysfunction. Journal of the American Geriatrics Society,1988,36(6):520-524.
58. Zhang H，Yip AW, Fan S，et al. Sexual dysfunction among Chinese married menaged30-60years: a population-based study in Hong Kong. Urology,2013，81(2):334-339.
59. 冷静，王益鑫，黄旭元，等.上海市1582例中老年男子勃起功能障碍流行病学调查.中国男科学杂志，2000,14(1):29-31.
60. 倪少义，王榕生，方培群，等.中老年人男性勃起功能障碍ED的流行病学调查.中国实用医药，2010，5(18):246-247.
61. 张唯力，舒勇，吴天平，等.重庆城区男子性功能状况的初步调查.重庆医科大学学报，2002，27(04):441-444.
62. Marszalek M，Wehrberger C, Hochreiter W,et al. Symptoms suggestive ofchronic pelvic pain syndrome in an urban population: prevalence andassociations with lower urinary tract symptoms and erectile function. TheJournal of urology,2007，177(5):1815-1819.
63. Liang CZ，Zhang XJ，Hao ZY，et al. Prevalence of sexual dysfunction in Chinesemen with chronic prostatitis. BJU international,2004，93(4):568-570.
64. Shoskes DA. The challenge of erectile dysfunction in the man with chronicprostatitis/chronic pelvic pain syndrome. Current urology reports,2012，13(4):263-267.
65. Gonen M，Kalkan M，Cenker A，et al. Prevalence of premature ejaculation inTurkish men with chronic pelvic pain syndrome. Journal of andrology，2005，26(5):601-603.
66. Lu CC，Lin CS. Estimates of medical comorbidities in erectile dysfunction inTaiwan-patient-based or population-based? The journal of sexual medicine,2012,9(11):2980.
67. Porst H, Montorsi F, Rosen RC,et al. The Premature Ejaculation Prevalence andAttitudes (PEPA) survey: prevalence, comorbidities, and professionalhelp-seeking. European urology,2007，51(3):816-823; discussion824.
68. Simons JS，Carey MP. Prevalence of sexual dysfunctions: results from a decadeof research. Archives of sexual behavior,2001，30(2):177-219.
69. Figueira I，Possidente E，Marques C，et al. Sexual dysfunction: a neglectedcomplication of panic disorder and social phobia. Archives of sexual behavior,2001，30(4):369-377.
70. Aschka C，Himmel W, Ittner E,et al. Sexual problems of male patients in familypractice. The Journal of family practice,2001，50(9):773-778.
71. Jannini EA，Simonelli C，Lenzi A. Disorders of ejaculation. Journal ofendocrinological investigation,2002，25(11):1006-1019.
72. Montague DK，Jarow J，Broderick GA，et al. AUA guideline on thepharmacologic management of premature ejaculation. The Journal of urology,2004，172(1):290-294.
73. McMahon CG，Abdo C，Incrocci L，et al. Disorders of orgasm and ejaculation inmen. The journal of sexual medicine，2004，1(1):58-65.
74. Brock GB，Benard F，Casey R，et al. Canadian male sexual health council surveyto assess prevalence and treatment of premature ejaculation in Canada. Thejournal of sexual medicine，2009，6(8):2115-2123.
75. Graziottin A, Althof S. What does premature ejaculation mean to the man, thewoman, and the couple? J Sex Med,2011，8Suppl4:304-309.
76. McCabe M，Althof SE，Assalian P，et al. Psychological and interpersonaldimensions of sexual function and dysfunction. J Sex Med,2010，7(1Pt2):327-336.
77. Waldinger MD，Schweitzer DH. Changing paradigms from a historical DSM-IIIand DSM-IV view toward an evidence-based deifnition of premature ejaculation.Part I~validity of DSM-IV-TR. The journal of sexual medicine，2006，3(4):682-692.
78. St Lawrence JS, Madakasira S. Evaluation and treatment of prematureejaculation: a critical review. International journal of psychiatry in medicine，1992,22(1):77-97.
79. Nolazco C，Bellora0，Lopez M，et al. Prevalence of sexual dysfunctions inArgentina. International journal of impotence research,2004，16(1):69-72.
80. Laumann EO，Nicolosi A，Glasser DB,et al. Sexual problems among women andmen aged40-80y: prevalence and correlates identiifed in the Global Study ofSexual Attitudes and Behaviors. International journal of impotence research,2005，17(1):39-57.
81. Serefoglu EC，Yaman0，Cayan S，et al. Prevalence of the complaint ofejaculating prematurely and the four premature ejaculation syndromes: resultsfrom the Turkish Society of Andrology Sexual Health Survey. The journal ofsexual medicine，2011，8(2):540-548.
82. Montorsi F. Prevalence of premature ejaculation: a global and regionalperspective. The journal of sexual medicine，2005，2Suppl2:96-102.
83. Corona G, Petrone L，Mannucci E,et al. Psycho-biological correlates of rapidejaculation in patients attending an andrologic unit for sexual dysfunctions.European urology,2004，46(5):615-622.
84. McMahon CG，Lee G, Park JK，et al. Premature ejaculation and erectiledysfunction prevalence and attitudes in the Asia-Paciifc region. The journal ofsexual medicine，2012，9(2):454-465.
85. 邢俊平，范晋海，王明珠，等.早泄病人慢性前列腺炎的发生率调查.中华男科学，2003，9(6):451-453.
86. Screponi E，Carosa E，Di Stasi SM，et al. Prevalence of chronic prostatitis in menwith premature ejaculation. Urology，2001，58(2):198-202.
87. Rowland DL， Slob AK. Premature ejaculation: psychophysiologicalconsiderations in theory, research, and treatment. Annual review of sex research,1997，8:224-253.
1. Krieger JN, Riley DE，Cheah PY,et al. Epidemiology of prostatitis: newevidence for a world-wide problem. World journal of urology,2003，21(2):70-74.
2. Mehik A，Hellstrom P，Sarpola A，et al. Fears, sexual disturbances andpersonality features in men with prostatitis: a population-based cross-sectionalstudy in Finland. BJU international,2001，88(1):35-38.
3. Nickel JC. Prostatitis: lessons from the20th century. BJU international,2000，85(2):179-185.
4. 梁朝朝.加强我国慢性前列腺炎的流行病学研究.中华泌尿外科杂志，2006，27(8):509-511.
5. 刘骋，梁朝朝，张学军，等.慢性前列腺炎病原学初步研究.中华泌尿外科杂志，2005，26(12):826-828.
6. Nickel JC, Nyberg LM，Hennenfent M. Research guidelines for chronicprostatitis: consensus report from the ifrst National Institutes of HealthInternational Prostatitis Collaborative Network. Urology，1999，54(2):229-233.
7. Krieger JN, Nyberg L，Jr., Nickel JC. NIH consensus definition andclassiifcation of prostatitis. JAMA: the journal of the American MedicalAssociation,1999，282(3):236-237.
8. Nickel JC. Recommendations for the evaluation of patients with prostatitis.World journal of urology,2003，21(2):75-81.
9. Weidner W, Anderson RU. Evaluation of acute and chronic bacterial prostatitisand diagnostic management of chronic prostatitis/chronic pelvic pain syndromewith special reference to infection/inflammation. International journal ofantimicrobial agents,2008，31Suppl l:S91-95.
10. Skerk V，Krhen I，Schonwald S，et al. The role of unusual pathogens in prostatitissyndrome. International journal of antimicrobial agents,2004，24Suppll:S53-56.
11. 张祥华，张骞，李学松,等.良性前列腺增生合并组织学前列腺炎的检出率——两种不同诊断标准的比较研究.中华临床医师杂志（电子版),2007(07):29-31.
12. 周强,李兰群,刘春英,等.慢性前列腺炎细菌培养与临床分析.中国性科学,2007,16(2):19-21.
13. 黄文霞.前列腺液微生物学实验诊断结果评价.中国医学杂志,2008,6(3):11-13.
14. Lee JC, Muller CH, Rothman I,et al. Prostate biopsy culture ifndings of menwith chronic pelvic pain syndrome do not differ from those of healthy controls.The Journal of urology,2003,169(2):584-587; discussion587-588.
15. 王应芳,孟灵,徐雅萍,等.慢性前列腺炎的病原菌及其耐药性研究.中华医院感染学杂志,2008,18(12):1793-1795.
16. 金敬爱,朱咏慧.前列腺液细菌培养及尿道病原体检测结果分析.国际检验医学杂志.2005,26(12):1222-1223.
17. Nickel JC, Alexander RB, Schaeffer AJ,et al. Leukocytes and bacteria in menwith chronic prostatitis/chronic pelvic pain syndrome compared toasymptomatic controls. The Journal of urology,2003,170(3):818-822.
18. 武立新,梁朝朝,唐智国,等.前列腺液白细胞计数与临床症状的相关分析.中华泌尿外科杂志,2006,27(3):194-196.
19. 姜辉,洪锴，白泉,等.慢性前列腺炎诊断和治疗的再评价.中国性科学,2008,17(03):13-15.
20. 熊晓冬,侯秉强,杨友招.对前列腺炎分类的再探讨.中国性科学,2009,18(8):25-27.
21. 李兰群，周强.慢性前列腺炎临床研究方法探讨.中国医药学报,2003,18(3):173-174.
22. Nickel JC，Sorensen R. Transurethral microwave thermotherapy for nonbacterialprostatitis: a randomized double-blind sham controlled study using newprostatitis specific assessment questionnaires. The Journal of urology,1996，155(6):1950-1954.
23. Wagenlehner FM，van Till JW，Magri V，et al. National Institutes of HealthChronic Prostatitis Symptom Index (NIH-CPSI) Symptom Evaluation inMultinational Cohorts of Patients with Chronic Prostatitis/Chronic Pelvic PainSyndrome. European urology,2012.
24. Shoskes DA, Nickel JC, Dolinga R，et al. Clinical phenotyping of patients withchronic prostatitis/chronic pelvic pain syndrome and correlation with symptomseverity. Urology,2009，73(3):538-542; discussion542-533.
25. Zhao Z，Zhang J，He J，et al. Clinical utility of the UPOINT phenotype system inChinese males with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS):a prospective study. PloS one，2013，8(l):e52044.
26. Shoskes DA, Nickel JC, Kattan MW. Phenotypically directed multimodaltherapy for chronic prostatitis/chronic pelvic pain syndrome: a prospective studyusing UPOINT. Urology，2010，75(6):1249-1253.
27. Samplaski MK，Li J，Shoskes DA. Clustering of UPOINT domains andsubdomains in men with chronic prostatitis/chronic pelvic pain syndrome andcontribution to symptom severity. The Journal of urology,2012，188(5):1788-1793.
28. Hedelin HH. Evaluation of a modiifcation of the UPOINT clinical phenotypesystem for the chronic pelvic pain syndrome. Scandinavian journal of urologyand nephrology,2009，43(5):373-376.
1. Mehik A, Hellstrom P, Sarpola A,et al. Fears, sexual disturbances andpersonality features in men with prostatitis: a population-based cross-sectionalstudy in Finland. BJU international,2001,88(1):35-38.
2. Nickel JC. Prostatitis: lessons from the20th century. BJU international,2000,85(2):179-185.
3. Nickel JC，Downey J，Hunter D，et al. Prevalence of prostatitis-like symptoms ina population based study using the National Institutes of Health chronicprostatitis symptom index. The Journal of urology,2001，165(3):842-845.
4. Kunishima Y, Mori M，Kitamura H,et al. Prevalence of prostatitis-like symptomsin Japanese men: Population-based study in a town in Hokkaido. Internationaljournal of urology: oiffcial journal of the Japanese Urological Association,2006，13(10):1286-1289.
5. Ku JH，Kim ME，Lee NK，et al. The prevalence of chronic prostatitis-likesymptoms in young men: a community-based survey. Urological research,2001，29(2):108-112.
6. Roberts RO，Jacobson DJ，Girman CJ，et al. Prevalence of prostatitis-likesymptoms in a community based cohort of older men. The Journal of urology,2002，168(6):2467-2471.
7. Mehik A，Hellstrom P, Lukkarinen0,et al. Epidemiology of prostatitis inFinnish men: a population-based cross-sectional study. BJU international,2000，86(4):443-448.
8. Rizzo M，Marchetti F，Travaglini F，et al. Prevalence, diagnosis and treatment ofprostatitis in Italy: a prospective urology outpatient practice study. BJUinternational,2003，92(9):955-959.
9. Tan JK，Png DJ, Liew LC,et al. Prevalence of prostatitis-like symptoms inSingapore: a population-based study. Singapore medical journal,2002，43(4):189-193.
10. Ferris JA, Pitts MK，Richters J,et al. National prevalence of urogenital pain andprostatitis-like symptoms in Australian men using the National Institutes ofHealth Chronic Prostatitis Symptoms Index. BJU international,2010，105(3):373-379.
11. Cheah PY，Liong ML, Yuen KH，et al. Chronic prostatitis: symptom survey withfollow-up clinical evaluation. Urology，2003，61(1):60-64.
12. Tripp DA, Nickel JC，Ross S，et al. Prevalence, symptom impact and predictorsof chronic prostatitis-like symptoms in Canadian males aged16-19years. BJUinternational,2009，103(8):1080-1084.
13. Tripp DA, Nickel JC, Pikard JL,et al. Chronic prostatitis-like symptoms inAfrican males aged16-19years. The Canadian journal of urology,2012，19(1):6081-6087.
14. 夏同礼，孔祥田，宓培，等.我国成人前列腺非特异性炎.中华泌尿外科杂志，1995，15(12):711-713.
15. Schatteman PH, Hoekx L，Wyndaele JJ,et al. Inlfammation in prostate biopsiesof men without prostatic malignancy or clinical prostatitis: correlation with totalserum PSA and PSA density. European urology,2000，37(4):404-412.
16. Shimomura T, Kiyota H, Takahashi H,et al.[Prostate histopathology of NIHcategory IV prostatitis detected by sextant prostate needle biopsy from thepatients with high prostatic speciifc antigen], Kansenshogaku zasshi The Journalof the Japanese Association for Infectious Diseases,2003，77(8):611-617.
17. True LD，Berger RE, Rothman I,et al. Prostate histopathology and the chronicprostatitis/chronic pelvic pain syndrome: a prospective biopsy study. The Journalofurology,1999，162(6):2014-2018.
18. Edlin RS，Heyns CF，Van Vuuren SP，et al. Prevalence of histological prostatitisin men with benign prostatic hyperplasia or adenocarcinoma of the prostatepresenting without urinary retention. South African journal of surgerySuid-Afrikaanse tydskrif vir chirurgie，2012，50(4):127-130.
19. Collins MM，Meigs JB，Barry MJ，et al. Prevalence and correlates of prostatitisin the health professionals follow-up study cohort. The Journal of urology,2002，167(3):1363-1366.
20. Liang CZ，Zhang XJ，Hao ZY，et al. An epidemiological study of patients withchronic prostatitis. BJU international,2004，94(4):568-570.
21. Moon TD，Hagen L，Heisey DM. Urinary symptomatology in younger men.Urology，1997，50(5):700-703.
22. Bartoletti R，Cai T, Mondaini N,et al. Prevalence, incidence estimation, riskfactors and characterization of chronic prostatitis/chronic pelvic pain syndromein urological hospital outpatients in Italy: results of a multicenter case-controlobservational study. The Journal of urology,2007，178(6):2411-2415; discussion2415.
23. Milton K. A dietary cure for prostatitis and the urethral syndrome. InfectiousDiseases in Clinical Practice,2002，11(3):107-110.
24. 王袓龙，孙自学，王瑞，等.郑州市高校男生慢性前列腺炎患病调查.中国公共卫生J00%25(9):1049-1050.
25. 高佃军，郭永顺，于海易，等.青年人群中前列腺炎样症状及其相关因素的调查.中华男科学杂志，2007,13(12):1087-1090.
26. Daniels NA，Ewing SK，Zmuda JM，et al. Correlates and prevalence of prostatitisin a large community-based cohort of older men. Urology,2005，66(5):964-970.
27. Hedelin H, Jonsson K. Chronic abacterial prostatitis and cold exposure: anexplorative study. Scandinavian journal of urology and nephrology,2007，41(5):430-435.
28. Hedelin H，Johannisson H，Welin L. Prevalence of the chronic prostatitis/chronicpelvic pain syndrome among40-69-year-old men residing in a temperate climate.Scandinavian journal of urology,2013.
29. 蓝天，王养民，陈烨，等.慢性前列腺炎相关危险因素的多中心联合调查研究.解放军医学杂志,2010,35(1):79-82.
30. 房蕾，韩家盛.某市出租车司机前列腺炎样症状调查.中国误诊学杂志,2009,9(21):5286-5287..
31. 张友宏,马立伟,刘文学,等.煤矿井下工人前列腺炎的调查分析与对策.中国男科学杂志,2007,21(2)：50-51..
32. Schaeffer A J. Epidemiology and demographics of prostatitis. Andrologia,2003,35(5):252-257.
33. 关晓海,陈晶,高伟兴,等.不同种族慢性前列腺炎245例发病情况比较.中国综合临床,2007,23(8):725-727.
2. Mehik A，Hellstrom P，Sarpola A，et al. Fears, sexual disturbances andpersonality features in men with prostatitis: a population-based cross-sectionalstudy in Finland. BJU international,2001，88(1):35-38.
3. Nickel JC. Prostatitis: lessons from the20th century. BJU international,2000,85(2):179-185.
4. 梁朝朝.加强我国慢性前列腺炎的流行病学研究.中华泌尿外科杂志，2006，27(8):509-511.
5. Ku JH，Kim ME，Lee NK，et al. The prevalence of chronic prostatitis-likesymptoms in young men: a community-based survey. Urological research,2001，29(2):108-112.
6. Nickel JC, Nyberg LM，Hennenfent M. Research guidelines for chronicprostatitis: consensus report from the ifrst National Institutes of HealthInternational Prostatitis Collaborative Network. Urology,1999，54(2):229-233.
7. Krieger JN, Nyberg L，Jr., Nickel JC. NIH consensus definition andclassiifcation of prostatitis. JAMA: the journal of the American MedicalAssociation,1999，282(3):236-237.
8. 刘骋，梁朝朝，张学军,等.慢性前列腺炎病原学初步研究.中华泌尿外科杂志，2005,26(12):826-828.
9. Nickel JC, Downey J，Hunter D，et al. Prevalence of prostatitis-like symptoms ina population based study using the National Institutes of Health chronicprostatitis symptom index. The Journal of urology,2001，165(3):842-845.
10. NIH Consensus Conference. Impotence. NIH Consensus Development Panel onImpotence. JAMA: the journal of the American Medical Association,1993，270(1):83-90.
11. Rosen RC，Cappelleri JC，Smith MD，et al. Development and evaluation of anabridged,5-item version of the International Index of Erectile Function (IIEF-5)as a diagnostic tool for erectile dysfunction. International journal of impotenceresearch,1999，11(6):319-326.
12. McMahon CG，Althof SE，Waldinger MD，et al. An evidence-based deifnition oflifelong premature ejaculation: report of the International Society for SexualMedicine (ISSM) ad hoc committee for the deifnition of premature ejaculation.The journal of sexual medicine，2008，5(7):1590-1606.
13. Carver BS，Bozeman CB，Williams BJ，et al. The prevalence of men withNational Institutes of Health category IV prostatitis and association with serumprostate specific antigen. The Journal of urology,2003，169(2):589-591.
14. Nickel JC, Downey J，Young I,et al. Asymptomatic inflammation and/orinfection in benign prostatic hyperplasia. BJU international,1999，84(9):976-981.
15. Tan JK，Png DJ, Liew LC,et al. Prevalence of prostatitis-like symptoms inSingapore: a population-based study. Singapore medical journal,2002，43(4):189-193.
16. Lee SW, Liong ML, Yuen KH,et al. Prostatitis-like symptoms: diagnosis andmanagement in a Malaysian primary care population. Urologia internationalis,2009，82(1):32-37.
17. Kunishima Y, Mori M，Kitamura H,et al. Prevalence of prostatitis-like symptomsin Japanese men: Population-based study in a town in Hokkaido. Internationaljournal of urology: oiffcial journal of the Japanese Urological Association,2006，13(10):1286-1289.
18. Mehik A，Hellstrom P, Lukkarinen0,et al. Epidemiology of prostatitis inFinnish men: a population-based cross-sectional study. BJU international,2000，86(4):443-448.
19. Rizzo M，Marchetti F，Travaglini F，et al. Prevalence, diagnosis and treatment ofprostatitis in Italy: a prospective urology outpatient practice study. BJUinternational,2003，92(9):955-959.
20. Collins MM，Stafford RS，O'Leary MP，et al. Distinguishing chronic prostatitisand benign prostatic hyperplasia symptoms: results of a national survey ofphysician visits. Urology,1999，53(5):921-925.
21. Roberts RO，Jacobson DJ，Girman CJ，et al. Prevalence of prostatitis-likesymptoms in a community based cohort of older men. The Journal of urology,2002，168(6):2467-2471.
22. Turner JA，Ciol MA, Von Korff M，et al. Validity and responsiveness of thenational institutes of health chronic prostatitis symptom index. The Journal ofurology,2003，169(2):580-583.
23.Cheah PY，Liong ML, Yuen KH，et al. Chronic prostatitis: symptom survey withfollow-up clinical evaluation. Urology，2003，61(1):60-64.
24.Clemens JQ, Meenan RT'，OKeeffe-Rosetti MC，et al. Prevalence ofprostatitis-like symptoms in a managed care population. The Journal of urology,2006，176(2):593-596; discussion596.
25. Tripp DA, Nickel JC，Ross S，et al. Prevalence, symptom impact and predictorsof chronic prostatitis-like symptoms in Canadian males aged16-19years. BJUinternational,2009，103(8):1080-1084.
26. Tripp DA, Nickel JC, Pikard JL,et al. Chronic prostatitis-like symptoms inAfrican males aged16-19years. The Canadian journal of urology,2012，19(1):6081-6087.
27. Ferris JA，Pitts MK，Richters J,et al. National prevalence of urogenital pain andprostatitis-like symptoms in Australian men using the National Institutes ofHealth Chronic Prostatitis Symptoms Index. BJU international,2010，105(3):373-379.
28. 夏同礼，孔祥田，宓培，等.我国成人前列腺非特异性炎.中华泌尿外科杂志，1995，15(12):711-713.
29. Schatteman PH, Hoekx L，Wyndaele JJ,et al. Inlfammation in prostate biopsiesof men without prostatic malignancy or clinical prostatitis: correlation with totalserum PSA and PSA density. European urology,2000，37(4):404-412.
30. Shimomura T, Kiyota H, Takahashi H,et al.[Prostate histopathology of NIHcategory IV prostatitis detected by sextant prostate needle biopsy from thepatients with high prostatic speciifc antigen], Kansenshogaku zasshi The Journalof the Japanese Association for Infectious Diseases,2003，77(8):611-617.
31. True LD，Berger RE, Rothman I,et al. Prostate histopathology and the chronicprostatitis/chronic pelvic pain syndrome: a prospective biopsy study. The Journalofurology,1999，162(6):2014-2018.
32. Edlin RS，Heyns CF，Van Vuuren SP，et al. Prevalence of histological prostatitisin men with benign prostatic hyperplasia or adenocarcinoma of the prostatepresenting without urinary retention. South African journal of surgerySuid-Afrikaanse tydskrif vir chirurgie，2012，50(4):127-130.
33. Collins MM，Meigs JB，Barry MJ，et al. Prevalence and correlates of prostatitisin the health professionals follow-up study cohort. The Journal of urology,2002，167(3):1363-1366.
34. Liang CZ，Zhang XJ，Hao ZY，et al. An epidemiological study of patients withchronic prostatitis. BJU international,2004，94(4):568-570.
35. Moon TD，Hagen L，Heisey DM. Urinary symptomatology in younger men.Urology，1997，50(5):700-703.
36. Bartoletti R，Cai T, Mondaini N,et al. Prevalence, incidence estimation, riskfactors and characterization of chronic prostatitis/chronic pelvic pain syndromein urological hospital outpatients in Italy: results of a multicenter case-controlobservational study. The Journal of urology,2007，178(6):2411-2415; discussion2415.
37. Milton K. A dietary cure for prostatitis and the urethral syndrome. InfectiousDiseases in Clinical Practice,2002，11(3):107-110.
38. 王祖龙，孙自学，王瑞，等.郑州市高校男生慢性前列腺炎患病调查.中国公共卫生,2009,25(9):1049-1050.
39. _個车，郭永顺，于海易，等.青年人群中列腺炎样症状及其相关因素的调查.中华男科学杂志，2007,13(12):1087-1090.
40. Daniels NA，Ewing SK，Zmuda JM，et al. Correlates and prevalence of prostatitisin a large community-based cohort of older men. Urology,2005，66(5):964-970.
41. Hedelin H, Jonsson K. Chronic abacterial prostatitis and cold exposure: anexplorative study. Scandinavian journal of urology and nephrology,2007，41(5):430-435.
42. Hedelin H，Johannisson H，Welin L. Prevalence of the chronic prostatitis/chronicpelvic pain syndrome among40-69-year-old men residing in a temperate climate.Scandinavian journal of urology,2013.
43. 蓝天，王养民，陈烨，等.慢性前列腺炎相关危险因素的多中心联合调查研究.解放军医学杂志，2010,35(1):79-82.
44. 房蕾，韩家盛.某市出租车司机前列腺炎样症状调查.中国误诊学杂志，2009々（21):5286-5287..
45. 张友宏，马立伟，刘文学，等.煤矿井下工人前列腺炎的调查分析与对策.中国男科学杂志J007J1(2):50-51..
46. Schaeffer A J. Epidemiology and demographics of prostatitis. Andrologia，2003，35(5):252-257.
47. 关晓海，陈晶，高伟兴，等.不同种族慢性前列腺炎245例发病情况比较.中国综合临床，2007,23(8):725-727.
48. Alexander RB, Propert KJ，Schaeffer AJ，et al. Ciprolfoxacin or tamsulosin inmen with chronic prostatitis/chronic pelvic pain syndrome: a randomized,double-blind trial. Annals of internal medicine，2004，141(8):581-589.
49. Nickel JC，Zadeikis N，Spivey M，et al. Clinical signiifcance of antimicrobialtherapy in chronic prostatitis associated with non-traditional uropathogens. JUrol.2005;173:S30.
50. Nickel JC, Downey J，Johnston B，et al. Predictors of patient response toantibiotic therapy for the chronic prostatitis/chronic pelvic pain syndrome: aprospective multicenter clinical trial. The Journal of urology,2001，165(5):1539-1544.
51. Calhoun EA, McNaughton Collins M，Pontari MA,et al. The economic impactof chronic prostatitis. Archives of internal medicine,2004，164(11):1231-1236.
52. Duloy AM, Calhoun EA，Clemens JQ. Economic impact of chronic prostatitis.Current urology reports,2007，8(4):336-339.
53. McKinlay JB. The worldwide prevalence and epidemiology of erectiledysfunction. International journal of impotence research,2000，12Suppl4:S6-S11.
54. Shamloul R， Ghanem H. Erectile dysfunction. The Lancet,2013，381(9861):153-165.
55. Feldman HA, Goldstein I, Hatzichristou DG,et al. Impotence and its medical andpsychosocial correlates: results of the Massachusetts Male Aging Study. TheJournal of urology,1994，151(1):54-61.
56. Blanker MH，Bosch JL，Groeneveld FP,et al. Erectile and ejaculatorydysfunction in a community-based sample of men50to78years old: prevalence,concern，and relation to sexual activity. Urology，2001，57(4):763-768.
57. Mulligan T，Retchin SM，Chinchilli VM，et al. The role of aging and chronicdisease in sexual dysfunction. Journal of the American Geriatrics Society,1988,36(6):520-524.
58. Zhang H，Yip AW, Fan S，et al. Sexual dysfunction among Chinese married menaged30-60years: a population-based study in Hong Kong. Urology,2013，81(2):334-339.
59. 冷静，王益鑫，黄旭元，等.上海市1582例中老年男子勃起功能障碍流行病学调查.中国男科学杂志，2000,14(1):29-31.
60. 倪少义，王榕生，方培群，等.中老年人男性勃起功能障碍ED的流行病学调查.中国实用医药，2010，5(18):246-247.
61. 张唯力，舒勇，吴天平，等.重庆城区男子性功能状况的初步调查.重庆医科大学学报，2002，27(04):441-444.
62. Marszalek M，Wehrberger C, Hochreiter W,et al. Symptoms suggestive ofchronic pelvic pain syndrome in an urban population: prevalence andassociations with lower urinary tract symptoms and erectile function. TheJournal of urology,2007，177(5):1815-1819.
63. Liang CZ，Zhang XJ，Hao ZY，et al. Prevalence of sexual dysfunction in Chinesemen with chronic prostatitis. BJU international,2004，93(4):568-570.
64. Shoskes DA. The challenge of erectile dysfunction in the man with chronicprostatitis/chronic pelvic pain syndrome. Current urology reports,2012，13(4):263-267.
65. Gonen M，Kalkan M，Cenker A，et al. Prevalence of premature ejaculation inTurkish men with chronic pelvic pain syndrome. Journal of andrology，2005，26(5):601-603.
66. Lu CC，Lin CS. Estimates of medical comorbidities in erectile dysfunction inTaiwan-patient-based or population-based? The journal of sexual medicine,2012,9(11):2980.
67. Porst H, Montorsi F, Rosen RC,et al. The Premature Ejaculation Prevalence andAttitudes (PEPA) survey: prevalence, comorbidities, and professionalhelp-seeking. European urology,2007，51(3):816-823; discussion824.
68. Simons JS，Carey MP. Prevalence of sexual dysfunctions: results from a decadeof research. Archives of sexual behavior,2001，30(2):177-219.
69. Figueira I，Possidente E，Marques C，et al. Sexual dysfunction: a neglectedcomplication of panic disorder and social phobia. Archives of sexual behavior,2001，30(4):369-377.
70. Aschka C，Himmel W, Ittner E,et al. Sexual problems of male patients in familypractice. The Journal of family practice,2001，50(9):773-778.
71. Jannini EA，Simonelli C，Lenzi A. Disorders of ejaculation. Journal ofendocrinological investigation,2002，25(11):1006-1019.
72. Montague DK，Jarow J，Broderick GA，et al. AUA guideline on thepharmacologic management of premature ejaculation. The Journal of urology,2004，172(1):290-294.
73. McMahon CG，Abdo C，Incrocci L，et al. Disorders of orgasm and ejaculation inmen. The journal of sexual medicine，2004，1(1):58-65.
74. Brock GB，Benard F，Casey R，et al. Canadian male sexual health council surveyto assess prevalence and treatment of premature ejaculation in Canada. Thejournal of sexual medicine，2009，6(8):2115-2123.
75. Graziottin A, Althof S. What does premature ejaculation mean to the man, thewoman, and the couple? J Sex Med,2011，8Suppl4:304-309.
76. McCabe M，Althof SE，Assalian P，et al. Psychological and interpersonaldimensions of sexual function and dysfunction. J Sex Med,2010，7(1Pt2):327-336.
77. Waldinger MD，Schweitzer DH. Changing paradigms from a historical DSM-IIIand DSM-IV view toward an evidence-based deifnition of premature ejaculation.Part I~validity of DSM-IV-TR. The journal of sexual medicine，2006，3(4):682-692.
78. St Lawrence JS, Madakasira S. Evaluation and treatment of prematureejaculation: a critical review. International journal of psychiatry in medicine，1992,22(1):77-97.
79. Nolazco C，Bellora0，Lopez M，et al. Prevalence of sexual dysfunctions inArgentina. International journal of impotence research,2004，16(1):69-72.
80. Laumann EO，Nicolosi A，Glasser DB,et al. Sexual problems among women andmen aged40-80y: prevalence and correlates identiifed in the Global Study ofSexual Attitudes and Behaviors. International journal of impotence research,2005，17(1):39-57.
81. Serefoglu EC，Yaman0，Cayan S，et al. Prevalence of the complaint ofejaculating prematurely and the four premature ejaculation syndromes: resultsfrom the Turkish Society of Andrology Sexual Health Survey. The journal ofsexual medicine，2011，8(2):540-548.
82. Montorsi F. Prevalence of premature ejaculation: a global and regionalperspective. The journal of sexual medicine，2005，2Suppl2:96-102.
83. Corona G, Petrone L，Mannucci E,et al. Psycho-biological correlates of rapidejaculation in patients attending an andrologic unit for sexual dysfunctions.European urology,2004，46(5):615-622.
84. McMahon CG，Lee G, Park JK，et al. Premature ejaculation and erectiledysfunction prevalence and attitudes in the Asia-Paciifc region. The journal ofsexual medicine，2012，9(2):454-465.
85. 邢俊平，范晋海，王明珠，等.早泄病人慢性前列腺炎的发生率调查.中华男科学，2003，9(6):451-453.
86. Screponi E，Carosa E，Di Stasi SM，et al. Prevalence of chronic prostatitis in menwith premature ejaculation. Urology，2001，58(2):198-202.
87. Rowland DL， Slob AK. Premature ejaculation: psychophysiologicalconsiderations in theory, research, and treatment. Annual review of sex research,1997，8:224-253.
1. Krieger JN, Riley DE，Cheah PY,et al. Epidemiology of prostatitis: newevidence for a world-wide problem. World journal of urology,2003，21(2):70-74.
2. Mehik A，Hellstrom P，Sarpola A，et al. Fears, sexual disturbances andpersonality features in men with prostatitis: a population-based cross-sectionalstudy in Finland. BJU international,2001，88(1):35-38.
3. Nickel JC. Prostatitis: lessons from the20th century. BJU international,2000，85(2):179-185.
4. 梁朝朝.加强我国慢性前列腺炎的流行病学研究.中华泌尿外科杂志，2006，27(8):509-511.
5. 刘骋，梁朝朝，张学军，等.慢性前列腺炎病原学初步研究.中华泌尿外科杂志，2005，26(12):826-828.
6. Nickel JC, Nyberg LM，Hennenfent M. Research guidelines for chronicprostatitis: consensus report from the ifrst National Institutes of HealthInternational Prostatitis Collaborative Network. Urology，1999，54(2):229-233.
7. Krieger JN, Nyberg L，Jr., Nickel JC. NIH consensus definition andclassiifcation of prostatitis. JAMA: the journal of the American MedicalAssociation,1999，282(3):236-237.
8. Nickel JC. Recommendations for the evaluation of patients with prostatitis.World journal of urology,2003，21(2):75-81.
9. Weidner W, Anderson RU. Evaluation of acute and chronic bacterial prostatitisand diagnostic management of chronic prostatitis/chronic pelvic pain syndromewith special reference to infection/inflammation. International journal ofantimicrobial agents,2008，31Suppl l:S91-95.
10. Skerk V，Krhen I，Schonwald S，et al. The role of unusual pathogens in prostatitissyndrome. International journal of antimicrobial agents,2004，24Suppll:S53-56.
11. 张祥华，张骞，李学松,等.良性前列腺增生合并组织学前列腺炎的检出率——两种不同诊断标准的比较研究.中华临床医师杂志（电子版),2007(07):29-31.
12. 周强,李兰群,刘春英,等.慢性前列腺炎细菌培养与临床分析.中国性科学,2007,16(2):19-21.
13. 黄文霞.前列腺液微生物学实验诊断结果评价.中国医学杂志,2008,6(3):11-13.
14. Lee JC, Muller CH, Rothman I,et al. Prostate biopsy culture ifndings of menwith chronic pelvic pain syndrome do not differ from those of healthy controls.The Journal of urology,2003,169(2):584-587; discussion587-588.
15. 王应芳,孟灵,徐雅萍,等.慢性前列腺炎的病原菌及其耐药性研究.中华医院感染学杂志,2008,18(12):1793-1795.
16. 金敬爱,朱咏慧.前列腺液细菌培养及尿道病原体检测结果分析.国际检验医学杂志.2005,26(12):1222-1223.
17. Nickel JC, Alexander RB, Schaeffer AJ,et al. Leukocytes and bacteria in menwith chronic prostatitis/chronic pelvic pain syndrome compared toasymptomatic controls. The Journal of urology,2003,170(3):818-822.
18. 武立新,梁朝朝,唐智国,等.前列腺液白细胞计数与临床症状的相关分析.中华泌尿外科杂志,2006,27(3):194-196.
19. 姜辉,洪锴，白泉,等.慢性前列腺炎诊断和治疗的再评价.中国性科学,2008,17(03):13-15.
20. 熊晓冬,侯秉强,杨友招.对前列腺炎分类的再探讨.中国性科学,2009,18(8):25-27.
21. 李兰群，周强.慢性前列腺炎临床研究方法探讨.中国医药学报,2003,18(3):173-174.
22. Nickel JC，Sorensen R. Transurethral microwave thermotherapy for nonbacterialprostatitis: a randomized double-blind sham controlled study using newprostatitis specific assessment questionnaires. The Journal of urology,1996，155(6):1950-1954.
23. Wagenlehner FM，van Till JW，Magri V，et al. National Institutes of HealthChronic Prostatitis Symptom Index (NIH-CPSI) Symptom Evaluation inMultinational Cohorts of Patients with Chronic Prostatitis/Chronic Pelvic PainSyndrome. European urology,2012.
24. Shoskes DA, Nickel JC, Dolinga R，et al. Clinical phenotyping of patients withchronic prostatitis/chronic pelvic pain syndrome and correlation with symptomseverity. Urology,2009，73(3):538-542; discussion542-533.
25. Zhao Z，Zhang J，He J，et al. Clinical utility of the UPOINT phenotype system inChinese males with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS):a prospective study. PloS one，2013，8(l):e52044.
26. Shoskes DA, Nickel JC, Kattan MW. Phenotypically directed multimodaltherapy for chronic prostatitis/chronic pelvic pain syndrome: a prospective studyusing UPOINT. Urology，2010，75(6):1249-1253.
27. Samplaski MK，Li J，Shoskes DA. Clustering of UPOINT domains andsubdomains in men with chronic prostatitis/chronic pelvic pain syndrome andcontribution to symptom severity. The Journal of urology,2012，188(5):1788-1793.
28. Hedelin HH. Evaluation of a modiifcation of the UPOINT clinical phenotypesystem for the chronic pelvic pain syndrome. Scandinavian journal of urologyand nephrology,2009，43(5):373-376.
1. Mehik A, Hellstrom P, Sarpola A,et al. Fears, sexual disturbances andpersonality features in men with prostatitis: a population-based cross-sectionalstudy in Finland. BJU international,2001,88(1):35-38.
2. Nickel JC. Prostatitis: lessons from the20th century. BJU international,2000,85(2):179-185.
3. Nickel JC，Downey J，Hunter D，et al. Prevalence of prostatitis-like symptoms ina population based study using the National Institutes of Health chronicprostatitis symptom index. The Journal of urology,2001，165(3):842-845.
4. Kunishima Y, Mori M，Kitamura H,et al. Prevalence of prostatitis-like symptomsin Japanese men: Population-based study in a town in Hokkaido. Internationaljournal of urology: oiffcial journal of the Japanese Urological Association,2006，13(10):1286-1289.
5. Ku JH，Kim ME，Lee NK，et al. The prevalence of chronic prostatitis-likesymptoms in young men: a community-based survey. Urological research,2001，29(2):108-112.
6. Roberts RO，Jacobson DJ，Girman CJ，et al. Prevalence of prostatitis-likesymptoms in a community based cohort of older men. The Journal of urology,2002，168(6):2467-2471.
7. Mehik A，Hellstrom P, Lukkarinen0,et al. Epidemiology of prostatitis inFinnish men: a population-based cross-sectional study. BJU international,2000，86(4):443-448.
8. Rizzo M，Marchetti F，Travaglini F，et al. Prevalence, diagnosis and treatment ofprostatitis in Italy: a prospective urology outpatient practice study. BJUinternational,2003，92(9):955-959.
9. Tan JK，Png DJ, Liew LC,et al. Prevalence of prostatitis-like symptoms inSingapore: a population-based study. Singapore medical journal,2002，43(4):189-193.
10. Ferris JA, Pitts MK，Richters J,et al. National prevalence of urogenital pain andprostatitis-like symptoms in Australian men using the National Institutes ofHealth Chronic Prostatitis Symptoms Index. BJU international,2010，105(3):373-379.
11. Cheah PY，Liong ML, Yuen KH，et al. Chronic prostatitis: symptom survey withfollow-up clinical evaluation. Urology，2003，61(1):60-64.
12. Tripp DA, Nickel JC，Ross S，et al. Prevalence, symptom impact and predictorsof chronic prostatitis-like symptoms in Canadian males aged16-19years. BJUinternational,2009，103(8):1080-1084.
13. Tripp DA, Nickel JC, Pikard JL,et al. Chronic prostatitis-like symptoms inAfrican males aged16-19years. The Canadian journal of urology,2012，19(1):6081-6087.
14. 夏同礼，孔祥田，宓培，等.我国成人前列腺非特异性炎.中华泌尿外科杂志，1995，15(12):711-713.
15. Schatteman PH, Hoekx L，Wyndaele JJ,et al. Inlfammation in prostate biopsiesof men without prostatic malignancy or clinical prostatitis: correlation with totalserum PSA and PSA density. European urology,2000，37(4):404-412.
16. Shimomura T, Kiyota H, Takahashi H,et al.[Prostate histopathology of NIHcategory IV prostatitis detected by sextant prostate needle biopsy from thepatients with high prostatic speciifc antigen], Kansenshogaku zasshi The Journalof the Japanese Association for Infectious Diseases,2003，77(8):611-617.
17. True LD，Berger RE, Rothman I,et al. Prostate histopathology and the chronicprostatitis/chronic pelvic pain syndrome: a prospective biopsy study. The Journalofurology,1999，162(6):2014-2018.
18. Edlin RS，Heyns CF，Van Vuuren SP，et al. Prevalence of histological prostatitisin men with benign prostatic hyperplasia or adenocarcinoma of the prostatepresenting without urinary retention. South African journal of surgerySuid-Afrikaanse tydskrif vir chirurgie，2012，50(4):127-130.
19. Collins MM，Meigs JB，Barry MJ，et al. Prevalence and correlates of prostatitisin the health professionals follow-up study cohort. The Journal of urology,2002，167(3):1363-1366.
20. Liang CZ，Zhang XJ，Hao ZY，et al. An epidemiological study of patients withchronic prostatitis. BJU international,2004，94(4):568-570.
21. Moon TD，Hagen L，Heisey DM. Urinary symptomatology in younger men.Urology，1997，50(5):700-703.
22. Bartoletti R，Cai T, Mondaini N,et al. Prevalence, incidence estimation, riskfactors and characterization of chronic prostatitis/chronic pelvic pain syndromein urological hospital outpatients in Italy: results of a multicenter case-controlobservational study. The Journal of urology,2007，178(6):2411-2415; discussion2415.
23. Milton K. A dietary cure for prostatitis and the urethral syndrome. InfectiousDiseases in Clinical Practice,2002，11(3):107-110.
24. 王袓龙，孙自学，王瑞，等.郑州市高校男生慢性前列腺炎患病调查.中国公共卫生J00%25(9):1049-1050.
25. 高佃军，郭永顺，于海易，等.青年人群中前列腺炎样症状及其相关因素的调查.中华男科学杂志，2007,13(12):1087-1090.
26. Daniels NA，Ewing SK，Zmuda JM，et al. Correlates and prevalence of prostatitisin a large community-based cohort of older men. Urology,2005，66(5):964-970.
27. Hedelin H, Jonsson K. Chronic abacterial prostatitis and cold exposure: anexplorative study. Scandinavian journal of urology and nephrology,2007，41(5):430-435.
28. Hedelin H，Johannisson H，Welin L. Prevalence of the chronic prostatitis/chronicpelvic pain syndrome among40-69-year-old men residing in a temperate climate.Scandinavian journal of urology,2013.
29. 蓝天，王养民，陈烨，等.慢性前列腺炎相关危险因素的多中心联合调查研究.解放军医学杂志,2010,35(1):79-82.
30. 房蕾，韩家盛.某市出租车司机前列腺炎样症状调查.中国误诊学杂志,2009,9(21):5286-5287..
31. 张友宏,马立伟,刘文学,等.煤矿井下工人前列腺炎的调查分析与对策.中国男科学杂志,2007,21(2)：50-51..
32. Schaeffer A J. Epidemiology and demographics of prostatitis. Andrologia,2003,35(5):252-257.
33. 关晓海,陈晶,高伟兴,等.不同种族慢性前列腺炎245例发病情况比较.中国综合临床,2007,23(8):725-727.
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