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Yoo and Shim: Clinical Use of High-Sensitivity C-Reactive Protein (hs-CRP) in Chronic Pelvic Pain Syndrome
Original Article
Infection/Inflammation
Korean Journal of Urology

Korean Journal of Urology 2009; 50(11): 1114-1119.

Published online: 19 November 2009

DOI: https://doi.org/10.4111/kju.2009.50.11.1114

Clinical Use of High-Sensitivity C-Reactive Protein (hs-CRP) in Chronic Pelvic Pain Syndrome

Jaeyeong Yoo, Bongsuk Shim

Department of Urology, Ewha Womans University School of Medicine, Seoul, Korea.

Correspondence to: Bongsuk Shim Department of Urology, Ewha Womans University School of Medicine, 911-1, Mok-dong, Seoul 158-710, Korea. TEL: 02-2650-2863, FAX: 02-2654-3682, bonstone@ewha.ac.kr

Received 2 July 2009       Accepted 9 October 2009

Copyright © The Korean Urological Association, 2009

Abstract

Purpose

The cause of chronic pelvic pain syndrome (CPPS) has traditionally been regarded as inflammation of the pelvis and pelvic organs. C-reactive protein (CRP) is an indicator of acute and chronic inflammation. We aimed to determine the clinical significance and use of high-sensitivity C-reactive protein (hs-CRP) in patients with CPPS.

Materials and Methods

From January 2005 to December 2006, we retrospectively reviewed 70 patients diagnosed as having CPPS (mean age, 45.4±10.09 years old). The variables we assessed in these patients were white blood cell count in the third voided urine specimen (VB3), scores on the NIH-Chronic Prostatitis Symptom Index (NIH-CPSI), peak flow rate (Qmax), postvoid residual urine (PVR), and hs-CRP level. Items were checked again after 8 weeks of treatment with antibiotics and anti-inflammatory agents. Patients who showed improvement in symptom scores were regarded as being in the positive response group. We analyzed correlations of hs-CRP with the other CPPS items.

Results

The hs-CRP level was statistically significantly correlated with other CPPS items in both the NIH category IIIa and IIIb groups. In the positive response group, there were statistically significant changes in the hs-CRP level, WBC count in VB3, and scores on the NIH-CPSI after treatment (p<0.05). In the negative response group, there were no significant changes in CPPS items.

Conclusions

The hs-CRP level had a clinically significant correlation with other CPPS items. In the positive response group especially, the hs-CRP level decreased after treatment. Measuring hs-CRP may have benefits in determining the severity of CPPS and in predicting the response to treatment.

Keywords: Prostatitis, Inflammation, C-reactive protein

Figures and Tables

Table 1
CPPS items according to NIH category
kju-50-1114-i001

CPPS: chronic pelvic pain syndrome, NIH: national institute of health, SD: standard deviation, IIIa: NIH category IIIa, IIIb: NIH category IIIb, hs-CRP: high sensitive C-reactive protein, VB3: voided bladder 3, WBC/HPF: white blood cell/high power field, NIH-CPSI: National Institute of Health-Chronic Prostatitis Symptom Index, QoL: quality of life, Qmax: maximal flow rate, PVR: postvoiding residual volume, Pvol: prostate volume, a: Mann Whitney U-test

Table 2
Correlations of CPPS items with hs-CRP
kju-50-1114-i002

CPPS: chronic pelvic pain syndrome, hs-CRP: high sensitive C-reactive protein, rho: Spearman's correlation coefficient, IIIa: NIH category IIIa, IIIb: NIH category IIIb, VB3: voided bladder 3, NIH-CPSI: National Institute of Health-Chronic Prostatitis Symptom Index, QoL: quality of life, Qmax: maximal flow rate, PVR: postvoiding residual volume, Pvol: prostate volume, a: p<0.01

Table 3
Changes in CPPS items after treatment in the NIH category IIIa group
kju-50-1114-i003

Wilcoxon signed rank test, CPPS: chronic pelvic pain syndrome, IIIa: NIH category IIIa, Group A: patients with response to treatment, Group B: patients without response to treatment, hs-CRP: high sensitive C-reactive protein, VB3: voided bladder 3, WBC/HPF: white blood cell/high power field, NIH-CPSI: National Institute of Health-Chronic Prostatitis Symptom Index, QoL: quality of life, Qmax: maximal flow rate, PVR: postvoiding residual volume, a: Mean±standard deviation, b: p<0.05, Wilcoxon signed rank test, c: p<0.01

Table 4
Changes in CPPS items after treatment in the NIH category IIIb group
kju-50-1114-i004

Wilcoxon signed rank test, CPPS: chronic pelvic pain syndrome, IIIb: NIH category IIIb, Group A: patients with response to treatment, Group B: patients without response to treatment, hs-CRP: high sensitive C-reactive protein, NIH-CPSI: National Institute of Health-Chronic Prostatitis Symptom Index, QoL: quality of life, Qmax: maximal flow rate, PVR: postvoiding residual volume, a: Mean±standard deviation, b: p<0.05, Wilcoxon signed rank test, c: p<0.01

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