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The effects of simulated microgravity on mammalian reproduction were studied using tail-suspended mice, during parabolic flight in a jet plane and in a horizontal clinostat device. In the tail-suspended mouse, which is a model of the shift of body fluid in a microgravity environment, atrophy of the testis and decrease of serum testosterone level were observed. The sperm motility decreased in the muG condition produced by the parabolic flight. There were no statistically significant differences in the efficiency of achieving normal fertilization in vitro, but there was a statistically significant decrease in the number of embryos reaching the morula and blastocyst stages after 96 hours in culture under clinostat rotation. These results suggest that the process of fertilization in vitro is not sensitive to the gravitational vector. However, the possibility exists that microgravity increases the disturbance of spermatogenesis and sperm motility or the frequency of early embryonic lethality. On the possibility of reproduction in space, there are some problems such as the cosmic radiation besides gravity. It is necessary to carry out further experiments in outer space.

Twenty-four previously untreated patients with a diagnosis of prostatic cancer were treated with chlormadinone acetate (CMA) alone (100 mg/day) for 4 weeks, and luteinizing hormone-releasing hormone analogue (LH-RHa) was added for the next 24 weeks. Marked decreases in blood LH, testosterone (T), prostate specific antigen (PSA), gamma-seminoprotein (gamma-Sm), and prostatic acid phosphatase (PAP) were observed after a single dose of CMA. T levels were significantly increased 3 days after the initial dose of LH-RHa, and did not return to the pretreatment level. There were no significant increases in any of the markers, nor were there any flare-up cases. Triglyceride levels, which were slightly elevated before the start of treatment, were significantly decreased 24 weeks after the completion of combined therapy. PSA was evaluated as partial response (PR) or better in 86.7% of the patients. Overall evaluation showed PR or better in 75.0% of the patients. These findings suggest that prior administration of CMA followed by combined administration with LH-RHa is useful in the treatment of prostatic cancer. No negative effects on lipid metabolism were observed at any time during the treatment period.

A 58-year-old man was admitted with a swelling in the frontal region. Computerized tomography scan, magnetic resonance imaging and angiography revealed a tumor in the right frontal sinus. The surgically extirpated specimen showed clear cell carcinoma which was suspected to be a metastasis from renal cell carcinoma. Subsequent urologic examination disclosed the right renal tumor. Since there were no other systemic metastases, right nephrectomy was performed. Pathologically, the renal tumor was clear cell subtype renal cell carcinoma and had the same histology as the frontal sinus tumor.

Eight patients were evaluated clinically, radiologically, and urodynamically to determine the outcome of continent urinary diversion with ileal neobladder performed to treat the recurrent superficial bladder cancer after cystectomy with subcapsular prostatectomy. The mean age of the patients was 55.3 years. After descending dissection of the urinary bladder without ligation or dissection of Santorini's plexus, the prostate was cut to the bladder neck distally for 2 cm under the subcapular prostatectomy. One patient who had a short 3 cm intestinal segment between the pouch and the urethra, had severely prolonged micturition with peristalsis in this short segment, and required a re-operation. Micturition was good in the other seven patients, all with detubularized neobladder directly to the prostate capsule in anastomosis. Pressure flow studies performed on these seven patients revealed two types of micturition; "fast bladder" and "intermittent flow", the latter resembling detrusor sphincter dyssynergia.

A 54-year-old male was referred to our outpatient clinic because of milky urine. He had lived in Kumamoto, an area of endemic filariasis. There were no microfilaria found in his blood smear. Lymphangiography showed dilation of the retroperitoneal lymphatics and bilateral renal refluxes. The thoracic duct was obvious. The initial treatment consisted of irrigating the bilateral renal pelvis with silver nitrate solution, but was not successful and recurrent acute urinary retention developed. Therefore, we performed stripping and ligation of the bilateral renal lymphatics. Chyluria disappeared immediately after surgery. The etiology and various treatments for chyluria are discussed.

It is important to know the proliferating ability and the malignant potential of tumor tissues. We have examined the expression of PCNA/cyclin, p53 and C-erbB-2 in transitional cell carcinoma of the human urinary bladder by an immunohistochemical method, and compared the results with the histological grade, stage and survival rate. Immunohistochemical studies, using monoclonal and polyclonal antibodies, on these proteins were performed with formaline fixed-paraffin sections of tumor tissue from 40 patients with bladder cancer. Generally, a higher grade and higher stage tumors expressed PCNA/cyclin, p53 and C-erbB-2 with a greater frequency than the tumors with a lower grade and lower stage and strongly stained cases had a lower survival rate than weakly stained cases. These findings suggest that the detection of each antigen is useful for estimating the malignant potential of transitional cell carcinoma as the adjuvant studies, because of its applicability to paraffin-embedded tissue sections and its simple, rapid technique.

Seventeen patients with prostatodynia (chronic prostatitis-like syndrome) refractory to conventional medical treatment were treated with electric acupuncture at a low-wave frequency. All of them had had a complicated clinical course and pelvic hypertonicity. This therapy was administered to mitigate the congestion of pelvic circulation, especially around the prostate. The clinical efficacy of longterm treatment was considered excellent in 30% and moderate in 70% of the patients, with an overall efficacy rate of 100%. Treatment with Chinese medicines and chemical agents could be withdrawn completely in 50% of the patients, treatment with chemical agents could be withdrawn in 30% of the patients, and the dose of either type of medication could be reduced in 20% of the patients. To examine whether the efficacy of electric acupuncture was related to the induction of cytokines we also examined the serum levels of INF-gamma, IL-1 beta and IL-6, but, no significant elevation of either of them was detected.

Antiandrogen therapy has an important role in the treatment of patients with benign prostatic hypertrophy who lack indication for surgery. Herein, the effects on lipid metabolism of administration of antiandrogen agents for benign prostatic hypertrophy are reported. Eighty patients with benign prostatic hypertrophy were each treated with the antiandrogen agents, chlormadinone acetate, allylestrenol, gestonolone caproate and oxendolone for 12 months. The levels of total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), alpha-lipoprotein, apoprotein, and maronediardehyde (MDA) were measured every 4 weeks after initiation of antiandrogen treatment. In the chlormadinone acetate group, the TG level was significantly decreased between 3 and 6 months after treatment (p < 0.05). In the oxendolone group, the alpha-lipoprotein level was also elevated between 3 and 6 months and between 6 to 12 months after treatment (p < 0.05). The MDA level was also significantly elevated 6 and 12 months after treatment. However, the levels of the other lipids were within the normal range. In conclusion, the changes in the levels of plasma lipoprotein, apoprotein and MDA resulting from antiandrogen therapy were unlikely to be a cause of ischemic coronary disease.

A 46-year-old man was admitted to our hospital with the complaint of gross hematuria and renal failure. The patient had undergone right nephrectomy 10 years earlier suffering from nephrotuberculosis, and the remaining left side manifested severe hydronephrosis and vesicoureteral reflux (VUR). After the immediate nephrostomy, renal function was recovered and hematuria was improved preservatively. By the rectal examination, a goose egg size and stony hard prostate was detected. The needle biopsy of the prostate revealed pathologically transitional cell carcinoma (TCC) G2, and the image findings showed stage of T4N0M0 of the prostatic carcinoma. Modified pelvic exenteration was performed, and specimens were examined by the step section method. The diagnosis was TCC, G2 > G3 and stage of pT4N0 in the right lobe of the prostate. This case is she 20th reported case in Japan. We emphasize the importance of the mapping of dissected specimens and the reviewed literature.

The urethral polyps in children are different from those in adults because the polyps usually originate at the proximal vermontanum, and are covered with transitional epithelium. A case of posterior urethral polyp in a child is reported herein. In this case, 5 years of age, the polyp was thought to be the cause of urinary tract infection (UTI) and histological findings revealed fibrous non-prostatic tissue. Transurethral resection of polyp was performed successfully.

In a multicenter trial at 17 institutions, the usefulness of an oral dose of 300 mg of tosufloxacin (TFLX) twice a day for 14 days were assessed in the management of chronic bacterial prostatitis (CBP) diagnosed by Meares and Stamey method. Nineteen patients who were evaluated by the UTI criteria were chosen out of the 27 patients diagnosed with CBP. The isolated bacteria from EPS were 18 species and 27 strains. In terms of MICs of isolates, TFLX gave lower MICs than any of the control drugs (CPFX, NFLX, OFLX, CCL). In particular, this tendency was clear for gram-positive coccus and anaerobes. The bacteriological elimination rate obtained for 14 strains and 19 species was 89.5% (17/19) [GPC; 75.0% (6/8), GNR; 100% (7/7), Anaerobes; 100% (4/4)]. The overall clinical efficacy by the UTI criteria was documented in 94.7% (18/19). According to the doctor's evaluation, the overall clinical efficacy rate was 68.4%. Safety evaluation revealed the development of gastrointestinal symptoms in 3 cases, which were not serious, with an incidence rate of 4.0% (3/75), while no laboratory abnormalities were observed. Transference of TFLX into the prostate is slightly lower than in other new quinolones. However, from this study we considered that the higher antibacterial activity of TFLX is one of the reasons for its usefulness for CBP.

The relation between symptom scoring (Boyarsky symptom severity score) and their outcome of the treatments for the patients with prostatodynia were evaluated. The patients with poor outcome were examined by uroflowmetry. Twenty-two of the 236 patients with prostadodynia complained of severe symptoms of voiding (score over 7) at the first presentation. Since those patients fell into the poor outcome category by the conventional treatments (p < 0.01), there may be some possibility that this group suffered from conditions other than prostatitis or other unknown causes. The 9 patients with severe voiding symptoms and poor outcome indicated abnormal uroflowmetric results such as abnormal peak flows in 8 patients and abnormal uroflow curves in all 9 patients. This strongly suggests that these patients have lower urinary tract dysfunctions. In conclusion, measurement of Boyarsky symptom severity scores and uroflowmentry is a useful screening method for the patients with prostatodynia with severe voiding symptoms to rule out the lower urinary tract dysfunctions.

Clinical efficacy of IPM/CS against urinary tract infections (UTI) was evaluated on 19 patients with malignancies (bladder tumor: 15, prostate cancer: 3, uterus cancer: 1) and 1 patient with a benign disorder (ureter stenosis) who had undergone ureterocutaneostomy between January, 1988 and December, 1990. Their ages ranged from 42 to 79 years. Postoperatively, they had UTI with pyuria of greater than or equal to 5/hpf and bacteriuria of greater than or equal to 10(4)/ml. IPM/CS was administered at a dose of 0.5 g (0.25g/0.25 g) twice a day through intravenous drip infusion. Its efficacy was evaluated according to the UTI criteria for clinical evaluation as ruled by the Japanese Society of Chemotherapy. Overall clinical value was rated "excellent" in 4 (20%), "moderate" in 9 (45%) and "poor" in 7 (35%) cases for a total of 65%. The efficacy by types of infection was 33% and 70.6% in the group of single infection and in the group of mixed infection, respectively. As to bacteriological efficacy 34 of the 38 strains (89.5%) isolated were eradicated following its administration. The eradication rate was 84.6% for P. aeruginosa, and 84.6% for E. faecalis. Microbes which appeared after its dosing amounted to 6 classes of 17 strains, 6 NFB strains of which were identified. As a side effect, elevation of serum GPT (5%) was noted. Regardless of the underlying conditions (malignant diseases and ureterocutaneostomy), clinical efficacy of IPM/CS was appreciable. In addition, the MIC for (P. aeruginosa, E. faecalis) of IPM/CS was lower than that of PIPC.

We analyzed the incidence of anal disease in patients with nonbacterial prostatitis (NBP) or with prostatitis-like syndrome (PLS), and evaluated the clinical efficacy. The complicated rate of anal disease in these patients was 29.7% (31.8% for NBP and 28.1% for PLS), and the overall incidence of active anal disease was 15.4% (16.2% for NBP and 14.8% for PLS), it yielded a significantly higher complicated rate than other urological disease (p less than 0.01). The most common type of anal disease was hemorrhoids, especially piles. The clinical cure rate for anal disease in NBP patients was 71.4%, and in PLS patients was 58.2%. The high incidence of hemorrhoids (especially piles) was in these patients by clinico-statistical observation suggests that the development of anal disease may be etiologically correlated with NBP and PLS. Furthermore, we noted that Kampo treatment (Keisibukuryogan) was useful in the treatment of prostatitis complicated by anal disease, especially when combined with anti-hemorrhoidal suppositories against active anal disease in PLS patients (p less than 0.05).

Bladder tumor antigen (BTA) is a tumor marker isolated from the urine of individuals with TCC of the bladder. This antigen can be detected by the Tu-MARK BTA test, a simple and rapid slide latex agglutination test performed on freshly voided urine. Sensitivity and specificity of BTA were calculated, and the correlation with pathological grade, histological stage, and urinary findings were statistically evaluated (chi 2-test) in 110 patients (72 male, 38 female; age: 16-91, mean age 54.4) examined between September, 1989 and April, 1990 including 46 TCC of the bladder (primary 28, secondary 18; grade 1:10, grade 2:27, grade 3:9, pTis: 2, pTa: 2, pT1: 23, pT2: 5, pT3: 4, pT4: 2), and 64 benign diseases. Sensitivity was 45.6%, specificity was 60.9%. In bladder tumor cases a correlation was seen between BTA and stage (p less than 0.02), and between BTA and grade (P less than 0.05). The positive ratio was higher in T1-T4 (55.9%) than in Tis.Ta (p less than 0.02). A high positive ratio of BTA was seen in bladder tumor cases with hematuria (70%, p less than 0.01) and pyuria (86.7%, p less than 0.01). This method is easy and rapid and the values are highly correlated with stage. Therefore, it should be useful for not only screening but followup of bladder tumor. Furthermore, BTA in combination with urine cytology is a more useful way for diagnosing TCC of the bladder.

Kampo treatment was attempted in cases of chronic nonbacterial prostatitis and prostatitis-like syndrome which was intractable or recurred when treated with western medicine. The clinical effects of Kampo treatment were excellent in 21.3% with an efficacy rate of 67.2% for the cases with chronic non-bacterial prostatitis, and excellent in 19.5% with an efficacy rate of 52.4% in the cases with prostatitis-like syndrome. When the clinical effects were compared with those of western therapy performed in the cases which had recurrence, Kampo treatment showed more excellent effects (p less than 0.1) for both types of disease, and the treatment with Chinese medicine was suggested useful. In a comparison of the effects between the cases given only Kampo treatment and those given both Kampo treatment and western treatment using anti-inflammatory agents, no difference was seen in the cases with the prostatitis-like syndrome, but in the cases with chronic non-bacterial prostatitis, the effects were better in the concomitant treatment group than in the group given only Kampo treatment (p less than 0.1). The response to the Kampo treatment differed depending on the type of disease. Among the antibacterial agents used concomitantly in the cases of chronic non-bacterial prostatitis, new-quinolones showed better results than ST compounds or tetracyclines, but no statistically significant differences were seen among the drugs. Of the Kampo drugs used, Keisibukuryogan and Simotuto showed high clinical usefulness in both types of disease and there was no statistically significant difference among the other drugs. The incidence rate of side effects (Goji) due to Kampo treatment was 6.3% and was higher in patients administered Keisibukuryogan.

In accordance with the criteria for clinical evaluation, established by the UTI research group, 43 cases of chronic bacterial prostatitis were retrospectively analyzed. The subjective symptoms were "resolved" in 18.5%, "improved" in 46.5%, and "persisted" in 34.9%. The white blood cells were "cleared" in 34.9%, "decreased" in 37.2%, and "unchanged" in 27.9%. The bacteria were "eliminated" in 51.2%, "decreased" in 16.2%, "replaced" in 11.6%, and "unchanged" in 21.0%. Overall clinical efficacy was "excellent" in 51.2%, "moderate" in 39.5%, and "poor" in 27.9%, with an overall effectiveness rate of 72.1%. Bacteria (isolated bacteria: 8 species, 52 strains) were "eradicated" in 69.2% (GNR 71.4%, GPC 66.7%), and "persisted" in 30.8%. The bacterial eradication rate was 87.5% for E. coli, 58.3% for S. epidermidis, and 75.0% for E. faecalis. The analytical results of the clinical effects, classified by characteristic factor, showed significantly better results, in the excellence rate (p less than 0.05) and the overall effectiveness rate (p less than 0.01) of primary cases as compared with relapse cases. Among the isolated bacterial species, GNR showed more favorable results in comparison with GPC but without any significant difference. Further, the results of 81.3% for E. coli, 66.7% for S. epidermidis, and 62.5% for E. faecalis, indicates no significant difference between respective bacterial species. The new quinolones showed a favorable rate of 92%, followed by 80% of ST (sulfamethoxazole-trimethoprim), and 78% of tetracyclines, with a significant difference (p less than 0.01) in comparison with the mean overall effectiveness rates of cephems, penicillins, and old quinolones.(ABSTRACT TRUNCATED AT 250 WORDS)

The visualization of non-ionic contrast medium (Omnipaque 300) in the excretory urography by bolus injection was examined with regard to the normal sided urinary tract in patients with urolithiasis using a densitometer and further compared with that of ionic contrast medium (60% Urografin). In relation to the photographing method, both contrast media showed an increasing frequency of high opaque site in the order of Tomo, A-P and P-A images, which tended to shift from the upper to the lower urinary tract. In relation to the site of determination, both agents showed a good image in the upper urinary tract by the each photographings, while P-A image was better than A-P image in the lower urinary tract, suggesting their high usefulness for the imaging diagnosis. The visualization in relation to the contrast medium used was better in Omnipaque 300 groups than in 60% Urografin group with a significant difference (P less than 0.05-0.01) in the calyx and pelvis of the kidney by the each photographings, suggesting a high usefulness of non-ionic contrast medium. A densitometer seemed to be a useful means for evaluation and examination of the visualization with excellent objectivity as compared with conventional macroscopic methods.

Changes in the visualization of non-ionic contrast medium (Omnipaque 300) in the urography by DIP were monitored for the normal sided urinary tract in patients with urolithiasis using a densitometer. In addition, changes of the visualization in relation to the dose of contrast medium used was examined and compared with that of ionic contrast medium (60% Urografin). The optimum photographing time was 15 minutes in the upper urinary tract (nephrogram, calyx, pelvis, upper ureter) and 20 minutes in the lower urinary tract (lower ureter, urinary bladder). Visualization of high usefulness appeared to be obtainable for the imaging diagnosis by DIP in subjects with normal renal function even when the photographing was completed 20 minutes after infusion of contrast medium. In relation to the doses of contrast medium used, no difference was observed in the variation pattern but a better imaging was obtained in the 100 ml group than 50 ml group with a significant difference (P less than 0.01) in the 15-20 minute images of the calyx and pelvis of the kidney and urinary bladder in particular, this suggested the high usefulness of 100 ml dosing for the imaging diagnosis. In the visualization of ionic contrast medium, some difference was observed in the variation pattern and the visualization was better in Ominpaque 300 groups than in 60% Urografin group with a significant difference (P less than 0.01) in the 15-20 minute images of the calyx and pelvis of the kidney and urinary bladder. This suggested the high usefulness of non-ionic contrast medium.

Two rare cases of pheochromocytoma were reported. Case 1 was 39-year-old housewife who was referred for history of high fever with left hypochondralgia twice in the previous 15 months before coming to our department. The patient had neither elevation of blood pressure nor that of central and peripheral venous catecholamine concentration. A left suprarenal mass was found in CT, which was suggested to be a cyst due to the numerical value between 23-24. Further ultrasonographic study indicated a solid tumor. Left adrenalectomy was done. Histologically, some of the viable atypical adrenal cells were found in the capsulating tissue contained the necrotic material which was almost occupying the entire mass. Case 2 was a 64-year-old female with hypertension who was admitted for further examination. On the hospital course, the blood pressure returned to normal without medication. Circulating blood volume was extremely reduced (below 1/2 of normal), the replacement of which raised the blood pressure to cause hypertension. An angiographic study indicated only a right adrenal mass, whereas left adrenal venous catecholamine concentration was significantly higher than that of the right side. After confirming right adrenal with no other disorders by CT scan, right adrenalectomy was carried out. Intraoperative correction of hypertension has been sustained and cardiovascular symptoms have disappeared.

Forty-six inpatients with complicated urinary tract infections (UTI) were treated with 2 g piperacillin (PIPC) twice a day through drip intravenous infusion. After 5 days, evaluation was made using the criteria proposed by the UTI Committee in Japan. The overall clinical efficacy was rated "excellent" in 4 (8.9%), "moderate" in 22 (47.8%), and "poor" in 20 (43.5%) cases with a total efficacy rate of 56.5% (26/46). We previously presented the clinical efficacy of PIPC in 74 cases with complicated UTI. Herein, a total of 120 cases were analyzed and these cases were divided into two groups. The overall clinical efficacy, bacteriological response, type of infection, background of patients and its safety were evaluated. Almost no change was seen for four years. Also this study revealed the usefulness against Enterococcus infections. In conclusion, PIPC is still a useful antimicrobial agent against complicated UTI even after the appearance of many new Cephems.

From 1985 to 1986, cisplatin (CDDP) therapy was performed 61 times in 24 patients with urological cancer. Thirty nine courses used fosfomycin (FOM) 4 g/day from the day before CDDP administration to the last dose of CDDP, and we statistically evaluated the prophylactic effect of FOM on CDDP nephrotoxicity using urinary NAG and FENa as parameters (t-test). In the 1-day CDDP group (CDDP 60-70 mg/m2 x 1 day) with FOM a peak NAG was seen on the 1st day but no significant NAG change, FENa has a peak on the 1st day, no significant increase between the previous and the 1st day, but a significant decrease was seen between the 3rd and the 5th day (p less than 0.05). In the 5-day CDDP group (CDDP 20 mg/m2 x 5 day) NAG reached a peak level on the 5th day with FOM, showed significant increase (p less than 0.05; between the previous and the 5th day) and decrease (p less than 0.01; between the 6th and the 14th), compared to those without FOM. FENa change tended to be similar, showing a significant increase, (p less than 0.05; between the 2nd and 4th) and decrease (p less than 0.05; between the 4th and 7th) with FOM but no significant change without FOM. NAG changes with FOM were classified by pre-CDDP dose creatinine clearance (Ccr, ml/min) into 3 groups (under 50, 50-100, over 100). In the 1-day CDDP group with any Ccr no significant NAG change obtained, but, in the 5-day CDDP group with 50-100 Ccr seen a NAG peak on the 6th day, significant increase (p less than 0.05; between the previous and the 6th) and decrease (p less than 0.05; between 6th and 12th). With over 100 Ccr NAG has 4th day peak, significant increase (p less than 0.05; between the previous and the 4th), and decrease (p less than 0.05; between 4th and 8th). A prophylactic effect of FOM on CDDP nephrotoxicity was found in the 5-day CDDP group not in the 1-day CDDP group, using urinary NAG and FENa. PVB and single CDDP regimen (5 day CDDP group) with FOM can be performed safely, if the pre-CDDP dose Ccr is over 50.

The outcome of postsurgical pyuria in benign prostatic hypertrophy was studied in 87 patients, and the factors that might affect the outcome were determined. No significant differences were found between operation method and duration until normalization of pyuria, which was 75.5 +/- 46.0 days for transurethral resection of the prostate, 72.7 +/- 30.6 days for suprapubic prostatectomy and 69.3 +/- 32.7 days for retropubic prostatectomy. Prognostic factors were statistically analyzed preoperatively, at operation, and postoperatively. The definite prognostic factors were preoperative diabetes mellitus, preoperative pyuria, preoperative bacteriuria, and postoperative hypoproteinemia. The probable prognostic factors were old-age, preoperative indwelling catheters, heavy prostate tissue, postoperative bacteriuria, postoperative anemia and postoperative complications.

Clinical efficacy of piperacillin against 74 cases with complicated urinary tract infection was examined. Piperacillin was administered at the dose of 4 g (2 g twice daily) through intravenous drip infusion. The overall clinical value was rated in "excellent", in 9 cases, "moderate" in 34 cases and "poor" in 31 cases with a total efficacy of 58.1%. In the analysis of clinical values based on background, its efficacy was statistically significantly lower in the patients at a higher age, those with complication of diabetes mellitus, and those with indwelling catheter. In operated cases compared to non-operated cases, it was suggested to be more effective for improving the disturbances in urinary flow as a result of the removal of the underlying conditions by the operation. As to bacteriological efficacy, 64 out of 95 strains (67.4%) isolated were eradicated following its administration. Microbes which appeared after its dosing belonged to 9 classes of 18 strains, of which 5 strains (27.8%) of Serratia were identified. Side effects were 2.5% (3/119), no serious cases appeared. Changes in laboratory examination results were elevated GOT (2.5%), GPT (1.7%), and ALP (0.8%) values, all being transient hanges.

We treated 229 cases of chronic prostatitis (bacterial in 29, non-bacterial in 200) and 238 cases of prostatitis-like syndrome and evaluated the clinical efficacy. Clinical efficacy was seen in 77.3% of the chronic prostatitis cases (82.8% bacterial, 76.5% non-bacterial) and 53.8% of the prostatitis-like syndrome cases, with a statistical difference between these two types of disease (p less than 0.01). Treatment included chemotherapy, anti-inflammation agents and minor tranquilizers. None of them were effective against the prostatitis-like syndrome. On the other hand, combination usage (chemotherapies and anti-inflammation agent) was satisfactory on chronic bacterial prostatitis. Also on chronic non-bacterial prostatitis, chemotherapy was significantly effective (p less than 0.05%). Chemotherapeutic effectiveness against chronic prostatitis (both bacterial and non-bacterial) was high with sulfamethoxazole-trimethoprim, tetracyclines, cephalosporins, nalidixic acid and penicillins in this order. There was no difference among these drugs. Prostatic massage was generally effective especially for chronic non-bacterial prostatitis (p less than 0.05) and prostatitis-like syndrome (p less than 0.01). Light psychological treatment was significantly effective toward some cases of prostatitis-like syndrome with strong psychosomatic factors (p less than 0.01).

We clinically evaluated 605 cases of chronic prostatis and other resembling disorders. The incidence was 4.34% of all out-patients (7.54% of male patients). The average age was 38.1 years, and many were adolescents. A greater number of out-patients were seen in October, November, and December (p less than 0.01) and June (p less than 0.05). The type of disease was chronic prostatitis in 48.1% (bacterial in 5.3%, non-bacterial in 42.8%) and prostatitis-like syndrome in 51.9%. The incidence among male patients was 3.63% for chronic prostatitis (bacterial in 0.40%, non-bacterial in 3.23%), and 3.91% for prostatitis-like syndrome. In the case of chronic prostatis, the abnormal finding rate (p less than 0.01), tenderness (p less than 0.01), induration (p less than 0.05) on prostatic palpation, non-pretreated rate (p less than 0.01), urological past history (p less than 0.05) except prostatitis and urological complications (p less than 0.01) were significantly higher. On the other hand, the negative rate on urine culture (p less than 0.01), no abnormal findings on palpation (p less than 0.01), discomfort (p less than 0.01), discomfort with tenderness (p less than 0.01) and past prostatitis episodes (p less than 0.01) were seen significantly more in the case of prostatitis-like syndrome. In conclusion, chronic prostatitis with inflammatory change on prostate and prostatitis-like syndrome without inflammation have similar clinical features, but should be diagnosed as totally different types of disease.