Idiopathic lower genitourinary tract syndromes in men cause major morbidity and expenditure of health care resources. For example, half of all adult men suffer from """"""""prostatitis"""""""" at some time, but the etiology is uncertain for over 90% of affected men. Therapy is empirical and often ineffective because we have limited understanding of the causes. The broad, long-term objective of this proposal is to determine the causes, consequences and optimal therapy for these conditions. Our hypothesis is that genitourinary tract infection causes common idiopathic syndromes, particularly nonbacterial prostatitis, prostatodynia and chronic urethritis. This project has three specific aims. 1) We will determine the role of previously suspected urogenital pathogens (e.g., Chlamydia trachomatis, Trichomonas vaginalis, genital mycoplasmas and viruses) using newly available detection methods. 2) We will investigate the potential role of previously unsuspected microorganisms for which we have promising new detection methods. 3) We will study the relationships among genitourinary infection, inflammation in prostatic secretions, sonographic appearance of the prostate and prostate histopathology. Clinical evaluation will include a standardized history and physical examination, symptom score, urological investigations and lower tract localization studies. Subjects will then have transrectal ultrasound and systematic biopsies of the prostate. Complementary experimental studies will determine the prevalence of infection using optimal culture methods plus highly sensitive polymerase chain reaction techniques. The polymerase chain reaction studies will use specific molecular probes as well as broad-spectrum probes to detect previously unsuspected pathogens. Understanding the etiology of common lower tract syndromes will improve urological evaluation and treatment of millions of men annually in the U.S.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Research Project (R01)
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Surgery, Anesthesiology and Trauma Study Section (SAT)
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University of Washington
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Lee, Shaun Wen Huey; Liong, Men Long; Yuen, Kah Hay et al. (2014) Acupuncture and immune function in chronic prostatitis/chronic pelvic pain syndrome: a randomized, controlled study. Complement Ther Med 22:965-9
Lee, Shaun Wen Huey; Liong, Men Long; Yuen, Kah Hay et al. (2011) Validation of a sham acupuncture procedure in a randomised, controlled clinical trial of chronic pelvic pain treatment. Acupunct Med 29:40-6
Riley, Donald E; Krieger, John N (2009) UTR dinucleotide simple sequence repeat evolution exhibits recurring patterns including regulatory sequence motif replacements. Gene 429:80-6
Riley, Donald E; Krieger, John N (2009) Embryonic nervous system genes predominate in searches for dinucleotide simple sequence repeats flanked by conserved sequences. Gene 429:74-9
Lee, Shaun Wen Huey; Liong, Men Long; Yuen, Kah Hay et al. (2008) Adverse impact of sexual dysfunction in chronic prostatitis/chronic pelvic pain syndrome. Urology 71:79-84
Lee, Shaun Wen Huey; Liong, Men Long; Yuen, Kah Hay et al. (2008) Acupuncture versus sham acupuncture for chronic prostatitis/chronic pelvic pain. Am J Med 121:79.e1-7
Riley, Donald E; Jeon, Joon Seong; Krieger, John N (2007) Simple repeat evolution includes dramatic primary sequence changes that conserve folding potential. Biochem Biophys Res Commun 355:619-25
Riley, Donald E; Krieger, John N (2005) Short tandem repeat (STR) replacements in UTRs and introns suggest an important role for certain STRs in gene expression and disease. Gene 344:203-11
Krieger, John N; Ross, Susan O; Limaye, Ajit P et al. (2005) Inconsistent localization of gram-positive bacteria to prostate-specific specimens from patients with chronic prostatitis. Urology 66:721-5
Riley, Donald E; Krieger, John N (2004) Short tandem repeats are associated with diverse mRNAs encoding membrane-targeted proteins. Bioessays 26:434-44

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