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Letters to the Editor
Rebuttal: A Prospective Study on Association of Prostatic Calcifications with Sexual Dysfunction in Men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) DOI: 10.1111/jsm.12781
Author’s reply: We are most grateful for the comments in the letter from Dr. Qian et al. on our paper recently published in The Journal of Sexual Medicine [1]. In our study design, infections localized to the prostate (i.e., acute or chronic bacterial prostatitis) were excluded. The presence of leukocytes in expressed prostatic secretions was categorized as the inflammatory subtype of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) (Type IIIA), not the category II prostatitis. I agree with Qian’s opinion that erectile function might be affected by aging diseases in these patients. In our study of 358 CP/CPPS patients, however, no significant differences were found in patients’ age, comorbidity presence (diabetes, cardiovascular disease, hypertension), and prostate size in the patients with and without prostatic calcifications. Furthermore, univariate and multivariate logistic regression analyses demonstrated that age, obesity, comorbidities, and prostate size were not the predisposing factors for erectile dysfunction (ED) in patients with CP/CPPS. This is likely due to the homogenous characteristics of the study population, which is considered as one of the advantages of our study, to eliminate the statistically significant effect of these risk factors on sexual dysfunction of the studied groups and enable us to draw the valid association between the presence of prostatic calcifications and ED. Although prostatic calcifications can be generally divided into two categories (type I and type II), the criteria for defining and classifying prostatic calcifications have yet to be well established [2]. For example, in the study by Park et al. [3], hyperechoic areas with shadowing and larger than 3 mm in size were diagnosed as prostatic calculi, whereas those without shadowing and tiny stippled calcifications (
Letters to the Editor
Rebuttal: A Prospective Study on Association of Prostatic Calcifications with Sexual Dysfunction in Men with Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) DOI: 10.1111/jsm.12781
Author’s reply: We are most grateful for the comments in the letter from Dr. Qian et al. on our paper recently published in The Journal of Sexual Medicine [1]. In our study design, infections localized to the prostate (i.e., acute or chronic bacterial prostatitis) were excluded. The presence of leukocytes in expressed prostatic secretions was categorized as the inflammatory subtype of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) (Type IIIA), not the category II prostatitis. I agree with Qian’s opinion that erectile function might be affected by aging diseases in these patients. In our study of 358 CP/CPPS patients, however, no significant differences were found in patients’ age, comorbidity presence (diabetes, cardiovascular disease, hypertension), and prostate size in the patients with and without prostatic calcifications. Furthermore, univariate and multivariate logistic regression analyses demonstrated that age, obesity, comorbidities, and prostate size were not the predisposing factors for erectile dysfunction (ED) in patients with CP/CPPS. This is likely due to the homogenous characteristics of the study population, which is considered as one of the advantages of our study, to eliminate the statistically significant effect of these risk factors on sexual dysfunction of the studied groups and enable us to draw the valid association between the presence of prostatic calcifications and ED. Although prostatic calcifications can be generally divided into two categories (type I and type II), the criteria for defining and classifying prostatic calcifications have yet to be well established [2]. For example, in the study by Park et al. [3], hyperechoic areas with shadowing and larger than 3 mm in size were diagnosed as prostatic calculi, whereas those without shadowing and tiny stippled calcifications (
