CORRELATION BETWEEN PARACLINICAL PARAMETERS AND CLINICAL MANIFESTATIONS OF CHRONIC PROSTATITIS / CHRONIC PELVIC PAIN SYNDROME

Introduction. Chronic prostatitis/chronic pelvic pain syndrome is a prevalent multifactorial disorder affecting men of reproductive age and characterized by pelvic pain and lower urinary tract dysfunction. Despite extensive research, its diagnosis remains challenging due to the absence of specific clinical markers and the inconsistency of paraclinical findings. Current diagnostic approaches emphasize the use of ultrasound, laboratory, and uroflowmetric assessments to evaluate the urological domain of the сhronic prostatitis phenotype; however, their correlation with symptom severity has not been definitively established. Objective. To assess the diagnostic value of ultrasound, laboratory, and uroflowmetric parameters and to determine their relationship with symptom severity according to the NIH-CPSI in patients with сhronic prostatitis/chronic pelvic pain syndrome. Participants and methods. The study included 128 men aged 18–40 years, stratified into subgroups with mild (≤14 points), moderate (15–29 points), and severe (≥30 points) symptoms. Transabdominal prostate ultrasound with postvoid residual measurement, serum prostate-specific antigen  assessment, and uroflowmetry were performed. Results. Patients with more severe clinical manifestations demonstrated larger prostate and residual urine volumes. Morphological features such as parenchymal heterogeneity or calcifications showed no significant association with symptom severity. Serum prostate-specific antigen  levels remained within physiological limits in most participants and did not correlate with disease severity, indicating the limited diagnostic value of this marker in сhronic prostatitis. Cytological examination of prostatic secretion revealed signs of mild aseptic inflammation unrelated to symptom intensity, suggesting a predominantly noninfectious and multifactorial inflammatory process. Uroflowmetric parameters reflected functional lower urinary tract disturbances characteristic chronic prostatitis / chronic pelvic pain syndrome, with reduced peak flow rate and prolonged voiding time observed more frequently in patients with pronounced symptoms. The correlation between uroflowmetric indices and dysuria subscores on the NIH-CPSI supports their diagnostic utility as objective measures of urinary tract function. Conclusions. No single paraclinical parameter provides an adequate assessment of сhronic prostatitis/chronic pelvic pain syndrome severity. The combined use of clinical evaluation via the NIH-CPSI and verification through ultrasound and uroflowmetry enhances the accuracy of patient stratification and may contribute to individualized management strategies.