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17. Doble A, Thomas BJ, Furr PM, Walker MM, Harris JR, Witherow RO, and Taylor-Robinson D: A search for infec- tious agents in chronic abacterial prostatitis using ultrasound guided biopsy. Br J Uro164: 297-301, 1989.
18. Orland SM, Hanno PM, and Wein AJ: Prostatitis, prostatosis, and prostatodynia. Urology 25: 439-459. 1985.
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EDITORlAL COMMENT This study is in two parts, which are linked by the com-
mon bond of a condition diagnosed by the absence of objec- tive findings. Nonbacterial prostatitis or prostatodynia refers to a symptom complex affecting the lower urinary tract, but without the bacteriological finding of chronic bacterial pros- tatitis. It is therefore important to remember that when test- ing a drug in patients with this condition, the absence of ob- jective findings introduces a placebo possibility that is probably highly significant. The authors address this in an
interesting way; realizing that this is the case, they introduce a symptom score that might be of value in the future when considering this condition. This is subjected to a rigorous statistical analysis and seems sound. The one shght criticism one might have is that the authors, although referring to a score that would be useful in nonbacterial prostatitis and prostatodynia, consistently refer to one of the groups as the “prostatitis group.”
Anything that helps in prostatodynia is of value; this is an open study and so the possible weakness of a potentially strong placebo effect is not excluded. The authors point out the possible rationale for the use of terazosin in this condi- tion, and this is helpful to the clinician. It is of help to the clinician that another agent can be offered to patients with this condition, but I would agree with the authors that a ran- domized placebo-controlled trial should be performed.
John Fitzpatrick, M.D. Surgical Pro/&sorial
47 Eccles Street Dublin 7, Ireland
UROLOGY / APRIL 1994 / VOLUME 43, NUMBER 4 465
