The measurement of seminal plasma cytokine, hs-CRP levels and lymphocyte subgroups in men with cpps, and determining the relationship of the disease with autoimmunity and the investigation of the response to two drugs treatment (Levofloksacine, Levofloksacine-Doxycycline )

Chronic pelvic pain syndrome (CPPS) is a common diagnosis, but the etiology of the disease is poorly understood. Diagnosis usually depends on the symptoms of the patients and treatment mainly focuseson antiinflammatory medications and antibiotics although there is an absence of a documented infection. In this study, we aimed to assess the importance of seminal plasma tumor necrosis factor alpha (TNF-?), interleukin 4 ( IL-4 ), interleukin 6 (IL-6), interleukin 8 (IL-8), hypersensitive-crp levels in the diagnosis of CPSS and the response of levofloxacin and levofloxacin+doxycycline treatment İN CPPS patients.Pretreatment semen samples from 37 men with CPPS were obtained. The patients are divided in to randomized groups. The treatment (Group-1) with 20 patients received levofloxacin (500 mg/day) and the Group-2 with (17 patients) received levofloxacin+doxycycline (500mg/day and 200 mg/day) for 4 weeks. TNF-?, IL-4, IL-6, IL-8 levels were measured in the seminal plasma by ELISA and hs-crp level was measured by Nephelometric method. After treatment, seminal plasma levels of these cytokines was measured again in men with CPPS. The patients are evaluated with chronic prostatic symptom index (CPSI) before and after the treatment. After the treatment both groups were compared according to CPSI and cytokine levels.After the treatment, a decrease was determined in CPSI and cytokine levels in group-1 but it were significant in CPSI (20,9±1,99-12,8±4,12-) and hs-crp (0,21±0,150,16±0,1) level (p<0,05). After the treatment, a decrease was determined in CPSI and cytokine levels in group-2 but it were significant in CPSI (20,5±1,97-11,8±3,79) and hs-crp (0,21±0,150,16±0,1) level (p<0,05). After the treatment, was determined in CPSI and cytokine levels in two groups it weren?t significant in CPSI and cytokine levels (p<0,05).Seminal plasma hs-crp level measurements may help to determine which CPPS patients would benefit from the antibiotic therapy and may prevent unnecessary long time antibiotic use.Key words: Chronic pelvic pain syndrome, interleukin , hipersensitive-crp, levofloxacin, doxycycline