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Social Determinants of Chronic Prostatitis/Chronic Pelvic Pain Syndrome Related Lifestyle and Behaviors Among Urban Men in China: a Case-Control Study

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Social Determinants of Chronic Prostatitis/Chronic Pelvic Pain Syndrome Related Lifestyle and Behaviors Among Urban Men in China: a Case-Control Study Hindawi Publishing Corporation BioMed Research International Volume 2016, Article ID 1687623, 7 pages http://dx.doi.org/10.1155/2016/1687623 Research Article Social Determinants of Chronic Prostatitis/Chronic Pelvic Pain Syndrome Related Lifestyle and Behaviors among Urban Men in China: A Case-Control Study Yan Wang,1 Chen Chen,1 Changcai Zhu,1 Liang Chen,1 Qingrong Han,2 and Huarong Ye3 1 Department of Preventive Medicine, School of Public Health, Wuhan University of Science and Technology, 2 Huangjia Lake West Road, Hongshan District, Wuhan, Hubei 430065, China 2Yiling Hospital, 31 East Lake Avenue, Yiling District, Yichang, Hubei 443100, China 3ChinaResources&WISCOGeneralHospital,209MetallurgyRoad,QingshanDistrict,Wuhan,Hubei430080,China Correspondence should be addressed to Changcai Zhu; [email protected] Received 15 December 2015; Accepted 29 June 2016 Academic Editor: Yongsheng Bai Copyright © 2016 Yan Wang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Purpose. In order to find key risk factors of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) among urban men in China, an age-matched case-control study was performed from September 2012 to May 2013 in Yichang, Hubei Province, China. Methodology. A total of 279 patients and 558 controls were recruited in this study. Data were collected by a self-administered questionnaire, including demographics, diet and lifestyle, psychological status, and a physical exam. Conditional logistic regression model was used to analyze collected data. Results. Chemical factors exposure, night shift, severity of mood, and poor self-health cognition were entered into the regression model, and result displayed that these four factors had odds ratios of 1.929 (95% CI, 1.321– 2.819), 1.456 (95% CI, 1.087–1.949), 1.619 (95% CI, 1.280–2.046), and 1.304 (95% CI, 1.094–1.555), respectively, which suggested that these four factors could significantly affect CP/CPPS. Conclusion. These results suggest that many factors affect CP/CPPS, including biological, social, and psychological factors. 1. Introduction [7]. New diagnostic/therapeutic criteria targeted to the uri- nary, psychosocial, organ-specific, infection, neurological/ Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) systemic, and tenderness (UPOINT) system were developed is a chronic pain disorder, which is characterized by the pres- by Shoskes et al. in 2009 to classify patients suffering with CP/ ence of noninfectious pelvic or perineal pain lasting longer CPPS and, more importantly, to direct appropriate therapy than 3 months. The International Prostatitis Collaborative [8]. Multimodal therapy based on the UPOINT phenotype Network of the National Institutes of Health (IPCN-NIH) system greatly improves the symptoms of CP/CPPS [9, 10]. has provided detailed criteria for diagnosing CP/CPPS [1, 2]. According to various epidemiological studies using different Currently, CP syndromes represent an important health- methodologies, the prevalence of CP/CPPS varies from care problem worldwide [11]. Furthermore, many studies approximately 8% to 20% worldwide [3–6]. A population- have suggested that CP places a large financial burden on based survey estimated that the prevalence of CP/CPPS-like patients and society. Chronic prostatitis increases healthcare symptoms in China is 4.5% [4]. expenditures directly and indirectly (e.g., unemployment). Although there have been many basic and clinical The average total costs (direct and indirect) for 3 months research studies, the exact etiology, pathophysiology, and of CP treatment is USD 1099 per person for resource con- mechanism of CP/CPPS remain indeterminate. This syn- sumption, with an expected annual total cost per person of drome is currently considered to be a multifactorial medical USD 4397 [12]. In China, treatment for CP is relatively costly condition and requires a multimodal treatment approach (USD 1151 or 8059 CNY per person) [13]. 2 BioMed Research International A cross-sectional study about CP/CPPS patients has domains of items, including demographics (age, degree been done previously; it was reported that there were many of education, occupation, medical insurance, and average potential factors that might have an influence on CP/CPPS, monthly income), lifestyle (frequency of eating fast food, time including smoking, drinking tea, sedentariness, overstress, of using a mobile per day, smoking, drinking, drinking tea, economic pressure, and self-health cognition [14, 15]. How- and sedentariness), working situation (occupational hazards, ever, as a cross-sectional study they could not give more night shift), psychological status (severity of bad mood, stress information about risk factors and affected degree. Therefore, of work, economic stress of family, self-health cognition, based on the results of the cross-sectional study several and spousal relationship), and a physical exam. The item of factorswereselectedandacase-controlstudywasconducted occupational hazards determined by type of work was asked for further study of risk factors of CP/CPPS. by questionnaire investigators. The questionnaire was self- administered after informed consent unless the participant 2. Materials and Methods was illiterate. 2.1. Study Setting and Target Population. This case-control 2.5. Statistical Analysis. The collected questionnaires were study was conducted in Yiling District, Yichang, Hubei collated manually for the first time. They were then checked Province, China. The study included one administrative againwhilethedatawereenteredintothedatabasesetupby district, one economic development zone, eight towns, and Epi database. Data were analyzed using descriptive statistical three townships. With a total area of 3424 square kilometers methods, the chi-square test, and conditional logistic regres- and a population of 546,500, this district is the most populous sion analysis. The Statistical Package for Sciences (SPSS) administrative region of Yichang. Most of the residents are software version 17.0 (SPSS Inc., Chicago, IL, USA) was used drivers or laborers. The target populations of this study are for data analysis. The significance level was set at < 0.05. composed of male patients diagnosed with CP/CPPS for the first time in Yiling Hospital and healthy men without 3. Results CP/CPPS symptoms in Yiling District. Data were collected from 279 patients with CP/CPPS between September 2012 3.1. Sociodemographic Characteristics. Atotalof279patients and May 2013. Five hundred and fifty-eight males matched and 558 controls were recruited to participate in this ret- by age (1 : 2) without CP/CPPS symptoms were enrolled into rospective survey. All of the participants completed the the control group. questionnaire. The age of all of the subjects ranged from 24to 59 years. The mean age of all of the subjects was 43.30 ± 7.92 2.2. Selection Criteria for Cases and Controls. Diagnosis years. The mean ages of patients and controls were 43.57±8.09 of patients with CP/CPPS was based on the IPCN-NIH years and 43.16 ± 7.84 years, respectively. consensus [1] following a critical medical interview, a digital For cases, 72.04% of subjects were aged between 30 and rectal examination, a prostate secretion examination after 49 years. Only one subject was illiterate, and most (82.79%) prostate massage, and urinalysis. Patients who suffered from had a middle school or high school diploma. A total of 78.14% pyuria and other genitourinary symptoms that may be asso- of the patients were employed as skilled laborers. A total ciated with benign prostatic hyperplasia, chronic bacterial of 86.73% of the patients had medical insurance for urban prostatitis, acute prostatitis, or genitourinary diseases other workers except for 3 who were reported as self-paying when than CP/CPPS were excluded from the study to minimize seeing a doctor. More than 80% of the patients had an average themeasurementbias.Thecontrolsubjectswerehealthy monthly income less than 3000 CNY (483 USD), and only 10 men without CP/CPPS symptoms who participated in a patients had an average monthly salary of more than 5000 physical examination in Yiling Hospital. People who had CNY (805 USD) (Table 1). been diagnosed with benign prostatic hyperplasia, chronic Similarly, 72.22% of the controls were aged between 30 bacterial prostatitis, acute prostatitis, or other genitourinary and 49 years. Most of the controls were employed as skilled diseases were excluded from the controls. Every case was laborers. A total of 86.73% of the controls had medical matched with two controls by age within ±2years. insuranceforurbanworkers,whereasfivesubjectswere reported as self-paying when seeing a doctor. Almost 80% of 2.3. Ethical Approval. The study was approved by the Medical the control subjects’ average monthly income was less than Ethics Committee of Wuhan University of Science and 3000 CNY (483 USD). All of the controls received school Technology. Written informed consent was obtained from the education, and 82.79% had a secondary school or high school study subjects who were assured of confidentiality by the use diploma (Table 1). of anonymous questionnaires. Verbal consent was also sought from community leaders prior to the focus group discussions. 3.2. Chi-Square Test for Single-Factor Analysis. Table 2 shows thevaluesofsignificantriskfactors.Table3showstheresults 2.4. Data Collection. An
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