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The diagnostic yield of the Meares & Stamey test can be significantly improved by symptom-based patient selection and the experience of the test performer

Prostate Cancer and Prostatic Diseases (2024)Cite this article

Subjects

Abstract

Background

Even if Meares-Stamey 4-glass (M&S) test is regarded a decisive tool for diagnosing prostatitis its use is only rarely performed in everyday clinical practice. Here, we analyze if the diagnostic yield of the M&S test could be improved by a pre-test categorization of patients due to undergo a M&S test.

Methods

All clinical and microbiological data of patients who underwent M&S test in two urological centers from January 2004 to December 2021 were analyzed in this retrospective cohort study. One center has a dedicated staff member for the study of prostatitis (Cohort I), while the other center is a general urological unit (Cohort II). All patients were divided into 3 groups on the basis of the assembled data: patients with symptoms related to prostatitis only (Group I), patients with symptoms related to both prostatitis and BPH (Group II), patients with symptoms related to BPH only (Group III). The rates of positive microbiological results in each group were compared.

Results

In the whole period, 9347 patients were analyzed and categorized as follows: Group I, 1884; Group II, 5151; Group III, 2312. Three-thousand and eight-hundred twenty-three patients showed positive culture results (40.9%). The most common isolated species was Escherichia coli (49.7%), followed by Enteroccus spp. (31.8%). The rates of positive M&S tests in the different symptom groups were: Group I, 1532 (81.4%); Group II, 1494 (29.0%); Group III, 797 (34.4%). The overall rate of positive M&S tests in each urology center showed that the center with a staff member who is dedicated to prostatitis studies (Cohort I) had a significantly higher rate of positive M&S tests than the general urological department (Cohort II) (64.3% vs 31.4%; p < 0.001).

Conclusions

Symptom-based patient selection and dedicated staff members will increase the diagnostic yield of the M&S test and reduce the number of unnecessary tests.

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Fig. 1: Study Schedule.

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Data availability

Data is unavailable due to privacy or ethical restrictions in accordance with Italian bylaws.

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Author information

Authors and Affiliations

  1. Department of Urology, Santa Chiara Regional Hospital, Trento, Italy

    Tommaso Cai, Irene Tamanini & Katia Odorizzi

  2. Institute of Clinical Medicine, University of Oslo, Oslo, Norway

    Tommaso Cai & Truls E. Bjerklund Johansen

  3. Department of Health Science, School of Medicine, University of Catanzaro, Catanzaro, Italy

    Luca Gallelli

  4. Department of Infectious Diseases, Santa Chiara Regional Hospital, Trento, Italy

    Massimiliano Lanzafame

  5. Microbiology Unit and STDs Centre, Santa Maria Annunziata Hospital, Firenze, Italy

    Sandra Mazzoli

  6. Department of Microbiology, Santa Chiara Regional Hospital, Trento, Italy

    Paolo Lanzafame

  7. Department of Cellular, Computational and Integrative Biology (CIBIO), University of Trento, Trento, Italy

    Orietta Massidda

  8. Interdepartmental Centre of Medical Sciences (CISMed), University of Trento, Trento, Italy

    Orietta Massidda

  9. Department of Urology, University of Naples, Federico II, Naples, Italy

    Alessandro Palmieri

  10. Clinic for Urology, Pediatric Urology and Andrology, Justus Liebig University, Giessen, Germany

    Florian M. E. Wagenlehner

  11. Department of Urology, Oslo University Hospital, Oslo, Norway

    Truls E. Bjerklund Johansen

  12. Institute of Clinical Medicine, University of Aarhus, Aarhus, Denmark

    Truls E. Bjerklund Johansen

  13. Department of Urology, Sant’Andrea Hospital, Sapienza University, Rome, Italy

    Cosimo De Nunzio

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  1. Tommaso Cai
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Contributions

Conceptualization, TC and SM; methodology, TC and OM; formal analysis, TC and LG; data collection, PL, IT, KO, ML; writing, original draft preparation, TC and TEBJ; writing, review and editing, FMEW and AP; supervision CDN. All authors have read and agreed to the published version of the manuscript.

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Correspondence to Tommaso Cai.

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Cai, T., Tamanini, I., Odorizzi, K. et al. The diagnostic yield of the Meares & Stamey test can be significantly improved by symptom-based patient selection and the experience of the test performer. Prostate Cancer Prostatic Dis (2024). https://doi.org/10.1038/s41391-024-00824-0

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