Counting WBCs

Counting White Blood Cells (WBCs) in the Expressed Prostatic Secretions (EPS)

As of 2004, no agreement has been reached on the best method to count WBCs in the prostatic fluid. Krieger et al. compared wet mounts, Gram-stains, and counting chambers, and has proposed using a counting chamber for WBC quantification in future research studies.[1] The National Institutes of Health uses a WBC count greater than 10 WBCs per wet mount field at 400 times magnification to diagnosis prostatitis, and they use a one-time collection of EPS only.

The Giessen Group uses 10 or more leukocytes per 1000x magnification in the EPS or VB3, after Papanicolaou staining as their definition of inflammatory prostatitis.[2]

Other centers use the number of white blood cells under 1,000 times magnification and use repetitive prostatic massage to follow the white blood cell count over time.

It’s my belief that examining the prostatic fluid more times and under higher power is more accurate as you are sampling the data more often.

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Written for ProstatitisAndBPH.org October 19, 2004, by Bradley Hennenfent, M.D.

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[1] Krieger JN, Ross SO, Deutsch LA, Fritsche TR, Riley DE: Counting leukocytes in expressed prostatic secretions from patients with chronic prostatitis/chronic pelvic pain syndrome. Urology. 2003 Jul;62(1):30-4.

[2] Schneider H, Ludwig M, Hossain HM, Diemer T, Weidner W: The 2001 Giessen Cohort Study on patients with prostatitis syndrome--an evaluation of inflammatory status and search for microorganisms 10 years after a first analysis. Andrologia. 2003 Oct;35(5):258-62.