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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Chronic prostatitis/chronic pelvic pain syndrome is a disease that is mainly characterized by three parameters: pain in the suprapubic and pelvic area, presence or absence of white blood cells in expressed prostatic secretions, and voiding disorders of various degrees. The causative factors underlying this very common condition are poorly understood. Therapeutic options (ie, antimicrobial treatment) often are based on the presence of an inflammatory reaction in the expressed prostatic secretions, but the benefit of recurring or prolonged courses of antimicrobial agents is highly variable. Observations have been made regarding functional and structural changes in the lower urinary tract that are suggestive to have an impact on the pathogenesis of chronic pelvic pain syndrome.
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PMID:Chronic pelvic pain syndrome and voiding dysfunction. 1526 Sep 33

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is prevalent in urological practice and has a significant impact on quality of life. Standard therapies often fail to achieve sustainable amelioration of symptoms. This article attempts to show that neuromodulatory treatment in the form of electroacupuncture can be a minimally invasive and effective treatment for CP/CPPS that is refractory to standard therapies. This neuromodulatory therapy lends support to the hypothesis that the end stage of CP/CPPS may be a neuropathic pain syndrome.
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PMID:Acupuncture for chronic prostatitis/chronic pelvic pain syndrome. 1526 Sep 34

The cause of category III A prostatitis, chronic prostatitis/chronic male pelvic pain syndrome category A (CP/CPPS A), is uncertain. Treatments for it are based on consensus opinion rather than on scientific data. Our aim was to examine the effect of zafirlukast, a leucotriene antagonist, on the symptoms of CP/CPPS A in our genitourinary (GU) medicine unit. CP/CPPS A was diagnosed by comparative white cell counts of split urine (Stamey) analysis or by finding an excess of polymorphs in expressed prostatic fluid. Symptom change was assessed by the National Institutes of Health Chronic Prostatitis Symptom Index (CPSI). Patients were given zafirlukast or placebo for four weeks in a random double-blind fashion. All patients also received doxycycline. In all, 31 patients were asked to participate and 17 entered the study. No difference in outcome could be shown between the active (10) and placebo (seven) patients. Zafirlukast cannot be demonstrated to be useful in the symptomatic treatment of CP/CPPS A. The problems of recruitment into this study (in spite of a large number of patients with prostatic type pain being seen in our unit) suggest that multicentre treatment trials using non-invasive diagnostic techniques such as the CPSI (rather than single GU medicine units diagnosing CP/CPPS A by uncomfortable direct prostatic testing) are likely to be the most effective and objective methods of undertaking treatment trials in the CP/ CPPS A field in the future.
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PMID:Treatment of category III A prostatitis with zafirlukast: a randomized controlled feasibility study. 1582 18

The aim of the study was to report our experiences in the treatment of chronic prostatitis using combination regimen including ciprofloxacin, doxazosin, allopurinol and biofeedback perineal massage. From May 2003 to April 2004, 7 patients with NIH Category II-chronic bacterial prostatitis and 7 patients with NIH Category IIIA-inflammatory chronic pelvic pain syndrome were treated. The NIH-Chronic Prostatitis Symptom Index (NIH-CPSI) was scored by the patient before and after the treatment, 6 months later. In Category II patients, the bacterial eradication rate was 71% after ciprofloxacin treatment during a follow-up of 6 months. The beneficial response rate to allopurinol, doxazosin and biofeedback perineal massage was 50%, 42% and 85%, respectively. In NIH Category IIIA patients, the individual beneficial response rate to ciprofloxacin, allopurinol, doxazosin and biofeedback perineal massage was 57%, 100%, 71% and 100%, respectively. Comparing pre-treatment and post-treatment results of the combination regimen, there was a statistically significant improvement in the 3 domains of pain score, urinary symptoms and quality of life impact of the NIH-CPSI. Combination regimen including ciprofloxacin, doxazosin allopurinol and biofeedback perineal massage in the treatment of chronic prostatitis is a safe and effective modality in our limited experience.
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PMID:Combination regimen in the treatment of chronic prostatitis. 1644 88

Chronic prostatitis has been a perplexing problem for urologists for decades. This review explores the perils and pitfalls urologists encounter with epidemiology, etiology, classification, diagnosis, and treatment of this syndrome. The major question involves the problem of developing rational treatment plans for patients with a medical condition associated with genitourinary pain, variable voiding, and sexual dysfunction but no obvious and accepted etiology. Exciting, innovative, ongoing research does offer some solutions and management strategies that urologists can even now incorporate into their practice while waiting for the fundamental questions to be answered.
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PMID:Perplexing problem of persistently painful prostatitis. 1698 90

This study compared the sexual and relationship functioning of 38 male patients with Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) to that of their female partners, and of both the men and women in these couples to those in 37 control couples. Male sexual function was also examined as a predictor of partner sexual function. In comparison to control males, the men with CP/CPPS reported significantly more sexual dysfunction and symptoms of depression. Furthermore, symptoms of depression mediated the relationship between some aspects of sexual function and male participant status as a patient or control. However, men with CP/CPPS did not report significantly decreased sexual satisfaction or relationship functioning compared to controls. Partners of men with CP/CPPS reported significantly more pain upon intercourse, vaginismus, and depressive symptoms when compared to control females. In addition, patients with CP/CPPS and their partners did not differ significantly from each other with regard to sexual functioning and satisfaction, relationship functioning, and symptoms of depression. Patient sexual functioning significantly predicted female partner sexual functioning. This study was the first to evaluate partners of men with CP/CPPS. Patients and partners in this study reported lower levels of sexual functioning in some domains, yet were comparable to control couples on measures of satisfaction and relationship functioning. Furthermore, the sexual and relationship functioning of patients and partners was significantly associated. The results of this study have implications for the assessment and management of CP/CPPS and for future research in this area.
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PMID:Sexual and relationship functioning in men with chronic prostatitis/chronic pelvic pain syndrome and their partners. 1718 30

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a major cause of illness, and its association with history of past urinary tract infections is unclear. We surveyed a racially, ethnically and socioeconomically diverse, community-based sample of adults aged 30-79 years in Boston, MA. This report gives estimates from the 2,301 men in the BACH survey: 700 black, 766 Hispanic and 835 white. Symptoms of chronic prostatitis--any perineal and/or ejaculatory pain and a pain score of > or =4--were derived from the NIH Chronic Prostatitis Symptom Index and were used to identify men with symptoms suggesting CP/CPPS. The overall prevalence of symptoms suggestive of CP/CPPS is 6.3%. The number of urinary tract infections, particularly >3, was associated with symptoms suggestive of CP/CPPS (P < 0.01). There is a strong association between current symptoms of CP/CPPS and a history of urinary tract infections, particularly of multiple infections. The causality between chronic UTIs and CP/CPPS needs to be clarified by further study.
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PMID:Association between past urinary tract infections and current symptoms suggestive of chronic prostatitis/chronic pelvic pain syndrome. 1753 8

Chronic pelvic pain syndrome (CPPS), formerly known as chronic abacterial prostatitis, is characterised by pelvic or perineal pain without evidence of urinary tract infection. It manifests as pain in a variety of areas including the perineum, rectum, prostate, penis, testicles and abdomen [Litwin MS, McNaughton-Collins M, Fowler Jr FJ, Nickel JC, Calhoun EA, Pontari MA, et al. The National Institutes of Health chronic prostatitis symptom index: development and validation of a new outcome measure. Chronic Prostatitis Collaborative Research Network. J Urol 1999;2:369-75]. It is also frequently associated with symptoms including urinary urgency, frequency, hesitancy and poor or interrupted flow. CPPS may be associated with white cells in the prostatic secretions (inflammatory) (NIH-3A), or white cell absence in the prostatic secretions (non-inflammatory) (NIH-3B) [Krieger JN, Nyberg Jr L, Nickel JC. NIH consensus definition and classification of prostatitis. JAMA 1999;3:236-7].
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PMID:Epidemiology and evaluation of chronic pelvic pain syndrome in men. 1816 97

The efficacy of tamsulosin in the treatment of chronic non-bacterial prostatitis was evaluated in a randomized clinical observation of 105 male outpatients conducted for 90 days. Patients were randomly divided into five groups (n = 21 per group) according to prostatitis type IIIA or IIIB and therapy regimens (tamsulosin, levofloxacin, or tamsulosin plus levofloxacin combination therapy). National Institutes of Health Chronic Prostatitis Symptom Index scores, expressed prostatic massage test and urodynamic urethral pressure and urethral closure pressure tests were performed to evaluate clinical efficacy of the treatments. Scores for pain, urinary symptoms and quality of life were significantly improved by days 45 and 90 after all treatments in both prostatitis categories. Improvements in symptom scores in the combined treatment group were significantly superior to those in the single treatment groups. Tamsulosin and levofloxacin are both effective in the treatment of, and may have an additive effect in, the treatment of non-bacterial prostatitis.
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PMID:Tamsulosin treatment of chronic non-bacterial prostatitis. 1838 Sep 33

We investigated the effectiveness of celecoxib in reducing symptoms in patients with difficult chronic pelvic pain syndrome (CPPS), NIH category IIIA. Sixty-four patients with category IIIA CPPS were randomized into two groups of 32 subjects each. One group was treated with celecoxib (200 mg daily) and the other with placebo. All patients underwent treatment for 6 weeks and were evaluated clinically before (baseline) and after 1, 2, 4, 6, and 8 weeks of treatment. The evaluation included the NIH Chronic Prostatitis Symptom Index (NIH-CPSI) and a subjective global assessment (SGA). Repeated measures analysis of variance was used to evaluate treatment and time effects and their interaction. A decrease (means +/- SD) in total NIH-CPSI score from 23.91 +/- 5.27 to 15.88 +/- 2.51 in the celecoxib group and from 24.25 +/- 5.09 to 19.50 +/- 2.50 in the placebo group was observed during treatment (0 to 6 weeks). A statistically significant decrease was observed in pain subscore (P < 0.006), quality of life subscore (P < 0.032) and total NIH-CPSI score (P < 0.015) after 2, 4 and 6 weeks, but not in urinary subscore. In addition, 38% of the celecoxib and 13% of the placebo subjects had at least a moderate improvement in SGA. The trend was similar for the NIH-CPSI scores. However, the response to treatment in terms of total NIH-CPSI score or subscore was not significantly different from placebo after interruption of treatment for 2 weeks. Our results show that celecoxib provides significant symptomatic improvement limited to the duration of the therapy in patients with difficult category IIIA CPPS compared to placebo.
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PMID:Celecoxib reduces symptoms in men with difficult chronic pelvic pain syndrome (Category IIIA). 1978 51


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