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

Seven patients presented with a large perineal abscess eight months to seven years after complete healing of the perineal wound following proctocolectomy. Six patients had had total proctocolectomies for ulcerative colitis and a seventh had undergone abdominoperineal resection for cancer. A typical clinical picture of perineal pain, fever, urinary tract complaints (including retention), and minimal local perineal findings was present. Prostatitis or a urinary tract infection was considered in five patients, but none of them responded to antibiotics. Ultrasound examination of the perineum may confirm the diagnosis; however, diagnostic and therapeutic surgical exploration of the healed perineum is recommended when this diagnosis is unclear.
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PMID:Late occurrence of perineal wound abscess years after total colectomy. 64 35

Authors review the up-to-date questions of the prostatitis diagnostics on the basis of data of nearly 2,000 patients. In case of symptoms indicative of chr. prostatitis it is essential to localise the inflammation to the prostate with laboratory methods and in case of negative finding to identify the organic and functional diseases hidden behind the nonspecific clinical picture. A modified variation of the bacterial localisation culture (4 glasses test) has been applied by the authors in addition to previous methods. Among the potential etiological factors the hypertrophy of prostate stands first above 45 years of age. In the majority of cases etiological factor cannot be proved under 45 years. Among the subjective symptoms the cystitis syndrome, the low back and scrotal pain predominate, whereas among the objective symptoms above 45 years the microscopic pyuria, under 45 years of age the concomittant urethritis. Among Drach's prostatitis prevails (61%) whereas in the older patients prostetodynia, chr. nonbacterial and bacterial prostatitis have similar prevalence. In acute and subacute prostatitis the cystitis and the epididymitis, in chr. prostatis the pathozoospermia (44%) and the neurosis are the most frequent complications. Prostatitis presents a common differential diagnostic problem not only for the urology, but also for the abdominal diagnostics, rheumatology, proctology etc.
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PMID:[Diagnosis of prostatitis in the light of current knowledge]. 247 51

Chronic abacterial prostatitis has all the hallmarks of a chronic pain syndrome without having been identified as such, either in the urology literature or in the pain literature. This review proposes that this common urological syndrome merits consideration as a 'chronic pain syndrome', as it is commonly defined. The presentation of this syndrome in PAIN results from the unlikely collaboration of a clinical psychologist and a urologist with an interest in exploring unconventional assessment and treatment recommendations for the patients he saw in a university-based Prostatitis Clinic. In addition to providing a review of the chronic prostatitis syndrome as it appears in the urology literature, we surveyed the journal, PAIN, from 1985 through 1995 to identify the 'body parts' specifically named in titles of articles on non-malignant pain. There was only one case study report on male genital or urological pain. Similar to other more commonly accepted chronic pain syndromes, chronic abacterial prostatitis has the following characteristics: pain as a primary complaint, low correspondence between symptoms and medical findings, a history of multiple, unsuccessful treatments. The consequence of recognizing this very common urological syndrome as a chronic pain syndrome is that a large group of symptomatic men for whom urologists have little to offer stands to benefit from a different perspective. Experience with other chronic pain syndromes, including back pain and headaches; has shown that interventions based on a multidisciplinary approach can prove complementary to traditional 'organ system' approaches to treatment of these frustrated, and frustrating, patients.
Pain 1997 Feb
PMID:Chronic abacterial prostatitis--a urological chronic pain syndrome? 951 69

Prostatitis refers to the inflammation and/or infection of the prostate gland, which occurs in several forms or syndromes and presents with varied etiologies, clinical features, and sequelae. The four common forms of prostatitis are acute bacterial prostatitis, chronic bacterial prostatitis, nonbacterial prostatitis, and prostatodynia. Differential diagnosis of prostatitis is based on history, physical exam findings, and, frequently, analysis of expressed prostatic secretions. Complaints may vary, but pain or discomfort in the rectal or perineal area is usually present. Clinicians in primary care settings should be knowledgeable about the types of prostatitis, etiology, and pathogenesis; the methods of diagnosis; and treatment/education issues.
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PMID:Prostatitis: diagnosis and treatment in primary care. 912 83

Prostatitis syndromes are frequent and cause pain and discomfort in adult males. Non bacterial types occur more often than bacterial prostatitis. Transrectal ultrasound permits a perfect evaluation of prostate, seminal vesicles and ejaculatory ducts. Fifty-five patients affected by prostatis syndrome and with negative bacteriological studies, underwent transrectal ultrasonography performed with 7.5 MHz probe. In 38 cases (70%) we found abnormalities such as subacute vesiculitis, asymmetric dilation of the seminal vesicle, dilated and calcific ejaculatory ducts, mullerian duct cyst, utricular cyst and calcification. Ultrasonography is able to detect these lesions that often are responsible of the clinical symptom of the prostatitis syndrome, and may have a therapeutic value through guided transperineal needle aspiration or in the planning specific endoscopic surgery.
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PMID:[Role of transrectal echography in the evaluation of obstructive seminal vesicle pathology in prostatitis syndrome]. 916 37

Prostatitis describes a spectrum of disorders involving inflammation of the prostate gland. This common yet poorly understood condition produces an array of symptoms, the most common of which are urinary obstruction, perineal pain, and ejaculatory complications. Although several theories have been proposed regarding its etiology, the exact mechanism of disease remains elusive. Definitive diagnosis can be hampered by a somewhat cumbersome testing procedure, but symptomology tends to be a reliable guide for treatment. Although treatment with antibiotics often fails, the fluoroquinolones are among the most effective agents for symptom management. Other interventions that may be appropriate include alpha-1-adrenergic blockers, a 5-alpha reductase inhibitor, or surgery. Chronic prostatitis may result in repeated urinary tract infections and chronic pain syndromes.
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PMID:Prostatitis. Work-up and treatment of men with telltale symptoms. 1130 21

Prostatitis results in >2 million physician office visits annually. Characterized by pelvic pain and voiding symptoms, chronic pelvic pain syndrome (CPPS) is poorly defined. The Chronic Prostatitis Collaborative Research Network (CPCRN) has put forward a uniform set of classifications for chronic prostatitis based on pain being the primary symptom. The CPCRN has also created a valid instrument for measuring symptoms: the Chronic Prostatitis Symptom Index. After nonbacterial prostatitis has been diagnosed, treatment of patients should be individualized. The condition may be caused by bladder, prostate, pelvic side wall, or seminal vesicle pathology. In addition to currently used treatments, several new therapies are being investigated after promising pilot studies. Despite the multiple approaches to management of CPPS, no hard and fast guidelines have been developed. This review provides an overview of assessment techniques and management options for men with CPPS.
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PMID:Etiology and management of chronic pelvic pain syndrome in men. 1501 57

The diagnosis of chronic pelvic pain syndrome takes into account the fact that no clear etiology has been identified underlying chronic prostatitis and its associations with multiple somatic and psychological complaints. Based on a representative survey, this study enquires into the prevalence of pelvic pain in the community, its association with sexual dysfunction, somatic complaints and aging. Of the 770 men surveyed, 60 (7.8%) fulfilled the criteria for pelvic pain syndrome. This was assessed by a validated Giessen Prostatitis Symptom Score. Sexual dysfunction (particularly erectile dysfunction and loss of libido) were more frequently reported by men with pelvic pain than by men without a pain syndrome. The great majority of men afflicted by pelvic pain complained of additional pain symptoms (particularly back and joint pain) and fatigue. While sexual and somatic complaints were age-associated in the asymptomatic men, this was not the case for the symptomatic men. Our findings stress the fact that chronic pelvic pain syndrome is a major health problem in middle and late adulthood in men. Differentiated knowledge about comorbidity is a prerequisite for developing new interdisciplinary approaches to the diagnosis and therapy of this to date unsatisfactorily treated syndrome.
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PMID:[Chronic pelvic pain and its comorbidity]. 1504 83

A prospective multi-center Italian urology outpatient survey, undertaken to determine the prevalence of prostatitis in Italy, provided an ideal opportunity to identify and characterize the typical prostatitis patient presenting to Italian urologists. A total of 70 urologists, representing a cross section of urologic centers in Italy, counted and recorded the overall total male patients reported in the clinic and the overall total patients diagnosed with prostatitis over a 5 week period in late 2001. Data on demographics, previous diagnoses, symptoms (frequency and severity), quality of life, physical examination and laboratory data were prospectively collected. A total of 1,148 patients were identified with prostatitis (12.8%). Of these, 1,074 patients had complete data and could be included in this characterization analysis. The mean age of the prostatitis patients was 47.1 years (range 16-83); two thirds had experienced their first symptom within the last year. A family history of prostatitis was reported by 20.4%. The most common urinary diseases were benign prostatic hyperplasia (17.4%), recurrent urinary tract infection (11.2%) and urinary calculogenesis (11.1%), while the most common concurrent diseases were diabetes (7.2%) and depression (6.8%). The most frequently reported and most severe symptoms at the time of evaluation were irritative voiding symptoms, perineal and suprapubic pain and discomfort. Over three quarters of the patients were dissatisfied with their quality of life. Bacteria were cultured in 15.6%, 17.7% and 14.0% of expressed prostatic secretions, urine specimens after prostatic massage and semen specimens, respectively. Prostatitis is a common outpatient diagnosis, comprising over 10% of male outpatient visits to urologists in Italy. This comprehensive characterization of the typical prostatitis patient diagnosed in routine urological outpatient practice can be employed to generate hypothesis-driven studies in diagnosis and treatment.
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PMID:Clinical characterization of the prostatitis patient in Italy: a prospective urology outpatient study. 1577 May 19

We review the diagnosis, categorization, and treatment of prostatitis/chronic pelvic pain syndrome based on the National Institutes of Health (NIH) classification. Prostatitis is an extremely common syndrome that afflicts 2%-10% of men. Formerly a purely clinical diagnosis, prostatitis is now classified within a complex series of syndromes (NIH category I-IV prostatitis) that vary widely in clinical presentation and response to treatment. Acute bacterial prostatitis (category I) and chronic bacterial prostatitis (category II) are characterized by uropathogenic infections of the prostate gland that respond well to antimicrobial treatment. In contrast, chronic prostatitis/chronic pelvic pain syndrome (category III), which accounts for 90%-95% of prostatitis cases, is of unknown etiology and is marked by a mixture of pain, urinary, and ejaculatory symptoms with no uniformly effective therapy. Asymptomatic inflammatory prostatitis (category IV) is an incidental finding of unknown clinical significance. This review describes the current status of prostatitis syndromes and explores the future prospects of new diagnostic tools and therapies.
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PMID:Prostatitis/chronic pelvic pain syndrome. 1640 45


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