Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030794 (pelvic pain)
 4,056 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In summary, prostatitis is a complex syndrome that spans a spectrum from acute prostatitis with a straightforward presentation to CP-CPPS with a complex array of symptoms. The identification of prostatic or pelvic pain becomes a requirement for the diagnosis of CP-CPPS. The NIH system of prostatitis categorization is a refinement of the traditional classification of prostatitis by Drach et al, which was based on the localization test of Meares and Stamey. The NIH categorization system allows for a framework to define the disease process, and the NIH-CPSI was created to quantify the symptoms of chronic prostatitis. Integral to the classification of prostatitis is the presence or absence of inflammation, determined by looking for leukocytes in the EPS, seminal fluid, and VB3 specimens. In addition, the role of bacteria as a cause in category III prostatitis continues to be debated. Future research into using inflammatory markers (eg, tumor necrosis factor-alpha, interleukin-2) and using PCR to identify the presence of bacteria may further refine the pathophysiology of prostatitis. The mainstream treatment of chronic prostatitis involves antimicrobials, non-steroidal anti-inflammatory medications, and alpha-blockers. The potential role of asymptomatic category IV chronic prostatitis in the etiology of prostate cancer may be delineated further with future research.
 ...
PMID:Acute and chronic prostatitis. 1504 89

Urinary tract infections (UTIs) are common infectious diseases that can be associated with substantial morbidity and significant expenditures. This review highlights the current concepts and recent advances in our understanding and management of this condition. Specific topics include pathogenesis, host factors, antimicrobial resistance, recurrent UTIs in women, diagnosis, treatment of uncomplicated and complicated UTIs, prophylaxis, catheter associated bacteriuria, pregnancy, diabetes, UTIs in men, prostatitis, and the chronic pelvic pain syndrome. UTIs can be viewed as an interaction between specific bacterial virulence factors and the patient. A new model explaining the pathogenesis of recurrent UTIs has been presented. There is a need to reconsider traditional treatment recommendations in the face of local resistance patterns, as well as the need to make better use of drugs that are currently available. Prospects for prevention of recurrent UTI include natural compounds, bacterial interference and immunization. With regard to UTI risk in women, patients can be classified based on age, and functional and hormonal status. Appropriate treatment approaches must be based on this classification. In contrast to uncomplicated UTIs, management of most complicated infections depends on clinical experience and resources at individual institutions rather than on evidence based guidelines. Asymptomatic bacteriuria generally should not be treated except in high-risk catheterized patients and in pregnancy. UTIs in men generally require formal urologic evaluation. Our understanding of the etiologies, diagnostic strategies, and treatment options for prostatitis and the chronic pelvic pain syndrome in men continues to evolve.
 ...
PMID:Current concepts in urinary tract infections. 1519 28

The clinical syndrome of chronic prostatitis ranges from well-defined chronic bacterial infections to poorly defined chronic pelvic pain syndrome (CPPS), previously referred to as "prostatodynia" or "abacterial prostatitis." Faced with the obscure nature of the disease, its protracted course, and the poor response to oral medication, urologists have considered alternative routes of drug administration. We review the indications and outcomes of local drug infiltration (intraprostatic antibiotic and zinc, intrasphincteric botulinum toxin A, pudendal nerve blocks) and discuss their potential use and benefit in the treatment of chronic prostatitis syndromes.
 ...
PMID:Chronic prostatitis/chronic pelvic pain syndrome: is there a role for local drug infiltration therapy? 1522 85

Prostatitis is an elusive clinical phenomenon that has become a synonymous term to describe a plethora of lower urinary tract symptoms in men including urinary problems, sexual dysfunction, and pelvic pain. Although symptom presentation has been standardized, an accurate, consistent clinical diagnosis continues to be elusive at best. As a result, recurrence is common, quality of life is compromised, and the patients and society feel the cost of this disease.
 ...
PMID:Prostatitis: the cost of disease and therapies to patients and society. 1526 Sep 36

Antigen-specific vaccines are one of several molecularly targeted approaches under investigation as possible treatments for prostate cancer. Important to the development of vaccines is the identification of appropriate target antigens. We hypothesized that antigens of the prostate might be identified in patients with the chronic prostatitis/pelvic pain syndrome, a syndrome for which an autoimmune pathology has been proposed. Such antigens might represent naturally recognized target antigens of the prostate that could be investigated in the future as prostate tumor antigens. In this report, we used SEREX to identify proteins expressed in a prostate cDNA expression library recognized by IgG from the sera of patients with chronic prostatitis. Candidate proteins were evaluated using a panel of sera from 62 subjects with symptomatic prostatitis and 71 control male blood donors. We identified one protein that was recognized primarily in sera from subjects with prostatitis compared with controls. MAD-PRO-34, a nucleolar autoantigen, was recognized in 6/62 subjects and 0/71 controls (p = 0.00897). This protein had previously been identified as an autoantigen in patients with prostate cancer. In addition, the NY-CO-7 protein was recognized in 9/62 subjects and 3/71 controls (p = 0.0654). Two subjects had IgG specific for both the MAD-PRO-34 and NY-CO-7 gene products. Our results demonstrate that some patients with the chronic prostatitis/pelvic pain syndrome have autoantibodies to specific proteins. Proteins identified, and MAD-PRO-34 in particular, could be further investigated as potential prostate tumor antigens.
 ...
PMID:Identification of antigen-specific IgG in sera from patients with chronic prostatitis. 1535 8

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a disabling condition that is poorly understood. The National Institutes of Diabetes and Digestive and Kidney Diseases-sponsored Collaborative Research Network has developed a symptom index, formed a cohort study, a case control study, a full-scale randomised clinical trial, a resource utilisation study and clinical trials, as well as basic research studies, in an effort to better understand and manage patients with this condition. Cohort, case control and resource utilisation studies have confirmed the substantial impact of CP/CPPS. Clinical trials in basic research suggest that anti-inflammatory therapy and alpha-blocker therapy may be effective. The minority of patients with acute or chronic bacterial prostatitis continues to respond favourably to oral fluoroquinolone therapy.
 ...
PMID:NIDDK-sponsored chronic prostatitis collaborative research network (CPCRN) 5-year data and treatment guidelines for bacterial prostatitis. 1536 7

Difficulties encountered in diagnosing and effectively treating chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is frustrating for clinicians and patients. Scientific evidence cannot establish an exact relationship between the prostate and the symptoms of CP/CPPS, and the prostate continues to be the diagnosis of convenience in this complex syndrome in men. However, if the pain is not the prostate's, whose pain is it? A heterogeneous group of insults can result in a common neurogenic pain response, resulting in recurring pain and voiding or sexual dysfunction. To add to this dilemma, certain life-threatening diagnoses, such as carcinoma-in-situ, is in the differential diagnosis and must be excluded. Urodynamics may be useful in evaluating and treating patients whose voiding symptoms predominate. However, many patients with CP/CPPS will not have measurable abnormalities by conventional methods and likely suffer from a functional somatic syndrome that is best treated with a multimodality approach.
 ...
PMID:Chronic prostatitis and sensory urgency: whose pain is it? 1554 Dec 12

Naiz (nimesulid) was given to 46 patients (age 24-52 years) with chronic abacterial prostatitis suffering from chronic pelvic pain syndrome (CPPS) which appeared from 20 to 3 years before the treatment. Microscopy of prostatic secretion showed normal count of leukocytes. Transrectal ultrasound investigation with dopplerography has found normal echostructure of the prostate but blood flow parameters were subnormal. Naiz was given in a dose 100 mg (1 tablet) twice a day for 15-20 days. The treatment relieved pain in 68-87% patients (mean 77.5%). The control ultrasound investigation detected much better circulation. Quality of life improved significantly. Side effects were mild. The effect persisted for 3 months of the follow-up. Thus, the addition of such nonsteroid antiinflammatory drug as naiz (nimesulid) to treatment of patients with chronic abacterial prostatitis is justified. The drug improves quality of life, induces side effects rarely and can be used for a long time with a persistent efficacy.
 ...
PMID:[Naiz (nimesulid) in combined treatment of patients with chronic non-bacterial prostatitis with chronic pelvic pain syndrome]. 1556 Jan 58

A double-blind placebo-controlled trial of teraosin efficacy (Kornam, Lek, Slovenia) was made in 51 patients with chronic abacterial prostatitis/chronic pelvic pain syndrome (CAP/CPPS) of category IIla according to NIH. All the patients were given a 2-week induction course of placebo followed by teraosin treatment (5 mg/day, n = 29) or placebo (n = 22) for 8 weeks. The participants of the study were followed up for 12 months. Pretreatment differences between the groups by NIH-CPSI system, symptoms frequency scale, leukocyte count of the prostate and uroflowmetry were insignificant. Teraosin and placebo patients showed a noticeable improvement (39.7 and 9.9% by symptoms frequency scale, respectively; by 36.4 and 6.6% by the linear scale, respectively). The drug reduced pain and dysuria, improved quality of life considerably (by 36.2%). Maximal urine flow accelerated by 22.96 and 10.01% in teraosin and placebo groups, respectively. Leukocyte count fell two-fold in the study group and lowered insignificantly in the placebo group. The recurrence-free interval was 25 and 9 weeks, respectively. Thus, teraosin monotherapy improves quality of life in CAP/CPPS patients, significantly relieves symptoms and prolongs recurrence-free interval vs placebo.
 ...
PMID:[Double-blind placebo-controlled trial of terazosine efficacy in patients with chronic abacterial prostatitis]. 1577 32

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.
 ...
PMID:Treatment of category III A prostatitis with zafirlukast: a randomized controlled feasibility study. 1582 18


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>