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Query: UMLS:C0030794 (pelvic pain)
 4,056 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The new National Institutes of Health (NIH) consensus classification identifies chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) based on the presence or absence of leukocytes in expressed prostatic secretions (EPS), postprostatic massage urine (VB3), or seminal fluid analysis. The purpose of this review is to determine the effect of the new classification on the proportion of symptomatic patients diagnosed with inflammation. We compare and contrast the new consensus classification with the traditional classification of prostatitis syndromes, then review how these changes effect patient classification in our clinical practice. Thorough clinical and microbiologic examination of 140 patients attending the University of Washington Prostatitis Clinic included evaluation of first void urine, mid-stream urine, EPS, VB3, and semen specimens. Inflammation was documented in 111 (26%) of 420 samples including 39 EPS samples, 32 VB3 samples, and 40 SFA specimens. Of the 140 patients, 73 (52%) had inflammatory CP/CPPS according to the NIH consensus criteria, but only 39 (28%) had nonbacterial prostatitis according to traditional EPS criteria (P < 0.001). The new NIH consensus concept of inflammatory CP/CPPS includes almost twice as many patients as the traditional category of nonbacterial prostatitis.
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PMID:The NIH Consensus concept of chronic prostatitis/chronic pelvic pain syndrome compared with traditional concepts of nonbacterial prostatitis and prostatodynia. 1214 61

Prostatitis reflects a broad spectrum of prostatic infections, both acute and chronic. Chronic prostatitis, known as National Institutes of Health category III or chronic pelvic pain syndrome, broadly defines a disease that is still poorly understood, and as a consequence, difficult to treat. Typical symptoms include pelvic pain and voiding dysfunction. Infection is often cited as the cause of this condition, despite frequent negative cultures. A close look at the local prostatic microenvironment may yield clues. The role of inflammatory mediators and what stimulates them can point to potential sites of prevention. A genetic link or relationship to other diseases may prove to be part of the cause. Furthermore, a neurologic source, whether anatomic or psychologic, has been strongly debated. Ultimately, it may become clear that chronic prostatitis represents the final common result of a disease that originates from a cascade of multiple stimuli.
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PMID:Theories of prostatitis etiology. 1214 62

Almost 10% of the adult male population suffer from prostatitis. The International Prostatitis Collaborative Network has devised and validated a clinically useful classification of prostatitis that urologists and primary care clinicians will find helpful. According to this schema, chronic bacterial prostatitis is clearly an infectious disease, and patients with chronic prostatitis associated with chronic pelvic pain syndrome can have either inflammatory or noninflammatory disease. Chronic bacterial prostatitis is uncommon, chronic nonbacterial prostatitis (CPPS) is extremely common. Antibiotic therapy is indicated in management of chronic bacterial prostatitis and inflammatory chronic pelvic pain syndrome. Fluoroquinolones are safe and effective in managing chronic bacterial prostatitis. Based on literature, noninflammatory chronic pelvic pain syndrome can be treated using adrenergic blockade, analgesic, tricyclic antidepressants, benzodiazepie, physical therapy.
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PMID:[Chronic prostatitis with chronic pelvic pain syndrome]. 1255 33

Prostatitis is a prevalent, confusing and frustrating clinical presentation for urologists. Three recent international and North American consensus meetings have drafted suggestions for the evaluation of a man presenting with prostatitis. Published consensus statements from the 2000 Washington meeting of the International Prostatitis Collaborative Network, the 2002 Virginia meeting of the National Institutes of Health Chronic Prostatitis Collaborative Research Network and the 2002 Giessen meeting of the International Consensus Conference on Advances in the Diagnosis and Treatment of Prostatitis were examined to develop suggestions for evaluation of the prostatitis patient by urologists. Clinical, laboratory and imaging evaluations for the patient presenting with prostatitis and chronic prostatitis/chronic pelvic pain syndrome can be categorized as basic or mandatory evaluations (which would include a complete history, focused physical examination, and urinalysis/urine culture), further or recommended evaluations (those that are recommended but not mandatory) and optional evaluations in selected patients. As more evidence and data are accumulated and published, these recommendations may eventually evolve into practice guidelines for the evaluation of men presenting with prostatitis symptoms.
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PMID:Recommendations for the evaluation of patients with prostatitis. 1268 35

A number of different self assessment questionnaires have been developed in order to evaluate specific symptoms of chronic prostatitis. The most popular indices in Germany are the Giessen Prostatitis Symptom Score(GPSS), the International Prostate Symptom Score (IPSS) and the Chronic Prostatitis Symptom Index of the National Institutes of Health (NIH-CPSI). The major aim of our study was the evaluation of these questionnaires in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). In addition, we analysed questionable differences in symptomatology between the subgroups NIH III A and B. A total of 203 native speaking German men with symptoms of CP/CPPS attending the Giessen prostatitis outpatient department were included in our protocol. According to the strict criteria of the Giessen examination protocol, 84 men were classified as CP/CPPS type NIH III B and 54 men as NIH III A. The psychometric and descriptive results were analysed with SPSS software. The Cronbach alpha, as a parameter for the internal consistency for each index, showed acceptable values. The correlation coefficient for each index was also sufficient. The median total scores of the GPSS and NIH-CPSI were significantly higher in patients with CP/CPPS type NIH III B. The IPSS results were the same. All symptom indices demonstrated acceptable to good values for psychometric validation. Similar symptomatic findings were available using GPSS and NIH-CPSI.
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PMID:Experience with different questionnaires in the management of patients with CP/CPPS: GPSS, IPSS and NIH-CPSI. 1276 18

So far the etiology of chronic prostatitis(CP), particularly chronic nonbacterial prostatitis(NBP) or chronic pelvic pain syndrome (CPPS), remains to be elucidated. According to recent epidemiologic data, the prevalence of CP ranged from 2.5% to 16% of the world population, affecting men of all ages and all ethnic origins. Since 1990s researchers of many countries have carried out largerscaled, deeper and more extensive studies than ever before on the etiology, diagnosis and treatment of the disease, with the sponsorship and coordination of such international institutions as the International Prostatitis Collaborative Network(IPCN), the Chronic Prostatitis Collaborative Research Network of the National Institute of Health (NIH-CPCRN) and so on. The main achievements of recent years include: the etiology of CP/CPPS being a complicated multi-step and multi-factor course, the establishment of the new clinical classification system, the introduction of the National Institute of Health chronic prostatitis symptom index, the new criteria of diagnosis and standardized clinical evaluation, the primary explorations of new treatment methods and medicines, etc. Further investigations suggested are the optimization of clinical classification, the screening and verification of treatment methods and medicines for CP/CPPS, etc.
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PMID:[Advances in the diagnosis and treatment of chronic prostatitis]. 1462 92

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

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.
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PMID:Prostatitis: the cost of disease and therapies to patients and society. 1526 Sep 36

Prostatitis, and particulary chronic pelvic pain syndrome, is a very challenging field in urology. Large randomized placebo treatment trials are necessary for a better evaluation of the different therapeutic options. This article is a review of the evolution in prostatitis diagnostic and actual treatments.
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PMID:[Prostatitis]. 1638 19


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