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

Prostatitis is one of the most common illnesses in men aged < or = 50 with different clinical presentation such as pelvic pain, Lower Urinary Tract Symptoms or sexual disfunction. Problems in the diagnosis and classification of this condition, however, have delayed epidemiologic research and consequently, our understanding of the natural history of prostatitis is limited. Nowadays, the Meares & Stamey test (M&S Test) in bacterial prostatitis is considered the most important test for diagnosis of bacterial prostatitis, even if several problems have been identified in running the M&S Test. The aim of the present study is to perform a review of the microbiological diagnosis approach to prostatitis patients and illustrate a new protocol, a modification of the standard Meares and Stamey test for the microbiological diagnosis of prostatitis, which includes total ejaculate (TE) from each patient.
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PMID:Conventional bacteriology in prostatitis patients: microbiological bias, problems and epidemiology on 1686 microbial isolates. 1769 12

In the 20th century, the term "prostatitis" traditionally referred to inflammation in the prostate, often attributed to infection. Prostatitis in this century usually refers to a chronic pain syndrome for which the presence of inflammation and involvement of the prostate are not always certain. This article discusses chronic prostatitis/chronic pelvic pain syndrome and the various factors associated with diagnosis and treatment.
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PMID:Chronic prostatitis/chronic pelvic pain syndrome. 1806 Oct 26

Prostatitis is a common healthcare issue affecting 10-14% of men of all ages and ethnicities. Acute bacterial prostatitis is associated with severe, mainly Gram-negative infection; treatment consists of broad-spectrum antibiotic therapy for 2-4 weeks, which can be tailored according to pathogen identification and susceptibility tests. Chronic bacterial prostatitis is more difficult to diagnose as the symptoms are shared by chronic pelvic pain syndrome; only 10% of patients with chronic prostatitis symptoms actually have bacterial infection. The pathogens associated with this condition are essentially common uropathogens, although there is debate around the role of Gram-positive bacteria. Definitive diagnosis is obtained with the Meares-Stamey four-glass test, or the two-glass test in routine practice, which differentiates between chronic bacterial prostatitis and chronic pelvic pain syndrome. The fluoroquinolones are the first choice of therapy for chronic bacterial prostatitis, in particular levofloxacin which is as effective as ciprofloxacin but shows a better prostatic penetration and is given once daily.
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PMID:Management of bacterial prostatitis: what's new? 1830 79

The term prostatitis syndrome refers to a number of conditions affecting the prostate. Prostatitis syndrome is clinically manifested through symptoms of the lower urogenital tract and perineum. Basic factors in the classification of prostatitis syndrome are clinical symptoms and signs, and the presence of leukocytes and bacteria in selectivelly collected urine samples and in expressed prostatic secretion obtained by the Meares and Stamey localization technique. Antimicrobial therapy is indicated in patients with acute bacterial prostatitis, chronic bacterial prostatitis and chronic inflammatory nonbacterial prostatitis, which also includes bacterial prostatitis unproved by classical methods. Empirical antimicrobial treatment should be initiated immediately in patients with acute bacterial prostatitis and in patients with acute exacerbation of chronic bacterial prostatitis. Targeted antimicrobial therapy is administered in patients with chronic bacterial prostatitis after obtained microbiological results, and empirical antimicrobial therapy lasting for 2-6 weeks in patients with chronic inflammatory nonbacterial prostatitis. Because of their broad spectrum of activity and pharmacodynamic and pharmacokinetic characteristics, fluoroquinolones, ciprofloxacin and ofloxacin are first choice antimicrobial drugs for the treatment of prostatic inflammatory diseases. The efficacy of administered antimicrobial treatment should be followed up 4-6 weeks (early follow-up) and 6 months (late follow up) after the end of antimicrobial therapy. The treatment of a noninflammatory chronic pelvic pain syndrome without proved infection includes phytotherapy, hygienic-dietetic measures, microwave thermotherapy, alpha-adrenergic blocking agents, muscle relaxants, analgesics, non-steroidal antiflogistics, 5-alpha-reductase inhibitors, modified living habits, psychotherapy and antispasmodic analgesics. All patients with chronic types of prostatitis syndrome should avoid drinking alcohol, carbonated beverages, spices, cycling, colds, especially sitting on cold surfaces.
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PMID:[Classification, diagnosis and treatment of prostatitis syndrome]. 1895 27

So far the etiology of chronic prostatitis (PC) and particularly chronic pelvic pain syndrome (CPPS) remains to be elucidated. According to recent epidemiologic data, CP is the most common urological disease in men below 50 years and occurs in 2.5%-16.0% of the world population. Since the 1990s, researchers of many countries have carried out deeper, more extensive and larger scaled 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. As prevalent as multiple sclerosis, CPPS is the most common yet most poorly understood "prostatitis syndrome". This article reviews the progress in the studies of the treatment of CPPS, explores the main problems and ventures the prospects for the development in this field.
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PMID:[Advances in the treatment of chronic prostatitis/chronic pelvic pain syndrome]. 1915 39

Prostatitis causes substantial morbidity to men, through associated urinary symptoms, sexual dysfunction, and pelvic pain; however, 90% to 95% of cases have an unknown etiology. Inflammation is associated with the development of carcinoma, and, therefore, it is imperative to identify and study the causes of prostatitis to improve our understanding of this disease and its role in prostate cancer. As estrogens cause prostatic inflammation, here we characterize the murine prostatic phenotype induced by elevated endogenous estrogens due to aromatase overexpression (AROM+). Early-life development of the AROM+ prostate was normal; however, progressive changes culminated in chronic inflammation and pre-malignancy. The AROM+ prostate was smaller at puberty compared with wild-type controls. Mast cell numbers were significantly increased at puberty and preceded chronic inflammation, which emerged by 40 weeks of age and was characterized by increased mast cell, macrophage, neutrophil, and T-lymphocyte numbers. The expression of key inflammatory mediators was also significantly altered, and premalignant prostatic intraepithelial neoplasia lesions emerged by 52 weeks of age. Taken together, these data link estrogens to prostatitis and premalignancy in the prostate, further implicating a role for estrogen in prostate cancer. These data also establish the AROM+ mouse as a novel, non-bacterial model for the study of prostatitis.
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PMID:Increased endogenous estrogen synthesis leads to the sequential induction of prostatic inflammation (prostatitis) and prostatic pre-malignancy. 1970 Jul 48

Prostatitis ranges from a straightforward clinical entity in its acute form to a complex, debilitating condition when chronic. It is often a source of frustration for the treating physician and patient. There are four classifications of prostatitis: acute bacterial, chronic bacterial, chronic prostatitis/chronic pelvic pain syndrome, and asymptomatic. Diagnosis of acute and chronic bacterial prostatitis is primarily based on history, physical examination, urine culture, and urine specimen testing pre- and post-prostatic massage. The differential diagnosis of prostatitis includes acute cystitis, benign prostatic hyperplasia, urinary tract stones, bladder cancer, prostatic abscess, enterovesical fistula, and foreign body within the urinary tract. The mainstay of therapy is an antimicrobial regimen. Chronic pelvic pain syndrome is a more challenging entity, in part because its pathology is poorly understood. Diagnosis is often based on exclusion of other urologic conditions (e.g., voiding dysfunction, bladder cancer) in association with its presentation. Commonly used medications include antimicrobials, alpha blockers, and anti-inflammatory agents, but the effectiveness of these agents has not been supported in clinical trials. Small studies provide limited support for the use of nonpharmacologic modalities. Asymptomatic prostatitis is an incidental finding in a patient being evaluated for other urologic problems.
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PMID:Prostatitis: diagnosis and treatment. 2070 71

Prostatitis, one of the most common urological infections afflicting adult men, has recently been divided into 4 different categories based on the National Institutes of Health consensus classification: acute bacterial prostatitis, chronic bacterial prostatitis, chronic nonbacterial prostatitis and pelvic pain syndrome, and asymptomatic inflammatory prostatitis. Most patients with prostatitis are found to have either nonbacterial prostatitis or prostatodynia. Prostatitis poses an international health problem, with epidemiologic studies suggesting a worldwide prevalence of more than 10%. This article reviews current modes of diagnosis and therapy for acute and chronic prostatitis.
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PMID:Prostatitis: acute and chronic. 2070 98

Prostatitis syndrome is a frequent condition in men. It is not known in most patients if the prostate is the only organ involved. Therefore, the disease is characterized as chronic prostatitis-chronic pelvic pain syndrome (CP-CPPS). Although many studies have been performed in patients with CP-CPPS, current trial evidence is conflicting and therapeutic options are controversial. Given the need for long-term treatment in CP-CPPS patients, phytotherapeutics, such as pollen extract, are an option due to few side effects. Preclinical studies on pollen extract have shown effects on smooth muscles of the bladder and urethra, strong antiinflammatory effects, and antiproliferative effects.
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PMID:Pollen extract for chronic prostatitis-chronic pelvic pain syndrome. 2179 90

Prostatitis is a disease that seriously affects the quality of patients' life. In the majority of cases, chronic prostatitis (chronic pelvic pain syndrome--CPPS) has an unclear pathogenesis. Anti-inflammatory and anti-infectious treatments have remained controversial. According to the latest research, prostatitis has been associated with oxidative stress (OxS) and/or OxS-related genetic polymorphisms. We have observed that prostatitis patients have systemic OxS in case of inflammation and pain. We propose a new explanation for the role of OxS in the pathogenesis of prostatitis and describe the putative OxS-related pathways in detail. The neural vicious circle starts by activation of primary sensory afferents. Glutamate mediates the signal to the neurons in the dorsal horn of the spinal cord, and facilitates calcium influx into their mitochondria. The latter causes an increased production of superoxide radicals. If the superoxide production is not effectively controlled by mitochondrial superoxide dismutase (Mn-SOD), then superoxide leads to OxS and lipid peroxidation. Consequent release of electrophilic lipid peroxidation products (LPP) from dorsal horn of the spinal cord causes pain by activating the primary sensory afferents, again. Additional LPP-mediated causes of pain include glutathione depletion and neuron sensitisation by isoprostanes. Excretion of LPP into urine may exert positive feedback as well. Currently, different information exists about chronic prostatitis (inflammation, pain, oxidative stress, neural sensitisation, lower urinary tract symptoms). The clear links between these data are actually absent. We propose that vicious circle based on LPP, especially isoprostanes, is the linking mechanism.
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PMID:Are prostatitis symptoms associated with an isoprostane-mediated vicious circle? 2185 29


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