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

Chronic nonbacterial prostatitis or chronic pelvic pain syndrome (CPPS) causes morbidity, both through symptoms and associated impairment in health-related quality of life, both of which illustrate the importance of patient-centered outcomes. Despite preliminary work by several investigators, research and clinical efforts to provide help for men afflicted with CPPS have been hampered by the absence of a widely accepted, reliable, and valid instrument to measure symptoms and quality-of-life impact. Investigators from the National Institutes of Health (NIH)-funded Chronic Prostatitis Collaborative Research Network (CPCRN) sought to remedy this problem by developing a psychometrically valid index of symptoms and quality-of-life impact in men with chronic prostatitis. This instrument, now validated in English, Spanish, German, and Korean, is known as the NIH Chronic Prostatitis Symptom Index (NIH-CPSI). It contains 13 items that are scored in 3 discrete domains: pain, urinary symptoms, and quality-of-life impact. In early studies, the NIH-CPSI has been shown to be reliable, valid, and responsive to change. Further work is needed to determine whether it performs as well in minority populations, men seeking care in nonreferral centers, and other diverse populations.
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PMID:A review of the development and validation of the National Institutes of Health Chronic Prostatitis Symptom Index. 1252 81

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

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.
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PMID:Acute and chronic prostatitis. 1504 89

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.
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PMID:[Double-blind placebo-controlled trial of terazosine efficacy in patients with chronic abacterial prostatitis]. 1577 32

To evaluate the efficacy of a terpene mixture (rowatinex) compared to ibuprofen, patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) were randomly selected to either receive rowatinex 200 mg t.i.d. or ibuprofen 600 mg t.i.d. After a 6-week treatment, the decrease in the mean total NIH-CPSI score was significant in both groups from 21.4 to 15.3, (6.1 (p < 0.01) and from 21.2 to 16.8, (4.4 (p = 0.04) in the rowatinex and ibuprofen group, respectively. The rate of definite improvement as defined as 25% improvement in the total score was superior (p = 0.04) in the rowatinex group (68%) versus the ibuprofen group (40%). Judging from these results, rowatinex gave significant symptomatic relief and may be of benefit for many men diagnosed with CP/CPPS. Further, including the placebo-controlled studies are necessary to define its role in the management of this difficult to treat disease.
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PMID:Preliminary experience with a terpene mixture versus ibuprofen for treatment of category III chronic prostatitis/chronic pelvic pain syndrome. 1641 72

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

The objective of the study is to determine the short- and long-term utility of the Chinese, Malay and English versions of the National Institutes of Health--Chronic Prostatitis Symptom Index (NIH-CPSI) in our ethnically diverse population. The NIH-CPSI was translated into Chinese and Malay, and then verified by back translation into English. Subjects included 100 new chronic prostatitis/chronic pelvic pain (CP/CPPS) patients, 71 new benign prostatic hyperplasia patients and 97 healthy individuals. Reliability was evaluated with test-retest reproducibility (TR) by calculating intraclass correlation coefficients (ICC). Internal consistency was evaluated by calculating Cronbach's alpha (alpha). Validity assessments included discriminant and construct validity. (Presented in the order of Chinese, Malay then English). ICC values for short-term (1 week) TR were 0.90, 0.80 and 0.89, while ICC values for long-term (14 weeks) TR were 0.54, 0.61 and 0.61. Cronbach's alpha values were 0.63, 0.62 and 0.57. The NIH-CPSI total score discriminated CP/CPPS patients (P<0.001) from the control groups with receiver operating curve values of 0.95, 0.98 and 0.94, respectively. Construct validity, reflected by the correlation coefficient values between the International Prostate Symptom Score and the NIH-CPSI of CP/CPPS patients were 0.72, 0.49 and 0.63 (all P<0.05). The Chinese, Malay and English versions of the NIH-CPSI each proved effective in our population. Short-term TR and discriminant validity were excellent for all three versions. However, long-term TR was only moderate, which might reflect variation in patients' perceptions of symptoms over time.
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PMID:Reliability and validity of the National Institutes of Health: Chronic Prostatitis Symptom Index in a Malaysian population. 1646 53

Our aim was to establish the Estonian version of the National Institutes of Health chronic prostatitis symptom index (NIH-CPSI), and to examine its validity and applicability in chronic prostatitis patients as well as in community-based study. The questionnaire was tested in 54 category III prostatitis patients. In addition, 452 men were enrolled into a community-based study that resulted in 83 completed questionnaires. The discriminatory power, psychometric properties and internal correlations of the questionnaire were tested. The questionnaire demonstrated good internal consistency, with Cronbach's alpha coefficient 0.82. The pain and quality of life domains demonstrated high correlations with each other and with the entire questionnaire. The total score and the scores of pain and quality of life domains of the Estonian NIH-CPSI differed significantly between the chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) patients and the men without CP/CPPS, and so the index proved a good discriminant validity. We can conclude that the Estonian NIH-CPSI is easily understood and reflects accurately the clinical symptoms and the quality of life in patients with chronic prostatitis. The similarity of the psychometric properties of the English and Estonian versions of the NIH-CPSI supports their measurement equivalence.
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PMID:The Estonian version of the National Institutes of Health chronic prostatitis symptom index. 1666 20

The effectiveness of alpha-adrenergic antagonists on patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) has not been supported by well-evaluated study. The meta-analysis was performed to supply the best evidence about use of this class of drugs in CP/CPPS. A fully recursive literature search to June 2005 was conducted in PubMed, EMBASE, the Cochrane Controlled Trials Register, and the Chinese Biomedicine Database to identify potentially relevant randomized controlled trials. RevMan4.2 was used for statistical analysis. Nine studies with 734 patients were included. Combined analysis showed a significant reduction of total NIH-CPSI or I-PSS in patients with treatment duration of more than 3 months. There were also valuable results in urinary symptom alleviation. Alpha-adrenergic antagonists did not show benefit in pain. The meta-analysis revealed that the use of alpha-adrenergic antagonists was warranted in CP/CPPS, and the treatment duration should be long enough (more than 3 months).
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PMID:The effect of alpha-adrenergic antagonists in chronic prostatitis/chronic pelvic pain syndrome: a meta-analysis of randomized controlled trials. 1687 Sep 51

We identified from our clinical database a total of 471 patients affected by cat. II chronic bacterial prostatitis (CBP), cat. III (IIIa and IIIb) chronic pelvic pain syndrome (CP/CPPS), or cat. IV asymptomatic inflammatory prostatitis (AIP), according to NIH criteria. 132 intent-to-treat patients, showing levels of PSA > or =4 ng/mL, were subjected to a 6-week course of combination pharmacological therapy with 500 mg/day ciprofloxacin, 500 mg/day azithromycin (3 days/week), 10 mg/day alfuzosin and 320 mg b.i.d. Serenoa repens extract. At the end of treatment, 111 per-protocol patients belonging to all categories of prostatitis showed a total 32.5% reduction of PSA levels. In the same group, 66 patients (59.4%) showed "normalization" of PSA values under the 4 ng/mL limit. Patients affected by cat. IIIb CP/CPPS showed the highest PSA reduction and normalization rates (40% and 68.4%, respectively). Follow-up data show that, after a marked, significant reduction at completion of therapy, PSA levels, urine peak flow rates and NIH-CPSI symptom scores remained constant or decreased throughout a period of 18 months in patients showing normalization of PSA values. Prostatic biopsy was proposed to 45 patients showing persistently high PSA values (> or = 4 ng/mL) at the end of treatment. Fourteen patients rejected biopsy; of the remaining 31, 10 were diagnosed with prostate cancer. Four months after a first biopsy, a second biopsy was proposed to the 21 patients with a negative first diagnosis and persistently elevated PSA levels. Three patients rejected the procedure; of the remaining 18, four were diagnosed with prostatic carcinoma. In summary, combination pharmacological therapy decreased the number of patients undergoing prostatic biopsy from 111 to 45. Normalization of PSA values in 59.4% of patients--not subjected to biopsy--increased the prostate cancer detection rate from 12.6% (14/111) to 31.1% (14/45). The reduction of PSA after a 6-week course of therapy was calculated in patients affected by cat. II, IIIa, IIIb and IV prostatitis after stratification with respect to the concomitant presence or absence of benign prostatic hyperplasia (BPH). PSA was reduced by 41% in cat. II CBP patients without BPH, compared to a 12.7% reduction in patients affected by BPH. Cat. IIIa CP/CPPS patients without BPH showed a 58.3% reduction of PSA levels, compared to a 20.7% reduction observed in CPPS/BPH patients. These data show that the presence of BPH may prevent the reduction of PSA induced by combination pharmacological therapy, and suggest that care has to be taken in the adoption of PSA as a marker of therapeutic efficacy in the presence of confounding factors like BPH. PSA should in our opinion be used as a significant component of a strategy integrating multiple diagnostic approaches.
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PMID:Reduction of PSA values by combination pharmacological therapy in patients with chronic prostatitis: implications for prostate cancer detection. 1769 14


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